Obamacare 2023 Rates for Boone County
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Obamacare > Rates > Missouri > Boone County
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Anthem Blue Cross and Blue ShieldLocal: 1-855-738-6677 | Toll Free: 1-855-738-6677 |
Toc - Plan #1 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$488.88 $554.88 $624.79 $873.14 $1,326.82 |
$862.87 $928.87 $998.78 $1,247.13 |
$1,236.86 $1,302.86 $1,372.77 $1,621.12 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$977.76 $1,109.76 $1,249.58 $1,746.28 $2,653.64 |
$1,351.75 $1,483.75 $1,623.57 $2,120.27 |
$1,725.74 $1,857.74 $1,997.56 $2,494.26 |
Toc - Plan #2 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 6800 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$403.91 $458.44 $516.20 $721.38 $1,096.21 |
$712.90 $767.43 $825.19 $1,030.37 |
$1,021.89 $1,076.42 $1,134.18 $1,339.36 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$807.82 $916.88 $1,032.40 $1,442.76 $2,192.42 |
$1,116.81 $1,225.87 $1,341.39 $1,751.75 |
$1,425.80 $1,534.86 $1,650.38 $2,060.74 |
Toc - Plan #3 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 0% for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$402.45 $456.78 $514.33 $718.78 $1,092.25 |
$710.32 $764.65 $822.20 $1,026.65 |
$1,018.19 $1,072.52 $1,130.07 $1,334.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$804.90 $913.56 $1,028.66 $1,437.56 $2,184.50 |
$1,112.77 $1,221.43 $1,336.53 $1,745.43 |
$1,420.64 $1,529.30 $1,644.40 $2,053.30 |
Toc - Plan #4 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 20% for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$407.21 $462.18 $520.41 $727.28 $1,105.17 |
$718.73 $773.70 $831.93 $1,038.80 |
$1,030.25 $1,085.22 $1,143.45 $1,350.32 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$814.42 $924.36 $1,040.82 $1,454.56 $2,210.34 |
$1,125.94 $1,235.88 $1,352.34 $1,766.08 |
$1,437.46 $1,547.40 $1,663.86 $2,077.60 |
Toc - Plan #5 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3900 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$486.41 $552.08 $621.63 $868.73 $1,320.12 |
$858.51 $924.18 $993.73 $1,240.83 |
$1,230.61 $1,296.28 $1,365.83 $1,612.93 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$972.82 $1,104.16 $1,243.26 $1,737.46 $2,640.24 |
$1,344.92 $1,476.26 $1,615.36 $2,109.56 |
$1,717.02 $1,848.36 $1,987.46 $2,481.66 |
Toc - Plan #6 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3000 for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$487.95 $553.82 $623.60 $871.48 $1,324.30 |
$861.23 $927.10 $996.88 $1,244.76 |
$1,234.51 $1,300.38 $1,370.16 $1,618.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$975.90 $1,107.64 $1,247.20 $1,742.96 $2,648.60 |
$1,349.18 $1,480.92 $1,620.48 $2,116.24 |
$1,722.46 $1,854.20 $1,993.76 $2,489.52 |
Toc - Plan #7 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$401.08 $455.23 $512.58 $716.33 $1,088.53 |
$707.91 $762.06 $819.41 $1,023.16 |
$1,014.74 $1,068.89 $1,126.24 $1,329.99 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$802.16 $910.46 $1,025.16 $1,432.66 $2,177.06 |
$1,108.99 $1,217.29 $1,331.99 $1,739.49 |
$1,415.82 $1,524.12 $1,638.82 $2,046.32 |
Toc - Plan #8 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 5400 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$478.16 $542.71 $611.09 $853.99 $1,297.73 |
$843.95 $908.50 $976.88 $1,219.78 |
$1,209.74 $1,274.29 $1,342.67 $1,585.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$956.32 $1,085.42 $1,222.18 $1,707.98 $2,595.46 |
$1,322.11 $1,451.21 $1,587.97 $2,073.77 |
$1,687.90 $1,817.00 $1,953.76 $2,439.56 |
