Obamacare 2022 Rates for Rockdale County
Obamacare > Rates > Georgia > Rockdale County
Obamacare > Rates > Georgia > Rockdale County
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Cigna HealthCare of Georgia, Inc.Local: | Toll Free: |
Toc - Plan #1 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Bronze
(HMO) Cigna Connect 8700 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$272.16 $308.91 $347.82 $486.08 $738.65 |
$480.36 $517.11 $556.02 $694.28 |
$688.56 $725.31 $764.22 $902.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$544.32 $617.82 $695.64 $972.16 $1,477.30 |
$752.52 $826.02 $903.84 $1,180.36 |
$960.72 $1,034.22 $1,112.04 $1,388.56 |
Toc - Plan #2 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 7800 ($0 Telehealth) |
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Benefits & Coverage
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$279.71 $317.48 $357.47 $499.57 $759.14 |
$493.69 $531.46 $571.45 $713.55 |
$707.67 $745.44 $785.43 $927.53 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$559.42 $634.96 $714.94 $999.14 $1,518.28 |
$773.40 $848.94 $928.92 $1,213.12 |
$987.38 $1,062.92 $1,142.90 $1,427.10 |
Toc - Plan #3 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 6500 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$282.82 $321.00 $361.44 $505.11 $767.57 |
$499.18 $537.36 $577.80 $721.47 |
$715.54 $753.72 $794.16 $937.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$565.64 $642.00 $722.88 $1,010.22 $1,535.14 |
$782.00 $858.36 $939.24 $1,226.58 |
$998.36 $1,074.72 $1,155.60 $1,442.94 |
Toc - Plan #4 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect HSA 7000 |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$284.24 $322.61 $363.25 $507.65 $771.42 |
$501.68 $540.05 $580.69 $725.09 |
$719.12 $757.49 $798.13 $942.53 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$568.48 $645.22 $726.50 $1,015.30 $1,542.84 |
$785.92 $862.66 $943.94 $1,232.74 |
$1,003.36 $1,080.10 $1,161.38 $1,450.18 |
Toc - Plan #5 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$285.88 $324.48 $365.36 $510.59 $775.89 |
$504.58 $543.18 $584.06 $729.29 |
$723.28 $761.88 $802.76 $947.99 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$571.76 $648.96 $730.72 $1,021.18 $1,551.78 |
$790.46 $867.66 $949.42 $1,239.88 |
$1,009.16 $1,086.36 $1,168.12 $1,458.58 |
Toc - Plan #6 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 3600 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$341.11 $387.16 $435.94 $609.23 $925.78 |
$602.06 $648.11 $696.89 $870.18 |
$863.01 $909.06 $957.84 $1,131.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$682.22 $774.32 $871.88 $1,218.46 $1,851.56 |
$943.17 $1,035.27 $1,132.83 $1,479.41 |
$1,204.12 $1,296.22 $1,393.78 $1,740.36 |
Toc - Plan #7 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 4500 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$340.04 $385.95 $434.57 $607.31 $922.87 |
$600.17 $646.08 $694.70 $867.44 |
$860.30 $906.21 $954.83 $1,127.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$680.08 $771.90 $869.14 $1,214.62 $1,845.74 |
$940.21 $1,032.03 $1,129.27 $1,474.75 |
$1,200.34 $1,292.16 $1,389.40 $1,734.88 |
Toc - Plan #8 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 6000 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$337.89 $383.51 $431.83 $603.48 $917.05 |
$596.38 $642.00 $690.32 $861.97 |
$854.87 $900.49 $948.81 $1,120.46 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$675.78 $767.02 $863.66 $1,206.96 $1,834.10 |
$934.27 $1,025.51 $1,122.15 $1,465.45 |
$1,192.76 $1,284.00 $1,380.64 $1,723.94 |
Toc - Plan #9 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 7300 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$341.15 $387.21 $435.99 $609.30 $925.89 |
$602.13 $648.19 $696.97 $870.28 |
$863.11 $909.17 $957.95 $1,131.26 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$682.30 $774.42 $871.98 $1,218.60 $1,851.78 |
$943.28 $1,035.40 $1,132.96 $1,479.58 |
$1,204.26 $1,296.38 $1,393.94 $1,740.56 |
Toc - Plan #10 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 3500 Enhanced Diabetes Care ($0 Preferred Insulin) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$341.57 $387.69 $436.53 $610.05 $927.03 |
$602.87 $648.99 $697.83 $871.35 |
$864.17 $910.29 $959.13 $1,132.65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$683.14 $775.38 $873.06 $1,220.10 $1,854.06 |
$944.44 $1,036.68 $1,134.36 $1,481.40 |
$1,205.74 $1,297.98 $1,395.66 $1,742.70 |
Toc - Plan #11 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 4200 Enhanced Asthma COPD Care ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$340.08 $385.99 $434.62 $607.38 $922.98 |
$600.24 $646.15 $694.78 $867.54 |
$860.40 $906.31 $954.94 $1,127.70 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$680.16 $771.98 $869.24 $1,214.76 $1,845.96 |
$940.32 $1,032.14 $1,129.40 $1,474.92 |
$1,200.48 $1,292.30 $1,389.56 $1,735.08 |
Toc - Plan #12 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Gold
(HMO) Cigna Connect 1600 ($0 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$403.36 $457.81 $515.49 $720.40 $1,094.71 |
$711.93 $766.38 $824.06 $1,028.97 |
$1,020.50 $1,074.95 $1,132.63 $1,337.54 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$806.72 $915.62 $1,030.98 $1,440.80 $2,189.42 |
$1,115.29 $1,224.19 $1,339.55 $1,749.37 |
$1,423.86 $1,532.76 $1,648.12 $2,057.94 |
Toc - Plan #13 Cigna HealthCare of Georgia, Inc. | ||||||||||||||||||||
Gold
(HMO) Cigna Connect 1250 Enhanced Diabetes Care ($0 Preferred Insulin) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$417.85 $474.26 $534.01 $746.27 $1,134.03 |
$737.50 $793.91 $853.66 $1,065.92 |
$1,057.15 $1,113.56 $1,173.31 $1,385.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$835.70 $948.52 $1,068.02 $1,492.54 $2,268.06 |
$1,155.35 $1,268.17 $1,387.67 $1,812.19 |
$1,475.00 $1,587.82 $1,707.32 $2,131.84 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-800-609-9754 | Toll Free: 1-800-609-9754 | TTY: 1-800-609-9754 |
