Obamacare 2023 Rates for Hamilton County
Obamacare > Rates > Nebraska > Hamilton County
ADVERTISEMENT
Obamacare > Rates > Nebraska > Hamilton County
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-833-7352 |
Toc - Plan #1 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Bronze Copay ($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 |
$474.97 $539.07 $606.99 $848.27 $1,289.03 |
$838.31 $902.41 $970.33 $1,211.61 |
$1,201.65 $1,265.75 $1,333.67 $1,574.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$949.94 $1,078.14 $1,213.98 $1,696.54 $2,578.06 |
$1,313.28 $1,441.48 $1,577.32 $2,059.88 |
$1,676.62 $1,804.82 $1,940.66 $2,423.22 |
Toc - Plan #2 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Bronze Copay + Dental Reimbursement ($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 |
$499.19 $566.57 $637.95 $891.53 $1,354.77 |
$881.06 $948.44 $1,019.82 $1,273.40 |
$1,262.93 $1,330.31 $1,401.69 $1,655.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$998.38 $1,133.14 $1,275.90 $1,783.06 $2,709.54 |
$1,380.25 $1,515.01 $1,657.77 $2,164.93 |
$1,762.12 $1,896.88 $2,039.64 $2,546.80 |
Toc - Plan #3 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Bronze HSA ($0 Virtual Care after Deductible 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 |
$556.11 $631.17 $710.70 $993.20 $1,509.26 |
$981.53 $1,056.59 $1,136.12 $1,418.62 |
$1,406.95 $1,482.01 $1,561.54 $1,844.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,112.22 $1,262.34 $1,421.40 $1,986.40 $3,018.52 |
$1,537.64 $1,687.76 $1,846.82 $2,411.82 |
$1,963.06 $2,113.18 $2,272.24 $2,837.24 |
Toc - Plan #4 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Medica Insure Catastrophic ($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 |
$353.18 $400.85 $451.36 $630.77 $958.52 |
$623.36 $671.03 $721.54 $900.95 |
$893.54 $941.21 $991.72 $1,171.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.36 $801.70 $902.72 $1,261.54 $1,917.04 |
$976.54 $1,071.88 $1,172.90 $1,531.72 |
$1,246.72 $1,342.06 $1,443.08 $1,801.90 |
Toc - Plan #5 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Insure Gold Share ($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 |
$638.49 $724.68 $815.98 $1,140.33 $1,732.84 |
$1,126.93 $1,213.12 $1,304.42 $1,628.77 |
$1,615.37 $1,701.56 $1,792.86 $2,117.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,276.98 $1,449.36 $1,631.96 $2,280.66 $3,465.68 |
$1,765.42 $1,937.80 $2,120.40 $2,769.10 |
$2,253.86 $2,426.24 $2,608.84 $3,257.54 |
Toc - Plan #6 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Insure Silver Share ($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 |
$660.96 $750.18 $844.70 $1,180.46 $1,793.82 |
$1,166.59 $1,255.81 $1,350.33 $1,686.09 |
$1,672.22 $1,761.44 $1,855.96 $2,191.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,321.92 $1,500.36 $1,689.40 $2,360.92 $3,587.64 |
$1,827.55 $2,005.99 $2,195.03 $2,866.55 |
$2,333.18 $2,511.62 $2,700.66 $3,372.18 |
Toc - Plan #7 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Bronze Share Plus ($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 |
$486.36 $552.01 $621.56 $868.62 $1,319.96 |
$858.42 $924.07 $993.62 $1,240.68 |
$1,230.48 $1,296.13 $1,365.68 $1,612.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$972.72 $1,104.02 $1,243.12 $1,737.24 $2,639.92 |
$1,344.78 $1,476.08 $1,615.18 $2,109.30 |
$1,716.84 $1,848.14 $1,987.24 $2,481.36 |
Toc - Plan #8 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Bronze Copay $0 PCP Office Visits ($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 |
$483.76 $549.05 $618.23 $863.97 $1,312.89 |
$853.83 $919.12 $988.30 $1,234.04 |
$1,223.90 $1,289.19 $1,358.37 $1,604.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$967.52 $1,098.10 $1,236.46 $1,727.94 $2,625.78 |
$1,337.59 $1,468.17 $1,606.53 $2,098.01 |
$1,707.66 $1,838.24 $1,976.60 $2,468.08 |
Toc - Plan #9 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure 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 |
$480.96 $545.87 $614.65 $858.97 $1,305.29 |
$848.88 $913.79 $982.57 $1,226.89 |
$1,216.80 $1,281.71 $1,350.49 $1,594.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$961.92 $1,091.74 $1,229.30 $1,717.94 $2,610.58 |
$1,329.84 $1,459.66 $1,597.22 $2,085.86 |
$1,697.76 $1,827.58 $1,965.14 $2,453.78 |
Toc - Plan #10 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Insure 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 |
$658.62 $747.52 $841.70 $1,176.27 $1,787.46 |
$1,162.45 $1,251.35 $1,345.53 $1,680.10 |
$1,666.28 $1,755.18 $1,849.36 $2,183.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,317.24 $1,495.04 $1,683.40 $2,352.54 $3,574.92 |
$1,821.07 $1,998.87 $2,187.23 $2,856.37 |
$2,324.90 $2,502.70 $2,691.06 $3,360.20 |
Toc - Plan #11 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Insure 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 |