Toc - Plan #9 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$475.07 $539.20 $607.14 $848.48 $1,289.34 |
$838.50 $902.63 $970.57 $1,211.91 |
$1,201.93 $1,266.06 $1,334.00 $1,575.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$950.14 $1,078.40 $1,214.28 $1,696.96 $2,578.68 |
$1,313.57 $1,441.83 $1,577.71 $2,060.39 |
$1,677.00 $1,805.26 $1,941.14 $2,423.82 |
Toc - Plan #10 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Catastrophic
(EPO) Anthem Catastrophic Pathway X 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$293.41 $333.02 $374.98 $524.03 $796.31 |
$517.87 $557.48 $599.44 $748.49 |
$742.33 $781.94 $823.90 $972.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$586.82 $666.04 $749.96 $1,048.06 $1,592.62 |
$811.28 $890.50 $974.42 $1,272.52 |
$1,035.74 $1,114.96 $1,198.88 $1,496.98 |
Toc - Plan #11 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 4350 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$417.35 $473.69 $533.37 $745.39 $1,132.69 |
$736.62 $792.96 $852.64 $1,064.66 |
$1,055.89 $1,112.23 $1,171.91 $1,383.93 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$834.70 $947.38 $1,066.74 $1,490.78 $2,265.38 |
$1,153.97 $1,266.65 $1,386.01 $1,810.05 |
$1,473.24 $1,585.92 $1,705.28 $2,129.32 |
Toc - Plan #12 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(EPO) Anthem Bronze Pathway X 9100/0% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$378.86 $430.01 $484.18 $676.64 $1,028.23 |
$668.69 $719.84 $774.01 $966.47 |
$958.52 $1,009.67 $1,063.84 $1,256.30 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$757.72 $860.02 $968.36 $1,353.28 $2,056.46 |
$1,047.55 $1,149.85 $1,258.19 $1,643.11 |
$1,337.38 $1,439.68 $1,548.02 $1,932.94 |
Toc - Plan #13 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 7500/50% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$415.24 $471.30 $530.68 $741.62 $1,126.96 |
$732.90 $788.96 $848.34 $1,059.28 |
$1,050.56 $1,106.62 $1,166.00 $1,376.94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$830.48 $942.60 $1,061.36 $1,483.24 $2,253.92 |
$1,148.14 $1,260.26 $1,379.02 $1,800.90 |
$1,465.80 $1,577.92 $1,696.68 $2,118.56 |
Toc - Plan #14 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 5800/40% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$473.93 $537.91 $605.68 $846.44 $1,286.25 |
$836.49 $900.47 $968.24 $1,209.00 |
$1,199.05 $1,263.03 $1,330.80 $1,571.56 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$947.86 $1,075.82 $1,211.36 $1,692.88 $2,572.50 |
$1,310.42 $1,438.38 $1,573.92 $2,055.44 |
$1,672.98 $1,800.94 $1,936.48 $2,418.00 |
Toc - Plan #15 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(EPO) Anthem Gold Pathway X 2000/25% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$727.82 $826.08 $930.15 $1,299.89 $1,975.30 |
$1,284.60 $1,382.86 $1,486.93 $1,856.67 |
$1,841.38 $1,939.64 $2,043.71 $2,413.45 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,455.64 $1,652.16 $1,860.30 $2,599.78 $3,950.60 |
$2,012.42 $2,208.94 $2,417.08 $3,156.56 |
$2,569.20 $2,765.72 $2,973.86 $3,713.34 |
ADVERTISEMENT
MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-676-3777 |
Toc - Plan #16 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with MU Health Care Bronze HSA ($0 Virtual Care after Deductible with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$495.55 $562.44 $633.30 $885.03 $1,344.89 |
$874.64 $941.53 $1,012.39 $1,264.12 |
$1,253.73 $1,320.62 $1,391.48 $1,643.21 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$991.10 $1,124.88 $1,266.60 $1,770.06 $2,689.78 |
$1,370.19 $1,503.97 $1,645.69 $2,149.15 |
$1,749.28 $1,883.06 $2,024.78 $2,528.24 |