Toc - Plan #14 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($2 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$456.43 $518.04 $583.31 $815.18 $1,238.74 |
$805.60 $867.21 $932.48 $1,164.35 |
$1,154.77 $1,216.38 $1,281.65 $1,513.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$912.86 $1,036.08 $1,166.62 $1,630.36 $2,477.48 |
$1,262.03 $1,385.25 $1,515.79 $1,979.53 |
$1,611.20 $1,734.42 $1,864.96 $2,328.70 |
Toc - Plan #15 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ Extra ($2 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$475.63 $539.84 $607.86 $849.48 $1,290.86 |
$839.49 $903.70 $971.72 $1,213.34 |
$1,203.35 $1,267.56 $1,335.58 $1,577.20 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$951.26 $1,079.68 $1,215.72 $1,698.96 $2,581.72 |
$1,315.12 $1,443.54 $1,579.58 $2,062.82 |
$1,678.98 $1,807.40 $1,943.44 $2,426.68 |
Toc - Plan #16 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($2 Rx + 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$453.34 $514.54 $579.37 $809.67 $1,230.37 |
$800.15 $861.35 $926.18 $1,156.48 |
$1,146.96 $1,208.16 $1,272.99 $1,503.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$906.68 $1,029.08 $1,158.74 $1,619.34 $2,460.74 |
$1,253.49 $1,375.89 $1,505.55 $1,966.15 |
$1,600.30 $1,722.70 $1,852.36 $2,312.96 |
Toc - Plan #17 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ Extra ($2 Rx + Dental + Vision + 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$474.26 $538.28 $606.10 $847.03 $1,287.14 |
$837.07 $901.09 $968.91 $1,209.84 |
$1,199.88 $1,263.90 $1,331.72 $1,572.65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$948.52 $1,076.56 $1,212.20 $1,694.06 $2,574.28 |
$1,311.33 $1,439.37 $1,575.01 $2,056.87 |
$1,674.14 $1,802.18 $1,937.82 $2,419.68 |
Toc - Plan #18 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ ($2 Rx + 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$445.80 $505.98 $569.73 $796.19 $1,209.89 |
$786.83 $847.01 $910.76 $1,137.22 |
$1,127.86 $1,188.04 $1,251.79 $1,478.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$891.60 $1,011.96 $1,139.46 $1,592.38 $2,419.78 |
$1,232.63 $1,352.99 $1,480.49 $1,933.41 |
$1,573.66 $1,694.02 $1,821.52 $2,274.44 |
Toc - Plan #19 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ Saver ($2 Rx + 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$451.97 $512.98 $577.62 $807.22 $1,226.64 |
$797.73 $858.74 $923.38 $1,152.98 |
$1,143.49 $1,204.50 $1,269.14 $1,498.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$903.94 $1,025.96 $1,155.24 $1,614.44 $2,453.28 |
$1,249.70 $1,371.72 $1,501.00 $1,960.20 |
$1,595.46 $1,717.48 $1,846.76 $2,305.96 |
Toc - Plan #20 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$454.71 $516.10 $581.12 $812.12 $1,234.09 |
$802.56 $863.95 $928.97 $1,159.97 |
$1,150.41 $1,211.80 $1,276.82 $1,507.82 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$909.42 $1,032.20 $1,162.24 $1,624.24 $2,468.18 |
$1,257.27 $1,380.05 $1,510.09 $1,972.09 |
$1,605.12 $1,727.90 $1,857.94 $2,319.94 |
Toc - Plan #21 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$380.64 $432.03 $486.46 $679.83 $1,033.06 |
$671.83 $723.22 $777.65 $971.02 |
$963.02 $1,014.41 $1,068.84 $1,262.21 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$761.28 $864.06 $972.92 $1,359.66 $2,066.12 |
$1,052.47 $1,155.25 $1,264.11 $1,650.85 |
$1,343.66 $1,446.44 $1,555.30 $1,942.04 |
Toc - Plan #22 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$398.13 $451.88 $508.81 $711.06 $1,080.53 |
$702.70 $756.45 $813.38 $1,015.63 |
$1,007.27 $1,061.02 $1,117.95 $1,320.20 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$796.26 $903.76 $1,017.62 $1,422.12 $2,161.06 |
$1,100.83 $1,208.33 $1,322.19 $1,726.69 |
$1,405.40 $1,512.90 $1,626.76 $2,031.26 |
Toc - Plan #23 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ Extra ($3 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.68 $474.06 $533.79 $745.97 $1,133.57 |
$737.20 $793.58 $853.31 $1,065.49 |
$1,056.72 $1,113.10 $1,172.83 $1,385.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.36 $948.12 $1,067.58 $1,491.94 $2,267.14 |
$1,154.88 $1,267.64 $1,387.10 $1,811.46 |
$1,474.40 $1,587.16 $1,706.62 $2,130.98 |
Toc - Plan #24 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ ($3 Rx + 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.16 $453.05 $510.13 $712.90 $1,083.32 |
$704.52 $758.41 $815.49 $1,018.26 |
$1,009.88 $1,063.77 $1,120.85 $1,323.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.32 $906.10 $1,020.26 $1,425.80 $2,166.64 |
$1,103.68 $1,211.46 $1,325.62 $1,731.16 |
$1,409.04 $1,516.82 $1,630.98 $2,036.52 |
Toc - Plan #25 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ Saver ($1 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.59 $456.94 $514.51 $719.02 $1,092.62 |
$710.57 $764.92 $822.49 $1,027.00 |
$1,018.55 $1,072.90 $1,130.47 $1,334.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.18 $913.88 $1,029.02 $1,438.04 $2,185.24 |
$1,113.16 $1,221.86 $1,337.00 $1,746.02 |
$1,421.14 $1,529.84 $1,644.98 $2,054.00 |
Toc - Plan #26 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.87 $454.99 $512.32 $715.96 $1,087.97 |
$707.54 $761.66 $818.99 $1,022.63 |
$1,014.21 $1,068.33 $1,125.66 $1,329.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$801.74 $909.98 $1,024.64 $1,431.92 $2,175.94 |
$1,108.41 $1,216.65 $1,331.31 $1,738.59 |
$1,415.08 $1,523.32 $1,637.98 $2,045.26 |
Toc - Plan #27 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Value+ Bronze ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.30 $418.02 $470.68 $657.78 $999.56 |
$650.05 $699.77 $752.43 $939.53 |
$931.80 $981.52 $1,034.18 $1,221.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.60 $836.04 $941.36 $1,315.56 $1,999.12 |
$1,018.35 $1,117.79 $1,223.11 $1,597.31 |
$1,300.10 $1,399.54 $1,504.86 $1,879.06 |
Toc - Plan #28 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential+ (Low Premium) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.92 $389.21 $438.25 $612.46 $930.68 |
$605.25 $651.54 $700.58 $874.79 |
$867.58 $913.87 $962.91 $1,137.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$685.84 $778.42 $876.50 $1,224.92 $1,861.36 |