Toc - Plan #17 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Medica with MU Health Care Catastrophic ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$292.28 $331.72 $373.52 $521.99 $793.21 |
$515.86 $555.30 $597.10 $745.57 |
$739.44 $778.88 $820.68 $969.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$584.56 $663.44 $747.04 $1,043.98 $1,586.42 |
$808.14 $887.02 $970.62 $1,267.56 |
$1,031.72 $1,110.60 $1,194.20 $1,491.14 |
Toc - Plan #18 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with MU Health Care Silver Share ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$577.89 $655.90 $738.54 $1,032.10 $1,568.38 |
$1,019.97 $1,097.98 $1,180.62 $1,474.18 |
$1,462.05 $1,540.06 $1,622.70 $1,916.26 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,155.78 $1,311.80 $1,477.08 $2,064.20 $3,136.76 |
$1,597.86 $1,753.88 $1,919.16 $2,506.28 |
$2,039.94 $2,195.96 $2,361.24 $2,948.36 |
Toc - Plan #19 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with MU Health Care Bronze Share Plus ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$421.88 $478.82 $539.15 $753.45 $1,144.95 |
$744.61 $801.55 $861.88 $1,076.18 |
$1,067.34 $1,124.28 $1,184.61 $1,398.91 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$843.76 $957.64 $1,078.30 $1,506.90 $2,289.90 |
$1,166.49 $1,280.37 $1,401.03 $1,829.63 |
$1,489.22 $1,603.10 $1,723.76 $2,152.36 |
Toc - Plan #20 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with MU Health Care Bronze Copay $0 PCP ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$409.88 $465.20 $523.81 $732.03 $1,112.39 |
$723.43 $778.75 $837.36 $1,045.58 |
$1,036.98 $1,092.30 $1,150.91 $1,359.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$819.76 $930.40 $1,047.62 $1,464.06 $2,224.78 |
$1,133.31 $1,243.95 $1,361.17 $1,777.61 |
$1,446.86 $1,557.50 $1,674.72 $2,091.16 |
Toc - Plan #21 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with MU Health Care Gold Copay $0 PCP ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$611.58 $694.13 $781.58 $1,092.26 $1,659.79 |
$1,079.43 $1,161.98 $1,249.43 $1,560.11 |
$1,547.28 $1,629.83 $1,717.28 $2,027.96 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,223.16 $1,388.26 $1,563.16 $2,184.52 $3,319.58 |
$1,691.01 $1,856.11 $2,031.01 $2,652.37 |
$2,158.86 $2,323.96 $2,498.86 $3,120.22 |
Toc - Plan #22 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with MU Health Care Bronze Premier ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.34 $466.86 $525.68 $734.64 $1,116.36 |
$726.01 $781.53 $840.35 $1,049.31 |
$1,040.68 $1,096.20 $1,155.02 $1,363.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.68 $933.72 $1,051.36 $1,469.28 $2,232.72 |
$1,137.35 $1,248.39 $1,366.03 $1,783.95 |
$1,452.02 $1,563.06 $1,680.70 $2,098.62 |
Toc - Plan #23 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with MU Health Care Gold Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$581.67 $660.18 $743.36 $1,038.84 $1,578.62 |
$1,026.64 $1,105.15 $1,188.33 $1,483.81 |
$1,471.61 $1,550.12 $1,633.30 $1,928.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,163.34 $1,320.36 $1,486.72 $2,077.68 $3,157.24 |
$1,608.31 $1,765.33 $1,931.69 $2,522.65 |
$2,053.28 $2,210.30 $2,376.66 $2,967.62 |
Toc - Plan #24 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with MU Health Care Silver Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$553.39 $628.09 $707.22 $988.34 $1,501.88 |
$976.73 $1,051.43 $1,130.56 $1,411.68 |
$1,400.07 $1,474.77 $1,553.90 $1,835.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,106.78 $1,256.18 $1,414.44 $1,976.68 $3,003.76 |
$1,530.12 $1,679.52 $1,837.78 $2,400.02 |