$948.17 $1,040.75 $1,138.83 $1,487.25 |
$1,210.50 $1,303.08 $1,401.16 $1,749.58 |
Toc - Plan #29 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.38 $394.27 $443.95 $620.42 $942.78 |
$613.12 $660.01 $709.69 $886.16 |
$878.86 $925.75 $975.43 $1,151.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.76 $788.54 $887.90 $1,240.84 $1,885.56 |
$960.50 $1,054.28 $1,153.64 $1,506.58 |
$1,226.24 $1,320.02 $1,419.38 $1,772.32 |
ADVERTISEMENT
Blue Cross Blue Shield Healthcare Plan of Georgia, IncLocal: 1-855-738-6652 | Toll Free: 1-855-738-6652 |
Toc - Plan #30 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 0 for HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.17 $337.29 $379.78 $530.75 $806.52 |
$524.51 $564.63 $607.12 $758.09 |
$751.85 $791.97 $834.46 $985.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$594.34 $674.58 $759.56 $1,061.50 $1,613.04 |
$821.68 $901.92 $986.90 $1,288.84 |
$1,049.02 $1,129.26 $1,214.24 $1,516.18 |
Toc - Plan #31 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X Guided Access HMO 3000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.43 $414.76 $467.02 $652.66 $991.78 |
$644.98 $694.31 $746.57 $932.21 |
$924.53 $973.86 $1,026.12 $1,211.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.86 $829.52 $934.04 $1,305.32 $1,983.56 |
$1,010.41 $1,109.07 $1,213.59 $1,584.87 |
$1,289.96 $1,388.62 $1,493.14 $1,864.42 |
Toc - Plan #32 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X Guided Access HMO 5500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.34 $396.50 $446.46 $623.92 $948.11 |
$616.59 $663.75 $713.71 $891.17 |
$883.84 $931.00 $980.96 $1,158.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.68 $793.00 $892.92 $1,247.84 $1,896.22 |
$965.93 $1,060.25 $1,160.17 $1,515.09 |
$1,233.18 $1,327.50 $1,427.42 $1,782.34 |
Toc - Plan #33 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 5600 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.52 $333.15 $375.12 $524.23 $796.61 |
$518.06 $557.69 $599.66 $748.77 |
$742.60 $782.23 $824.20 $973.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$587.04 $666.30 $750.24 $1,048.46 $1,593.22 |
$811.58 $890.84 $974.78 $1,273.00 |
$1,036.12 $1,115.38 $1,199.32 $1,497.54 |
Toc - Plan #34 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 6000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290.71 $329.96 $371.53 $519.21 $788.99 |
$513.10 $552.35 $593.92 $741.60 |
$735.49 $774.74 $816.31 $963.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$581.42 $659.92 $743.06 $1,038.42 $1,577.98 |
$803.81 $882.31 $965.45 $1,260.81 |
$1,026.20 $1,104.70 $1,187.84 $1,483.20 |
Toc - Plan #35 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Catastrophic
(HMO) Anthem Catastrophic Pathway X Guided Access HMO 8700 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$213.17 $241.95 $272.43 $380.72 $578.54 |
$376.25 $405.03 $435.51 $543.80 |
$539.33 $568.11 $598.59 $706.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$426.34 $483.90 $544.86 $761.44 $1,157.08 |
$589.42 $646.98 $707.94 $924.52 |
$752.50 $810.06 $871.02 $1,087.60 |
Toc - Plan #36 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 8000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$280.20 $318.03 $358.10 $500.44 $760.46 |
$494.55 $532.38 $572.45 $714.79 |
$708.90 $746.73 $786.80 $929.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$560.40 $636.06 $716.20 $1,000.88 $1,520.92 |
$774.75 $850.41 $930.55 $1,215.23 |
$989.10 $1,064.76 $1,144.90 $1,429.58 |
Toc - Plan #37 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X Guided Access HMO 4950 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.92 $410.78 $462.53 $646.39 $982.25 |
$638.79 $687.65 $739.40 $923.26 |
$915.66 $964.52 $1,016.27 $1,200.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$723.84 $821.56 $925.06 $1,292.78 $1,964.50 |
$1,000.71 $1,098.43 $1,201.93 $1,569.65 |
$1,277.58 $1,375.30 $1,478.80 $1,846.52 |
Toc - Plan #38 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway X Guided Access HMO 1900 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.70 $469.55 $528.71 $738.87 $1,122.78 |
$730.18 $786.03 $845.19 $1,055.35 |
$1,046.66 $1,102.51 $1,161.67 $1,371.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.40 $939.10 $1,057.42 $1,477.74 $2,245.56 |
$1,143.88 $1,255.58 $1,373.90 $1,794.22 |
$1,460.36 $1,572.06 $1,690.38 $2,110.70 |
Toc - Plan #39 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 5000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.36 $346.58 $390.25 $545.37 $828.75 |
$538.96 $580.18 $623.85 $778.97 |
$772.56 $813.78 $857.45 $1,012.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.72 $693.16 $780.50 $1,090.74 $1,657.50 |
$844.32 $926.76 $1,014.10 $1,324.34 |
$1,077.92 $1,160.36 $1,247.70 $1,557.94 |
Toc - Plan #40 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X Guided Access HMO 2600 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.60 $446.74 $503.02 $702.97 $1,068.23 |
$694.70 $747.84 $804.12 $1,004.07 |
$995.80 $1,048.94 $1,105.22 $1,305.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$787.20 $893.48 $1,006.04 $1,405.94 $2,136.46 |
$1,088.30 $1,194.58 $1,307.14 $1,707.04 |
$1,389.40 $1,495.68 $1,608.24 $2,008.14 |
Toc - Plan #41 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X Guided Access HMO 6000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.18 $395.18 $444.97 $621.85 $944.96 |
$614.54 $661.54 $711.33 $888.21 |
$880.90 $927.90 $977.69 $1,154.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.36 $790.36 $889.94 $1,243.70 $1,889.92 |
$962.72 $1,056.72 $1,156.30 $1,510.06 |
$1,229.08 $1,323.08 $1,422.66 $1,776.42 |
ADVERTISEMENT
CareSourceLocal: 1-833-230-2030 | Toll Free: 1-833-230-2030 | TTY: 1-800-255-0056 |
Toc - Plan #42 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266.74 $302.75 $340.89 $476.40 $723.93 |
$470.80 $506.81 $544.95 $680.46 |
$674.86 $710.87 $749.01 $884.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$533.48 $605.50 $681.78 $952.80 $1,447.86 |