$1,953.46 $2,102.86 $2,261.12 $2,823.36 |
Toc - Plan #25 Medica | ||||||||||||||||||||
Bronze
(EPO) Medica with MU Health Care Bronze Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.05 $447.24 $503.59 $703.76 $1,069.43 |
$695.49 $748.68 $805.03 $1,005.20 |
$996.93 $1,050.12 $1,106.47 $1,306.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.10 $894.48 $1,007.18 $1,407.52 $2,138.86 |
$1,089.54 $1,195.92 $1,308.62 $1,708.96 |
$1,390.98 $1,497.36 $1,610.06 $2,010.40 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #26 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.04 $477.88 $538.09 $751.98 $1,142.71 |
$743.14 $799.98 $860.19 $1,074.08 |
$1,065.24 $1,122.08 $1,182.29 $1,396.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.08 $955.76 $1,076.18 $1,503.96 $2,285.42 |
$1,164.18 $1,277.86 $1,398.28 $1,826.06 |
$1,486.28 $1,599.96 $1,720.38 $2,148.16 |
Toc - Plan #27 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 7150 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.58 $483.04 $543.89 $760.09 $1,155.03 |
$751.15 $808.61 $869.46 $1,085.66 |
$1,076.72 $1,134.18 $1,195.03 $1,411.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$851.16 $966.08 $1,087.78 $1,520.18 $2,310.06 |
$1,176.73 $1,291.65 $1,413.35 $1,845.75 |
$1,502.30 $1,617.22 $1,738.92 $2,171.32 |
Toc - Plan #28 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$660.54 $749.71 $844.17 $1,179.73 $1,792.71 |
$1,165.85 $1,255.02 $1,349.48 $1,685.04 |
$1,671.16 $1,760.33 $1,854.79 $2,190.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,321.08 $1,499.42 $1,688.34 $2,359.46 $3,585.42 |
$1,826.39 $2,004.73 $2,193.65 $2,864.77 |
$2,331.70 $2,510.04 $2,698.96 $3,370.08 |
Toc - Plan #29 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 5500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463.02 $525.53 $591.74 $826.96 $1,256.65 |
$817.23 $879.74 $945.95 $1,181.17 |
$1,171.44 $1,233.95 $1,300.16 $1,535.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$926.04 $1,051.06 $1,183.48 $1,653.92 $2,513.30 |
$1,280.25 $1,405.27 $1,537.69 $2,008.13 |
$1,634.46 $1,759.48 $1,891.90 $2,362.34 |
Toc - Plan #30 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6800 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.45 $480.62 $541.17 $756.29 $1,149.25 |
$747.39 $804.56 $865.11 $1,080.23 |
$1,071.33 $1,128.50 $1,189.05 $1,404.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846.90 $961.24 $1,082.34 $1,512.58 $2,298.50 |
$1,170.84 $1,285.18 $1,406.28 $1,836.52 |
$1,494.78 $1,609.12 $1,730.22 $2,160.46 |
Toc - Plan #31 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect HSA 7050 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.90 $481.13 $541.75 $757.09 $1,150.47 |
$748.18 $805.41 $866.03 $1,081.37 |
$1,072.46 $1,129.69 $1,190.31 $1,405.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.80 $962.26 $1,083.50 $1,514.18 $2,300.94 |
$1,172.08 $1,286.54 $1,407.78 $1,838.46 |
$1,496.36 $1,610.82 $1,732.06 $2,162.74 |
Toc - Plan #32 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Simple Choice 9100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403.78 $458.29 $516.03 $721.15 $1,095.86 |
$712.67 $767.18 $824.92 $1,030.04 |
$1,021.56 $1,076.07 $1,133.81 $1,338.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$807.56 $916.58 $1,032.06 $1,442.30 $2,191.72 |
$1,116.45 $1,225.47 $1,340.95 $1,751.19 |
$1,425.34 $1,534.36 $1,649.84 $2,060.08 |
Toc - Plan #33 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Simple Choice 5800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.79 $524.13 $590.17 $824.76 $1,253.30 |
$815.06 $877.40 $943.44 $1,178.03 |