$737.54 $809.56 $885.84 $1,156.86 |
$941.60 $1,013.62 $1,089.90 $1,360.92 |
Toc - Plan #43 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.77 $423.09 $476.40 $665.76 $1,011.69 |
$657.94 $708.26 $761.57 $950.93 |
$943.11 $993.43 $1,046.74 $1,236.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.54 $846.18 $952.80 $1,331.52 $2,023.38 |
$1,030.71 $1,131.35 $1,237.97 $1,616.69 |
$1,315.88 $1,416.52 $1,523.14 $1,901.86 |
Toc - Plan #44 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374.65 $425.23 $478.80 $669.12 $1,016.80 |
$661.26 $711.84 $765.41 $955.73 |
$947.87 $998.45 $1,052.02 $1,242.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$749.30 $850.46 $957.60 $1,338.24 $2,033.60 |
$1,035.91 $1,137.07 $1,244.21 $1,624.85 |
$1,322.52 $1,423.68 $1,530.82 $1,911.46 |
Toc - Plan #45 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.45 $448.84 $505.39 $706.27 $1,073.25 |
$697.97 $751.36 $807.91 $1,008.79 |
$1,000.49 $1,053.88 $1,110.43 $1,311.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.90 $897.68 $1,010.78 $1,412.54 $2,146.50 |
$1,093.42 $1,200.20 $1,313.30 $1,715.06 |
$1,395.94 $1,502.72 $1,615.82 $2,017.58 |
Toc - Plan #46 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Deductible Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.56 $463.71 $522.14 $729.68 $1,108.83 |
$721.11 $776.26 $834.69 $1,042.23 |
$1,033.66 $1,088.81 $1,147.24 $1,354.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.12 $927.42 $1,044.28 $1,459.36 $2,217.66 |
$1,129.67 $1,239.97 $1,356.83 $1,771.91 |
$1,442.22 $1,552.52 $1,669.38 $2,084.46 |
Toc - Plan #47 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace HSA Eligible Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.06 $338.30 $380.92 $532.33 $808.93 |
$526.08 $566.32 $608.94 $760.35 |
$754.10 $794.34 $836.96 $988.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$596.12 $676.60 $761.84 $1,064.66 $1,617.86 |
$824.14 $904.62 $989.86 $1,292.68 |
$1,052.16 $1,132.64 $1,217.88 $1,520.70 |
Toc - Plan #48 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$255.54 $290.03 $326.58 $456.39 $693.53 |
$451.03 $485.52 $522.07 $651.88 |
$646.52 $681.01 $717.56 $847.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$511.08 $580.06 $653.16 $912.78 $1,387.06 |
$706.57 $775.55 $848.65 $1,108.27 |
$902.06 $971.04 $1,044.14 $1,303.76 |
Toc - Plan #49 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.71 $310.66 $349.80 $488.84 $742.84 |
$483.10 $520.05 $559.19 $698.23 |
$692.49 $729.44 $768.58 $907.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$547.42 $621.32 $699.60 $977.68 $1,485.68 |
$756.81 $830.71 $908.99 $1,187.07 |
$966.20 $1,040.10 $1,118.38 $1,396.46 |
Toc - Plan #50 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.99 $431.29 $485.63 $678.66 $1,031.29 |
$670.68 $721.98 $776.32 $969.35 |
$961.37 $1,012.67 $1,067.01 $1,260.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$759.98 $862.58 $971.26 $1,357.32 $2,062.58 |
$1,050.67 $1,153.27 $1,261.95 $1,648.01 |
$1,341.36 $1,443.96 $1,552.64 $1,938.70 |
Toc - Plan #51 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.88 $433.43 $488.03 $682.02 $1,036.40 |
$674.01 $725.56 $780.16 $974.15 |
$966.14 $1,017.69 $1,072.29 $1,266.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$763.76 $866.86 $976.06 $1,364.04 $2,072.80 |
$1,055.89 $1,158.99 $1,268.19 $1,656.17 |
$1,348.02 $1,451.12 $1,560.32 $1,948.30 |
Toc - Plan #52 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.67 $457.02 $514.60 $719.16 $1,092.83 |
$710.71 $765.06 $822.64 $1,027.20 |
$1,018.75 $1,073.10 $1,130.68 $1,335.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.34 $914.04 $1,029.20 $1,438.32 $2,185.66 |
$1,113.38 $1,222.08 $1,337.24 $1,746.36 |
$1,421.42 $1,530.12 $1,645.28 $2,054.40 |
Toc - Plan #53 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Deductible Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.78 $471.91 $531.37 $742.58 $1,128.43 |
$733.85 $789.98 $849.44 $1,060.65 |
$1,051.92 $1,108.05 $1,167.51 $1,378.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.56 $943.82 $1,062.74 $1,485.16 $2,256.86 |
$1,149.63 $1,261.89 $1,380.81 $1,803.23 |
$1,467.70 $1,579.96 $1,698.88 $2,121.30 |
Toc - Plan #54 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2030
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$262.22 $297.61 $335.11 $468.31 $711.65 |
$462.81 $498.20 $535.70 $668.90 |
$663.40 $698.79 $736.29 $869.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$524.44 $595.22 $670.22 $936.62 $1,423.30 |
$725.03 $795.81 $870.81 $1,137.21 |
$925.62 $996.40 $1,071.40 $1,337.80 |
ADVERTISEMENT
Ambetter from Peach State Health PlanLocal: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231 |
Toc - Plan #55 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Ambetter Essential Care 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.77 $328.88 $370.32 $517.52 $786.42 |
$511.44 $550.55 $591.99 $739.19 |
$733.11 $772.22 $813.66 $960.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$579.54 $657.76 $740.64 $1,035.04 $1,572.84 |
$801.21 $879.43 $962.31 $1,256.71 |
$1,022.88 $1,101.10 $1,183.98 $1,478.38 |
Toc - Plan #56 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 4 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.23 $430.42 $484.64 $677.29 $1,029.20 |
$669.33 $720.52 $774.74 $967.39 |
$959.43 $1,010.62 $1,064.84 $1,257.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.46 $860.84 $969.28 $1,354.58 $2,058.40 |
$1,048.56 $1,150.94 $1,259.38 $1,644.68 |
$1,338.66 $1,441.04 $1,549.48 $1,934.78 |
Toc - Plan #57 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 11 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.87 $416.38 $468.84 $655.21 $995.65 |
$647.52 $697.03 $749.49 $935.86 |
$928.17 $977.68 $1,030.14 $1,216.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.74 $832.76 $937.68 $1,310.42 $1,991.30 |
$1,014.39 $1,113.41 $1,218.33 $1,591.07 |
$1,295.04 $1,394.06 $1,498.98 $1,871.72 |
Toc - Plan #58 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Secure Care 5 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$387.38 $439.67 $495.06 $691.85 $1,051.33 |