$1,168.33 $1,230.67 $1,296.71 $1,531.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$923.58 $1,048.26 $1,180.34 $1,649.52 $2,506.60 |
$1,276.85 $1,401.53 $1,533.61 $2,002.79 |
$1,630.12 $1,754.80 $1,886.88 $2,356.06 |
Toc - Plan #34 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Simple Choice 2000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$658.13 $746.98 $841.09 $1,175.42 $1,786.17 |
$1,161.60 $1,250.45 $1,344.56 $1,678.89 |
$1,665.07 $1,753.92 $1,848.03 $2,182.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,316.26 $1,493.96 $1,682.18 $2,350.84 $3,572.34 |
$1,819.73 $1,997.43 $2,185.65 $2,854.31 |
$2,323.20 $2,500.90 $2,689.12 $3,357.78 |
ADVERTISEMENT
Ambetter from Home State HealthLocal: 1-855-650-3789 | Toll Free: 1-855-650-3789 | TTY: 1-855-650-3789 |
Toc - Plan #35 Ambetter from Home State Health | ||||||||||||||||||||
Bronze
(EPO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.76 $469.61 $528.77 $738.96 $1,122.92 |
$730.28 $786.13 $845.29 $1,055.48 |
$1,046.80 $1,102.65 $1,161.81 $1,372.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.52 $939.22 $1,057.54 $1,477.92 $2,245.84 |
$1,144.04 $1,255.74 $1,374.06 $1,794.44 |
$1,460.56 $1,572.26 $1,690.58 $2,110.96 |
Toc - Plan #36 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Premier Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$479.22 $543.91 $612.43 $855.87 $1,300.58 |
$845.82 $910.51 $979.03 $1,222.47 |
$1,212.42 $1,277.11 $1,345.63 $1,589.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$958.44 $1,087.82 $1,224.86 $1,711.74 $2,601.16 |
$1,325.04 $1,454.42 $1,591.46 $2,078.34 |
$1,691.64 $1,821.02 $1,958.06 $2,444.94 |
Toc - Plan #37 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$477.45 $541.89 $610.17 $852.71 $1,295.77 |
$842.69 $907.13 $975.41 $1,217.95 |
$1,207.93 $1,272.37 $1,340.65 $1,583.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$954.90 $1,083.78 $1,220.34 $1,705.42 $2,591.54 |
$1,320.14 $1,449.02 $1,585.58 $2,070.66 |
$1,685.38 $1,814.26 $1,950.82 $2,435.90 |
Toc - Plan #38 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$593.66 $673.79 $758.68 $1,060.25 $1,611.16 |
$1,047.80 $1,127.93 $1,212.82 $1,514.39 |
$1,501.94 $1,582.07 $1,666.96 $1,968.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,187.32 $1,347.58 $1,517.36 $2,120.50 $3,222.32 |
$1,641.46 $1,801.72 $1,971.50 $2,574.64 |
$2,095.60 $2,255.86 $2,425.64 $3,028.78 |
Toc - Plan #39 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.03 $508.50 $572.56 $800.16 $1,215.91 |
$790.76 $851.23 $915.29 $1,142.89 |
$1,133.49 $1,193.96 $1,258.02 $1,485.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$896.06 $1,017.00 $1,145.12 $1,600.32 $2,431.82 |
$1,238.79 $1,359.73 $1,487.85 $1,943.05 |
$1,581.52 $1,702.46 $1,830.58 $2,285.78 |
Toc - Plan #40 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.78 $516.17 $581.20 $812.22 $1,234.25 |
$802.68 $864.07 $929.10 $1,160.12 |
$1,150.58 $1,211.97 $1,277.00 $1,508.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.56 $1,032.34 $1,162.40 $1,624.44 $2,468.50 |
$1,257.46 $1,380.24 $1,510.30 $1,972.34 |
$1,605.36 $1,728.14 $1,858.20 $2,320.24 |
Toc - Plan #41 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$501.79 $569.52 $641.28 $896.18 $1,361.84 |
$885.65 $953.38 $1,025.14 $1,280.04 |
$1,269.51 $1,337.24 $1,409.00 $1,663.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,003.58 $1,139.04 $1,282.56 $1,792.36 $2,723.68 |
$1,387.44 $1,522.90 $1,666.42 $2,176.22 |
$1,771.30 $1,906.76 $2,050.28 $2,560.08 |
Toc - Plan #42 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.02 $524.38 $590.45 $825.15 $1,253.89 |
$815.46 $877.82 $943.89 $1,178.59 |