$683.72 $736.01 $791.40 $988.19 |
$980.06 $1,032.35 $1,087.74 $1,284.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.76 $879.34 $990.12 $1,383.70 $2,102.66 |
$1,071.10 $1,175.68 $1,286.46 $1,680.04 |
$1,367.44 $1,472.02 $1,582.80 $1,976.38 |
Toc - Plan #59 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 12 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.32 $411.22 $463.03 $647.08 $983.30 |
$639.49 $688.39 $740.20 $924.25 |
$916.66 $965.56 $1,017.37 $1,201.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724.64 $822.44 $926.06 $1,294.16 $1,966.60 |
$1,001.81 $1,099.61 $1,203.23 $1,571.33 |
$1,278.98 $1,376.78 $1,480.40 $1,848.50 |
Toc - Plan #60 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 29 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.77 $406.05 $457.21 $638.95 $970.95 |
$631.45 $679.73 $730.89 $912.63 |
$905.13 $953.41 $1,004.57 $1,186.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.54 $812.10 $914.42 $1,277.90 $1,941.90 |
$989.22 $1,085.78 $1,188.10 $1,551.58 |
$1,262.90 $1,359.46 $1,461.78 $1,825.26 |
Toc - Plan #61 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 28 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.09 $441.61 $497.24 $694.90 $1,055.96 |
$686.74 $739.26 $794.89 $992.55 |
$984.39 $1,036.91 $1,092.54 $1,290.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$778.18 $883.22 $994.48 $1,389.80 $2,111.92 |
$1,075.83 $1,180.87 $1,292.13 $1,687.45 |
$1,373.48 $1,478.52 $1,589.78 $1,985.10 |
Toc - Plan #62 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 2 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.19 $360.00 $405.36 $566.48 $860.83 |
$559.83 $602.64 $648.00 $809.12 |
$802.47 $845.28 $890.64 $1,051.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$634.38 $720.00 $810.72 $1,132.96 $1,721.66 |
$877.02 $962.64 $1,053.36 $1,375.60 |
$1,119.66 $1,205.28 $1,296.00 $1,618.24 |
Toc - Plan #63 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 5 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$313.97 $356.34 $401.24 $560.73 $852.08 |
$554.15 $596.52 $641.42 $800.91 |
$794.33 $836.70 $881.60 $1,041.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$627.94 $712.68 $802.48 $1,121.46 $1,704.16 |
$868.12 $952.86 $1,042.66 $1,361.64 |
$1,108.30 $1,193.04 $1,282.84 $1,601.82 |
Toc - Plan #64 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 22 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.80 $378.85 $426.58 $596.15 $905.91 |
$589.15 $634.20 $681.93 $851.50 |
$844.50 $889.55 $937.28 $1,106.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$667.60 $757.70 $853.16 $1,192.30 $1,811.82 |
$922.95 $1,013.05 $1,108.51 $1,447.65 |
$1,178.30 $1,268.40 $1,363.86 $1,703.00 |
Toc - Plan #65 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care: $1,500 Medical Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.54 $387.63 $436.47 $609.97 $926.90 |
$602.81 $648.90 $697.74 $871.24 |
$864.08 $910.17 $959.01 $1,132.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.08 $775.26 $872.94 $1,219.94 $1,853.80 |
$944.35 $1,036.53 $1,134.21 $1,481.21 |
$1,205.62 $1,297.80 $1,395.48 $1,742.48 |
Toc - Plan #66 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care: $0 Medical Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.13 $407.60 $458.96 $641.39 $974.66 |
$633.86 $682.33 $733.69 $916.12 |
$908.59 $957.06 $1,008.42 $1,190.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.26 $815.20 $917.92 $1,282.78 $1,949.32 |
$992.99 $1,089.93 $1,192.65 $1,557.51 |
$1,267.72 $1,364.66 $1,467.38 $1,832.24 |
Toc - Plan #67 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.13 $389.44 $438.51 $612.81 $931.22 |
$605.62 $651.93 $701.00 $875.30 |
$868.11 $914.42 $963.49 $1,137.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.26 $778.88 $877.02 $1,225.62 $1,862.44 |
$948.75 $1,041.37 $1,139.51 $1,488.11 |
$1,211.24 $1,303.86 $1,402.00 $1,750.60 |
Toc - Plan #68 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 31 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.24 $389.57 $438.65 $613.01 $931.53 |
$605.81 $652.14 $701.22 $875.58 |
$868.38 $914.71 $963.79 $1,138.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.48 $779.14 $877.30 $1,226.02 $1,863.06 |
$949.05 $1,041.71 $1,139.87 $1,488.59 |
$1,211.62 $1,304.28 $1,402.44 $1,751.16 |
Toc - Plan #69 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 32 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.32 $398.74 $448.97 $627.44 $953.45 |
$620.07 $667.49 $717.72 $896.19 |
$888.82 $936.24 $986.47 $1,164.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.64 $797.48 $897.94 $1,254.88 $1,906.90 |
$971.39 $1,066.23 $1,166.69 $1,523.63 |
$1,240.14 $1,334.98 $1,435.44 $1,792.38 |
Toc - Plan #70 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Secure Care 20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.89 $411.86 $463.76 $648.10 $984.85 |
$640.49 $689.46 $741.36 $925.70 |
$918.09 $967.06 $1,018.96 $1,203.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.78 $823.72 $927.52 $1,296.20 $1,969.70 |
$1,003.38 $1,101.32 $1,205.12 $1,573.80 |
$1,280.98 $1,378.92 $1,482.72 $1,851.40 |
Toc - Plan #71 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 12 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.56 $428.52 $482.51 $674.31 $1,024.68 |
$666.39 $717.35 $771.34 $963.14 |
$955.22 $1,006.18 $1,060.17 $1,251.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.12 $857.04 $965.02 $1,348.62 $2,049.36 |
$1,043.95 $1,145.87 $1,253.85 $1,637.45 |
$1,332.78 $1,434.70 $1,542.68 $1,926.28 |
Toc - Plan #72 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 4 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.19 $448.53 $505.04 $705.79 $1,072.52 |
$697.50 $750.84 $807.35 $1,008.10 |
$999.81 $1,053.15 $1,109.66 $1,310.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.38 $897.06 $1,010.08 $1,411.58 $2,145.04 |
$1,092.69 $1,199.37 $1,312.39 $1,713.89 |
$1,395.00 $1,501.68 $1,614.70 $2,016.20 |