$1,168.90 $1,231.26 $1,297.33 $1,532.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$924.04 $1,048.76 $1,180.90 $1,650.30 $2,507.78 |
$1,277.48 $1,402.20 $1,534.34 $2,003.74 |
$1,630.92 $1,755.64 $1,887.78 $2,357.18 |
Toc - Plan #43 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$470.69 $534.22 $601.53 $840.64 $1,277.43 |
$830.76 $894.29 $961.60 $1,200.71 |
$1,190.83 $1,254.36 $1,321.67 $1,560.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$941.38 $1,068.44 $1,203.06 $1,681.28 $2,554.86 |
$1,301.45 $1,428.51 $1,563.13 $2,041.35 |
$1,661.52 $1,788.58 $1,923.20 $2,401.42 |
Toc - Plan #44 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$568.59 $645.34 $726.65 $1,015.49 $1,543.14 |
$1,003.56 $1,080.31 $1,161.62 $1,450.46 |
$1,438.53 $1,515.28 $1,596.59 $1,885.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,137.18 $1,290.68 $1,453.30 $2,030.98 $3,086.28 |
$1,572.15 $1,725.65 $1,888.27 $2,465.95 |
$2,007.12 $2,160.62 $2,323.24 $2,900.92 |
Toc - Plan #45 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$560.16 $635.77 $715.87 $1,000.43 $1,520.25 |
$988.68 $1,064.29 $1,144.39 $1,428.95 |
$1,417.20 $1,492.81 $1,572.91 $1,857.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,120.32 $1,271.54 $1,431.74 $2,000.86 $3,040.50 |
$1,548.84 $1,700.06 $1,860.26 $2,429.38 |
$1,977.36 $2,128.58 $2,288.78 $2,857.90 |
Toc - Plan #46 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$649.77 $737.48 $830.40 $1,160.48 $1,763.46 |
$1,146.84 $1,234.55 $1,327.47 $1,657.55 |
$1,643.91 $1,731.62 $1,824.54 $2,154.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,299.54 $1,474.96 $1,660.80 $2,320.96 $3,526.92 |
$1,796.61 $1,972.03 $2,157.87 $2,818.03 |
$2,293.68 $2,469.10 $2,654.94 $3,315.10 |
Toc - Plan #47 Ambetter from Home State Health | ||||||||||||||||||||
Bronze
(EPO) CMS Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.45 $447.69 $504.09 $704.47 $1,070.51 |
$696.20 $749.44 $805.84 $1,006.22 |
$997.95 $1,051.19 $1,107.59 $1,307.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.90 $895.38 $1,008.18 $1,408.94 $2,141.02 |
$1,090.65 $1,197.13 $1,309.93 $1,710.69 |
$1,392.40 $1,498.88 $1,611.68 $2,012.44 |
Toc - Plan #48 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.94 $492.51 $554.56 $774.99 $1,177.68 |
$765.89 $824.46 $886.51 $1,106.94 |
$1,097.84 $1,156.41 $1,218.46 $1,438.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$867.88 $985.02 $1,109.12 $1,549.98 $2,355.36 |
$1,199.83 $1,316.97 $1,441.07 $1,881.93 |
$1,531.78 $1,648.92 $1,773.02 $2,213.88 |
Toc - Plan #49 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.16 $523.40 $589.34 $823.61 $1,251.55 |
$813.94 $876.18 $942.12 $1,176.39 |
$1,166.72 $1,228.96 $1,294.90 $1,529.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.32 $1,046.80 $1,178.68 $1,647.22 $2,503.10 |
$1,275.10 $1,399.58 $1,531.46 $2,000.00 |
$1,627.88 $1,752.36 $1,884.24 $2,352.78 |
Toc - Plan #50 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$560.54 $636.21 $716.36 $1,001.11 $1,521.29 |
$989.35 $1,065.02 $1,145.17 $1,429.92 |
$1,418.16 $1,493.83 $1,573.98 $1,858.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,121.08 $1,272.42 $1,432.72 $2,002.22 $3,042.58 |
$1,549.89 $1,701.23 $1,861.53 $2,431.03 |
$1,978.70 $2,130.04 $2,290.34 $2,859.84 |
Toc - Plan #51 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$427.23 $484.90 $545.99 $763.02 $1,159.48 |
$754.05 $811.72 $872.81 $1,089.84 |
$1,080.87 $1,138.54 $1,199.63 $1,416.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$854.46 $969.80 $1,091.98 $1,526.04 $2,318.96 |
$1,181.28 $1,296.62 $1,418.80 $1,852.86 |
$1,508.10 $1,623.44 $1,745.62 $2,179.68 |
Toc - Plan #52 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.61 $525.05 $591.20 $826.21 $1,255.50 |
$816.50 $878.94 $945.09 $1,180.10 |
$1,170.39 $1,232.83 $1,298.98 $1,533.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$925.22 $1,050.10 $1,182.40 $1,652.42 $2,511.00 |
$1,279.11 $1,403.99 $1,536.29 $2,006.31 |
$1,633.00 $1,757.88 $1,890.18 $2,360.20 |
Toc - Plan #53 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$612.98 $695.73 $783.38 $1,094.77 $1,663.61 |
$1,081.91 $1,164.66 $1,252.31 $1,563.70 |
$1,550.84 $1,633.59 $1,721.24 $2,032.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,225.96 $1,391.46 $1,566.76 $2,189.54 $3,327.22 |
$1,694.89 $1,860.39 $2,035.69 $2,658.47 |
$2,163.82 $2,329.32 $2,504.62 $3,127.40 |
Toc - Plan #54 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$492.99 $559.54 $630.03 $880.47 $1,337.95 |
$870.12 $936.67 $1,007.16 $1,257.60 |
$1,247.25 $1,313.80 $1,384.29 $1,634.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$985.98 $1,119.08 $1,260.06 $1,760.94 $2,675.90 |
$1,363.11 $1,496.21 $1,637.19 $2,138.07 |
$1,740.24 $1,873.34 $2,014.32 $2,515.20 |
Toc - Plan #55 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Premier Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$494.82 $561.61 $632.37 $883.74 $1,342.92 |
$873.35 $940.14 $1,010.90 $1,262.27 |
$1,251.88 $1,318.67 $1,389.43 $1,640.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$989.64 $1,123.22 $1,264.74 $1,767.48 $2,685.84 |
$1,368.17 $1,501.75 $1,643.27 $2,146.01 |
$1,746.70 $1,880.28 $2,021.80 $2,524.54 |
Toc - Plan #56 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$469.59 $532.97 $600.12 $838.67 $1,274.43 |
$828.82 $892.20 $959.35 $1,197.90 |
$1,188.05 $1,251.43 $1,318.58 $1,557.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$939.18 $1,065.94 $1,200.24 $1,677.34 $2,548.86 |
$1,298.41 $1,425.17 $1,559.47 $2,036.57 |
$1,657.64 $1,784.40 $1,918.70 $2,395.80 |
Toc - Plan #57 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$518.13 $588.06 $662.16 $925.36 $1,406.17 |
$914.49 $984.42 $1,058.52 $1,321.72 |
$1,310.85 $1,380.78 $1,454.88 $1,718.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,036.26 $1,176.12 $1,324.32 $1,850.72 $2,812.34 |
$1,432.62 $1,572.48 $1,720.68 $2,247.08 |
$1,828.98 $1,968.84 $2,117.04 $2,643.44 |
Toc - Plan #58 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$486.02 $551.62 $621.12 $868.01 $1,319.02 |
$857.81 $923.41 $992.91 $1,239.80 |
$1,229.60 $1,295.20 $1,364.70 $1,611.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$972.04 $1,103.24 $1,242.24 $1,736.02 $2,638.04 |
$1,343.83 $1,475.03 $1,614.03 $2,107.81 |
$1,715.62 $1,846.82 $1,985.82 $2,479.60 |
Toc - Plan #59 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$587.11 $666.35 $750.31 $1,048.55 $1,593.38 |
$1,036.24 $1,115.48 $1,199.44 $1,497.68 |
$1,485.37 $1,564.61 $1,648.57 $1,946.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,174.22 $1,332.70 $1,500.62 $2,097.10 $3,186.76 |
$1,623.35 $1,781.83 $1,949.75 $2,546.23 |
$2,072.48 $2,230.96 $2,398.88 $2,995.36 |
Toc - Plan #60 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$477.06 $541.45 $609.67 $852.01 $1,294.71 |
$842.00 $906.39 $974.61 $1,216.95 |
$1,206.94 $1,271.33 $1,339.55 $1,581.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$954.12 $1,082.90 $1,219.34 $1,704.02 $2,589.42 |
$1,319.06 $1,447.84 $1,584.28 $2,068.96 |
$1,684.00 $1,812.78 $1,949.22 $2,433.90 |
Toc - Plan #61 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$578.40 $656.47 $739.18 $1,033.00 $1,569.74 |
$1,020.87 $1,098.94 $1,181.65 $1,475.47 |