Toc - Plan #73 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 11 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.31 $433.91 $488.57 $682.78 $1,037.55 |
$674.77 $726.37 $781.03 $975.24 |
$967.23 $1,018.83 $1,073.49 $1,267.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.62 $867.82 $977.14 $1,365.56 $2,075.10 |
$1,057.08 $1,160.28 $1,269.60 $1,658.02 |
$1,349.54 $1,452.74 $1,562.06 $1,950.48 |
Toc - Plan #74 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Ambetter Essential Care 1 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.97 $342.72 $385.90 $539.29 $819.51 |
$532.97 $573.72 $616.90 $770.29 |
$763.97 $804.72 $847.90 $1,001.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$603.94 $685.44 $771.80 $1,078.58 $1,639.02 |
$834.94 $916.44 $1,002.80 $1,309.58 |
$1,065.94 $1,147.44 $1,233.80 $1,540.58 |
Toc - Plan #75 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Secure Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403.69 $458.17 $515.90 $720.96 $1,095.58 |
$712.50 $766.98 $824.71 $1,029.77 |
$1,021.31 $1,075.79 $1,133.52 $1,338.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$807.38 $916.34 $1,031.80 $1,441.92 $2,191.16 |
$1,116.19 $1,225.15 $1,340.61 $1,750.73 |
$1,425.00 $1,533.96 $1,649.42 $2,059.54 |
Toc - Plan #76 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 28 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.46 $460.19 $518.17 $724.14 $1,100.40 |
$715.63 $770.36 $828.34 $1,034.31 |
$1,025.80 $1,080.53 $1,138.51 $1,344.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810.92 $920.38 $1,036.34 $1,448.28 $2,200.80 |
$1,121.09 $1,230.55 $1,346.51 $1,758.45 |
$1,431.26 $1,540.72 $1,656.68 $2,068.62 |
Toc - Plan #77 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 29 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.82 $423.14 $476.45 $665.84 $1,011.81 |
$658.02 $708.34 $761.65 $951.04 |
$943.22 $993.54 $1,046.85 $1,236.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.64 $846.28 $952.90 $1,331.68 $2,023.62 |
$1,030.84 $1,131.48 $1,238.10 $1,616.88 |
$1,316.04 $1,416.68 $1,523.30 $1,902.08 |
Toc - Plan #78 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 2 HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$330.54 $375.15 $422.41 $590.32 $897.05 |
$583.39 $628.00 $675.26 $843.17 |
$836.24 $880.85 $928.11 $1,096.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$661.08 $750.30 $844.82 $1,180.64 $1,794.10 |
$913.93 $1,003.15 $1,097.67 $1,433.49 |
$1,166.78 $1,256.00 $1,350.52 $1,686.34 |
Toc - Plan #79 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.18 $371.34 $418.12 $584.32 $887.94 |
$577.46 $621.62 $668.40 $834.60 |
$827.74 $871.90 $918.68 $1,084.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$654.36 $742.68 $836.24 $1,168.64 $1,775.88 |
$904.64 $992.96 $1,086.52 $1,418.92 |
$1,154.92 $1,243.24 $1,336.80 $1,669.20 |
Toc - Plan #80 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care 22 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.85 $394.79 $444.54 $621.24 $944.03 |
$613.95 $660.89 $710.64 $887.34 |
$880.05 $926.99 $976.74 $1,153.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$695.70 $789.58 $889.08 $1,242.48 $1,888.06 |
$961.80 $1,055.68 $1,155.18 $1,508.58 |
$1,227.90 $1,321.78 $1,421.28 $1,774.68 |
Toc - Plan #81 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care: $1,500 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.91 $403.94 $454.84 $635.63 $965.91 |
$628.17 $676.20 $727.10 $907.89 |
$900.43 $948.46 $999.36 $1,180.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.82 $807.88 $909.68 $1,271.26 $1,931.82 |
$984.08 $1,080.14 $1,181.94 $1,543.52 |
$1,256.34 $1,352.40 $1,454.20 $1,815.78 |
Toc - Plan #82 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Essential Care: $0 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374.24 $424.76 $478.27 $668.38 $1,015.67 |
$660.53 $711.05 $764.56 $954.67 |
$946.82 $997.34 $1,050.85 $1,240.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748.48 $849.52 $956.54 $1,336.76 $2,031.34 |
$1,034.77 $1,135.81 $1,242.83 $1,623.05 |
$1,321.06 $1,422.10 $1,529.12 $1,909.34 |
Toc - Plan #83 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 31 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.69 $405.96 $457.11 $638.81 $970.73 |
$631.31 $679.58 $730.73 $912.43 |
$904.93 $953.20 $1,004.35 $1,186.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.38 $811.92 $914.22 $1,277.62 $1,941.46 |
$989.00 $1,085.54 $1,187.84 $1,551.24 |
$1,262.62 $1,359.16 $1,461.46 $1,824.86 |
Toc - Plan #84 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Balanced Care 32 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.10 $415.52 $467.87 $653.84 $993.58 |
$646.16 $695.58 $747.93 $933.90 |
$926.22 $975.64 $1,027.99 $1,213.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$732.20 $831.04 $935.74 $1,307.68 $1,987.16 |
$1,012.26 $1,111.10 $1,215.80 $1,587.74 |
$1,292.32 $1,391.16 $1,495.86 $1,867.80 |
Toc - Plan #85 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Secure Care 20 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.16 $429.20 $483.27 $675.37 $1,026.29 |
$667.44 $718.48 $772.55 $964.65 |
$956.72 $1,007.76 $1,061.83 $1,253.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.32 $858.40 $966.54 $1,350.74 $2,052.58 |
$1,045.60 $1,147.68 $1,255.82 $1,640.02 |
$1,334.88 $1,436.96 $1,545.10 $1,929.30 |
Toc - Plan #86 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Select Plus Silver 11 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.11 $393.96 $443.59 $619.92 $942.03 |
$612.64 $659.49 $709.12 $885.45 |
$878.17 $925.02 $974.65 $1,150.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.22 $787.92 $887.18 $1,239.84 $1,884.06 |
$959.75 $1,053.45 $1,152.71 $1,505.37 |
$1,225.28 $1,318.98 $1,418.24 $1,770.90 |
Toc - Plan #87 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Select Plus Silver 30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.66 $368.48 $414.90 $579.83 $881.10 |
$573.02 $616.84 $663.26 $828.19 |
$821.38 $865.20 $911.62 $1,076.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$649.32 $736.96 $829.80 $1,159.66 $1,762.20 |
$897.68 $985.32 $1,078.16 $1,408.02 |
$1,146.04 $1,233.68 $1,326.52 $1,656.38 |
Toc - Plan #88 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Select Plus Silver 31 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.77 $368.61 $415.05 $580.03 $881.41 |
$573.21 $617.05 $663.49 $828.47 |
$821.65 $865.49 $911.93 $1,076.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$649.54 $737.22 $830.10 $1,160.06 $1,762.82 |
$897.98 $985.66 $1,078.54 $1,408.50 |
$1,146.42 $1,234.10 $1,326.98 $1,656.94 |
Toc - Plan #89 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Select Plus Silver 32 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.40 $377.26 $424.79 $593.64 $902.10 |
$586.68 $631.54 $679.07 $847.92 |
$840.96 $885.82 $933.35 $1,102.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.80 $754.52 $849.58 $1,187.28 $1,804.20 |
$919.08 $1,008.80 $1,103.86 $1,441.56 |
$1,173.36 $1,263.08 $1,358.14 $1,695.84 |
Toc - Plan #90 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Select Plus Gold 20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.36 $389.70 $438.80 $613.22 $931.84 |
$606.02 $652.36 $701.46 $875.88 |
$868.68 $915.02 $964.12 $1,138.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.72 $779.40 $877.60 $1,226.44 $1,863.68 |
$949.38 $1,042.06 $1,140.26 $1,489.10 |
$1,212.04 $1,304.72 $1,402.92 $1,751.76 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 |
Toc - Plan #91 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.76 $339.09 $381.81 $533.58 $810.83 |
$527.31 $567.64 $610.36 $762.13 |
$755.86 $796.19 $838.91 $990.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597.52 $678.18 $763.62 $1,067.16 $1,621.66 |
$826.07 $906.73 $992.17 $1,295.71 |
$1,054.62 $1,135.28 $1,220.72 $1,524.26 |
Toc - Plan #92 Aetna CVS Health | ||||||||||||||||||||
Bronze
(HMO) Aetna CVS Bronze: $0 Walk-In Clinic Visits, Telehealth, Atlanta |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290.56 $329.78 $371.33 $518.94 $788.58 |
$512.84 $552.06 $593.61 $741.22 |
$735.12 $774.34 $815.89 $963.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$581.12 $659.56 $742.66 $1,037.88 $1,577.16 |
$803.40 $881.84 $964.94 $1,260.16 |
$1,025.68 $1,104.12 $1,187.22 $1,482.44 |
Toc - Plan #93 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Aetna CVS Gold: $0 Walk-In Clinic Visits, Telehealth, Atlanta |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.65 $449.07 $505.65 $706.64 $1,073.80 |
$698.32 $751.74 $808.32 $1,009.31 |
$1,000.99 $1,054.41 $1,110.99 $1,311.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$791.30 $898.14 $1,011.30 $1,413.28 $2,147.60 |
$1,093.97 $1,200.81 $1,313.97 $1,715.95 |
$1,396.64 $1,503.48 $1,616.64 $2,018.62 |
Toc - Plan #94 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Aetna CVS Silver 2: $0 Walk-In Clinic Visits, Telehealth, Atlanta |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.17 $407.66 $459.02 $641.48 $974.80 |
$633.94 $682.43 $733.79 $916.25 |
$908.71 $957.20 $1,008.56 $1,191.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.34 $815.32 $918.04 $1,282.96 $1,949.60 |
$993.11 $1,090.09 $1,192.81 $1,557.73 |
$1,267.88 $1,364.86 $1,467.58 $1,832.50 |
Toc - Plan #95 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Aetna CVS Silver 1: $0 Walk-In Clinic Visits, Telehealth, Atlanta |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.47 $472.70 $532.25 $743.82 $1,130.30 |
$735.07 $791.30 $850.85 $1,062.42 |
$1,053.67 $1,109.90 $1,169.45 $1,381.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.94 $945.40 $1,064.50 $1,487.64 $2,260.60 |
$1,151.54 $1,264.00 $1,383.10 $1,806.24 |
$1,470.14 $1,582.60 $1,701.70 $2,124.84 |
ADVERTISEMENT
Kaiser PermanenteLocal: 1-800-494-5314 | Toll Free: 1-800-494-5314 |
Toc - Plan #96 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 500/20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$380.19 $431.51 $485.88 $679.01 $1,031.83 |
$671.03 $722.35 $776.72 $969.85 |
$961.87 $1,013.19 $1,067.56 $1,260.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$760.38 $863.02 $971.76 $1,358.02 $2,063.66 |
$1,051.22 $1,153.86 $1,262.60 $1,648.86 |
$1,342.06 $1,444.70 $1,553.44 $1,939.70 |
Toc - Plan #97 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 3000/30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.65 $441.12 $496.70 $694.14 $1,054.81 |
$685.97 $738.44 $794.02 $991.46 |
$983.29 $1,035.76 $1,091.34 $1,288.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.30 $882.24 $993.40 $1,388.28 $2,109.62 |
$1,074.62 $1,179.56 $1,290.72 $1,685.60 |
$1,371.94 $1,476.88 $1,588.04 $1,982.92 |
Toc - Plan #98 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 3500/20%/HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.42 $421.56 $474.68 $663.36 $1,008.03 |
$655.56 $705.70 $758.82 $947.50 |
$939.70 $989.84 $1,042.96 $1,231.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.84 $843.12 $949.36 $1,326.72 $2,016.06 |
$1,026.98 $1,127.26 $1,233.50 $1,610.86 |
$1,311.12 $1,411.40 $1,517.64 $1,895.00 |
Toc - Plan #99 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Bronze Virtual Complete 5000/60 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.58 $319.59 $359.86 $502.90 $764.20 |
$496.99 $535.00 $575.27 $718.31 |
$712.40 $750.41 $790.68 $933.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$563.16 $639.18 $719.72 $1,005.80 $1,528.40 |
$778.57 $854.59 $935.13 $1,221.21 |
$993.98 $1,070.00 $1,150.54 $1,436.62 |
Toc - Plan #100 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Bronze 6500/40%/HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.50 $316.09 $355.92 $497.39 $755.84 |
$491.55 $529.14 $568.97 $710.44 |
$704.60 $742.19 $782.02 $923.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$557.00 $632.18 $711.84 $994.78 $1,511.68 |
$770.05 $845.23 $924.89 $1,207.83 |
$983.10 $1,058.28 $1,137.94 $1,420.88 |
Toc - Plan #101 Kaiser Permanente | ||||||||||||||||||||
Catastrophic
(HMO) KP GA Catastrophic 8700/0 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$243.88 $276.81 $311.68 $435.58 $661.90 |