$1,463.34 $1,541.41 $1,624.12 $1,917.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,156.80 $1,312.94 $1,478.36 $2,066.00 $3,139.48 |
$1,599.27 $1,755.41 $1,920.83 $2,508.47 |
$2,041.74 $2,197.88 $2,363.30 $2,950.94 |
Toc - Plan #62 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$670.93 $761.49 $857.43 $1,198.26 $1,820.87 |
$1,184.18 $1,274.74 $1,370.68 $1,711.51 |
$1,697.43 $1,787.99 $1,883.93 $2,224.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,341.86 $1,522.98 $1,714.86 $2,396.52 $3,641.74 |
$1,855.11 $2,036.23 $2,228.11 $2,909.77 |
$2,368.36 $2,549.48 $2,741.36 $3,423.02 |
Toc - Plan #63 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Virtual Access Bronze - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.66 $494.46 $556.76 $778.07 $1,182.36 |
$768.93 $827.73 $890.03 $1,111.34 |
$1,102.20 $1,161.00 $1,223.30 $1,444.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$871.32 $988.92 $1,113.52 $1,556.14 $2,364.72 |
$1,204.59 $1,322.19 $1,446.79 $1,889.41 |
$1,537.86 $1,655.46 $1,780.06 $2,222.68 |
Toc - Plan #64 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Ambetter Virtual Access Silver - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$460.25 $522.37 $588.18 $821.98 $1,249.08 |
$812.33 $874.45 $940.26 $1,174.06 |
$1,164.41 $1,226.53 $1,292.34 $1,526.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$920.50 $1,044.74 $1,176.36 $1,643.96 $2,498.16 |
$1,272.58 $1,396.82 $1,528.44 $1,996.04 |
$1,624.66 $1,748.90 $1,880.52 $2,348.12 |
Toc - Plan #65 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Ambetter Virtual Access Gold- Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$572.96 $650.29 $732.22 $1,023.28 $1,554.97 |
$1,011.26 $1,088.59 $1,170.52 $1,461.58 |
$1,449.56 $1,526.89 $1,608.82 $1,899.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,145.92 $1,300.58 $1,464.44 $2,046.56 $3,109.94 |
$1,584.22 $1,738.88 $1,902.74 $2,484.86 |
$2,022.52 $2,177.18 $2,341.04 $2,923.16 |
Toc - Plan #66 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) CMS Standard Virtual Access Basic Bronze ? Virtual PCP Selection Required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$451.28 $512.20 $576.73 $805.98 $1,224.76 |
$796.50 $857.42 $921.95 $1,151.20 |
$1,141.72 $1,202.64 $1,267.17 $1,496.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$902.56 $1,024.40 $1,153.46 $1,611.96 $2,449.52 |
$1,247.78 $1,369.62 $1,498.68 $1,957.18 |
$1,593.00 $1,714.84 $1,843.90 $2,302.40 |
Toc - Plan #67 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) CMS Standard Virtual Access Basic Silver ? Virtual PCP Selection Required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$479.61 $544.34 $612.92 $856.56 $1,301.62 |
$846.50 $911.23 $979.81 $1,223.45 |
$1,213.39 $1,278.12 $1,346.70 $1,590.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$959.22 $1,088.68 $1,225.84 $1,713.12 $2,603.24 |
$1,326.11 $1,455.57 $1,592.73 $2,080.01 |
$1,693.00 $1,822.46 $1,959.62 $2,446.90 |
Toc - Plan #68 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) CMS Standard Virtual Access Basic Gold ? Virtual PCP Selection Required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$582.97 $661.66 $745.02 $1,041.17 $1,582.16 |
$1,028.94 $1,107.63 $1,190.99 $1,487.14 |
$1,474.91 $1,553.60 $1,636.96 $1,933.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,165.94 $1,323.32 $1,490.04 $2,082.34 $3,164.32 |
$1,611.91 $1,769.29 $1,936.01 $2,528.31 |
$2,057.88 $2,215.26 $2,381.98 $2,974.28 |
‡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 Boone County here.
Boone County is in “Rating Area 5” of Missouri.
Currently, there are 68 plans offered in Rating Area 5.