$430.45 $463.38 $498.25 $622.15 |
$617.02 $649.95 $684.82 $808.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$487.76 $553.62 $623.36 $871.16 $1,323.80 |
$674.33 $740.19 $809.93 $1,057.73 |
$860.90 $926.76 $996.50 $1,244.30 |
Toc - Plan #102 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 1500/20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.55 $414.90 $467.17 $652.87 $992.10 |
$645.20 $694.55 $746.82 $932.52 |
$924.85 $974.20 $1,026.47 $1,212.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$731.10 $829.80 $934.34 $1,305.74 $1,984.20 |
$1,010.75 $1,109.45 $1,213.99 $1,585.39 |
$1,290.40 $1,389.10 $1,493.64 $1,865.04 |
Toc - Plan #103 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 4500/35 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.79 $417.44 $470.04 $656.88 $998.19 |
$649.15 $698.80 $751.40 $938.24 |
$930.51 $980.16 $1,032.76 $1,219.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.58 $834.88 $940.08 $1,313.76 $1,996.38 |
$1,016.94 $1,116.24 $1,221.44 $1,595.12 |
$1,298.30 $1,397.60 $1,502.80 $1,876.48 |
Toc - Plan #104 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 1700/25 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.45 $400.03 $450.44 $629.48 $956.56 |
$622.08 $669.66 $720.07 $899.11 |
$891.71 $939.29 $989.70 $1,168.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.90 $800.06 $900.88 $1,258.96 $1,913.12 |
$974.53 $1,069.69 $1,170.51 $1,528.59 |
$1,244.16 $1,339.32 $1,440.14 $1,798.22 |
Toc - Plan #105 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver Virtual Complete 4800/40 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.65 $396.86 $446.86 $624.48 $948.96 |
$617.13 $664.34 $714.34 $891.96 |
$884.61 $931.82 $981.82 $1,159.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$699.30 $793.72 $893.72 $1,248.96 $1,897.92 |
$966.78 $1,061.20 $1,161.20 $1,516.44 |
$1,234.26 $1,328.68 $1,428.68 $1,783.92 |
ADVERTISEMENT
Friday Health PlansLocal: 1-844-521-7999 | Toll Free: 1-844-521-7999 | TTY: 1-800-659-2656 |
Toc - Plan #106 Friday Health Plans | ||||||||||||||||||||
Catastrophic
(HMO) Friday Catastrophic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$225.87 $256.36 $288.66 $403.40 $613.00 |
$398.66 $429.15 $461.45 $576.19 |
$571.45 $601.94 $634.24 $748.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$451.74 $512.72 $577.32 $806.80 $1,226.00 |
$624.53 $685.51 $750.11 $979.59 |
$797.32 $858.30 $922.90 $1,152.38 |
Toc - Plan #107 Friday Health Plans | ||||||||||||||||||||
Bronze
(HMO) Friday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$246.54 $279.83 $315.08 $440.33 $669.12 |
$435.15 $468.44 $503.69 $628.94 |
$623.76 $657.05 $692.30 $817.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$493.08 $559.66 $630.16 $880.66 $1,338.24 |
$681.69 $748.27 $818.77 $1,069.27 |
$870.30 $936.88 $1,007.38 $1,257.88 |
Toc - Plan #108 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) Friday Bronze Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$252.22 $286.27 $322.33 $450.46 $684.52 |
$445.17 $479.22 $515.28 $643.41 |
$638.12 $672.17 $708.23 $836.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$504.44 $572.54 $644.66 $900.92 $1,369.04 |
$697.39 $765.49 $837.61 $1,093.87 |
$890.34 $958.44 $1,030.56 $1,286.82 |
Toc - Plan #109 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) Friday Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$260.12 $295.24 $332.44 $464.58 $705.98 |
$459.12 $494.24 $531.44 $663.58 |
$658.12 $693.24 $730.44 $862.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$520.24 $590.48 $664.88 $929.16 $1,411.96 |
$719.24 $789.48 $863.88 $1,128.16 |
$918.24 $988.48 $1,062.88 $1,327.16 |
Toc - Plan #110 Friday Health Plans | ||||||||||||||||||||
Silver
(HMO) Friday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$319.58 $362.72 $408.42 $570.77 $867.33 |
$564.06 $607.20 $652.90 $815.25 |
$808.54 $851.68 $897.38 $1,059.73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$639.16 $725.44 $816.84 $1,141.54 $1,734.66 |
$883.64 $969.92 $1,061.32 $1,386.02 |
$1,128.12 $1,214.40 $1,305.80 $1,630.50 |
Toc - Plan #111 Friday Health Plans | ||||||||||||||||||||
Gold
(HMO) Friday Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.63 $365.05 $411.04 $574.42 $872.89 |
$567.67 $611.09 $657.08 $820.46 |
$813.71 $857.13 $903.12 $1,066.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$643.26 $730.10 $822.08 $1,148.84 $1,745.78 |
$889.30 $976.14 $1,068.12 $1,394.88 |
$1,135.34 $1,222.18 $1,314.16 $1,640.92 |
Toc - Plan #112 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) Friday Bronze Plus Copay |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$254.68 $289.06 $325.48 $454.86 $691.21 |
$449.51 $483.89 $520.31 $649.69 |
$644.34 $678.72 $715.14 $844.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$509.36 $578.12 $650.96 $909.72 $1,382.42 |
$704.19 $772.95 $845.79 $1,104.55 |
$899.02 $967.78 $1,040.62 $1,299.38 |
Toc - Plan #113 Friday Health Plans | ||||||||||||||||||||
Silver
(HMO) Friday Silver Copay |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$327.96 $372.24 $419.13 $585.74 $890.09 |
$578.85 $623.13 $670.02 $836.63 |
$829.74 $874.02 $920.91 $1,087.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.92 $744.48 $838.26 $1,171.48 $1,780.18 |
$906.81 $995.37 $1,089.15 $1,422.37 |
$1,157.70 $1,246.26 $1,340.04 $1,673.26 |
Toc - Plan #114 Friday Health Plans | ||||||||||||||||||||
Gold
(HMO) Friday Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-521-7999
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.39 $381.81 $429.91 $600.80 $912.97 |
$593.73 $639.15 $687.25 $858.14 |
$851.07 $896.49 $944.59 $1,115.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.78 $763.62 $859.82 $1,201.60 $1,825.94 |
$930.12 $1,020.96 $1,117.16 $1,458.94 |
$1,187.46 $1,278.30 $1,374.50 $1,716.28 |
‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Rockdale County here.
Rockdale County is in “Rating Area 3” of Georgia.
Currently, there are 114 plans offered in Rating Area 3.