$633.28 $718.77 $809.32 $1,131.03 $1,718.70 |
$1,117.73 $1,203.22 $1,293.77 $1,615.48 |
$1,602.18 $1,687.67 $1,778.22 $2,099.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,266.56 $1,437.54 $1,618.64 $2,262.06 $3,437.40 |
$1,751.01 $1,921.99 $2,103.09 $2,746.51 |
$2,235.46 $2,406.44 $2,587.54 $3,230.96 |
Toc - Plan #12 Medica | ||||||||||||||||||||
Bronze
(EPO) Medica Insure 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 |
$468.19 $531.39 $598.34 $836.17 $1,270.65 |
$826.35 $889.55 $956.50 $1,194.33 |
$1,184.51 $1,247.71 $1,314.66 $1,552.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$936.38 $1,062.78 $1,196.68 $1,672.34 $2,541.30 |
$1,294.54 $1,420.94 $1,554.84 $2,030.50 |
$1,652.70 $1,779.10 $1,913.00 $2,388.66 |
Toc - Plan #13 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Insure Gold HSA ($0 Virtual Care after Deductible 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 |
$784.31 $890.18 $1,002.33 $1,400.76 $2,128.58 |
$1,384.30 $1,490.17 $1,602.32 $2,000.75 |
$1,984.29 $2,090.16 $2,202.31 $2,600.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,568.62 $1,780.36 $2,004.66 $2,801.52 $4,257.16 |
$2,168.61 $2,380.35 $2,604.65 $3,401.51 |
$2,768.60 $2,980.34 $3,204.64 $4,001.50 |
Toc - Plan #14 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Copay ($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 |
$363.82 $412.92 $464.94 $649.76 $987.37 |
$642.13 $691.23 $743.25 $928.07 |
$920.44 $969.54 $1,021.56 $1,206.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.64 $825.84 $929.88 $1,299.52 $1,974.74 |
$1,005.95 $1,104.15 $1,208.19 $1,577.83 |
$1,284.26 $1,382.46 $1,486.50 $1,856.14 |
Toc - Plan #15 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Copay + Dental Reimbursement ($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 |
$382.37 $433.98 $488.66 $682.89 $1,037.72 |
$674.87 $726.48 $781.16 $975.39 |
$967.37 $1,018.98 $1,073.66 $1,267.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.74 $867.96 $977.32 $1,365.78 $2,075.44 |
$1,057.24 $1,160.46 $1,269.82 $1,658.28 |
$1,349.74 $1,452.96 $1,562.32 $1,950.78 |
Toc - Plan #16 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze HSA ($0 Virtual Care after Deductible 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 |
$425.97 $483.47 $544.38 $760.77 $1,156.06 |
$751.83 $809.33 $870.24 $1,086.63 |
$1,077.69 $1,135.19 $1,196.10 $1,412.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$851.94 $966.94 $1,088.76 $1,521.54 $2,312.12 |
$1,177.80 $1,292.80 $1,414.62 $1,847.40 |
$1,503.66 $1,618.66 $1,740.48 $2,173.26 |
Toc - Plan #17 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Medica with CHI Health Catastrophic ($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 |
$270.53 $307.04 $345.73 $483.16 $734.20 |
$477.48 $513.99 $552.68 $690.11 |
$684.43 $720.94 $759.63 $897.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$541.06 $614.08 $691.46 $966.32 $1,468.40 |
$748.01 $821.03 $898.41 $1,173.27 |
$954.96 $1,027.98 $1,105.36 $1,380.22 |
Toc - Plan #18 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with CHI Health Silver Share ($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 |
$506.28 $574.62 $647.02 $904.21 $1,374.03 |
$893.58 $961.92 $1,034.32 $1,291.51 |
$1,280.88 $1,349.22 $1,421.62 $1,678.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,012.56 $1,149.24 $1,294.04 $1,808.42 $2,748.06 |
$1,399.86 $1,536.54 $1,681.34 $2,195.72 |
$1,787.16 $1,923.84 $2,068.64 $2,583.02 |
Toc - Plan #19 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Share Plus ($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 |
$372.54 $422.83 $476.10 $665.35 $1,011.06 |
$657.53 $707.82 $761.09 $950.34 |
$942.52 $992.81 $1,046.08 $1,235.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.08 $845.66 $952.20 $1,330.70 $2,022.12 |
$1,030.07 $1,130.65 $1,237.19 $1,615.69 |
$1,315.06 $1,415.64 $1,522.18 $1,900.68 |
Toc - Plan #20 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Copay $0 PCP Office Visits ($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 |
$370.55 $420.56 $473.55 $661.78 $1,005.64 |
$654.01 $704.02 $757.01 $945.24 |
$937.47 $987.48 $1,040.47 $1,228.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.10 $841.12 $947.10 $1,323.56 $2,011.28 |
$1,024.56 $1,124.58 $1,230.56 $1,607.02 |
$1,308.02 $1,408.04 $1,514.02 $1,890.48 |
Toc - Plan #21 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with CHI Health Gold Copay $0 PCP Office Visits ($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 |
$508.33 $576.94 $649.63 $907.86 $1,379.58 |
$897.19 $965.80 $1,038.49 $1,296.72 |
$1,286.05 $1,354.66 $1,427.35 $1,685.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,016.66 $1,153.88 $1,299.26 $1,815.72 $2,759.16 |
$1,405.52 $1,542.74 $1,688.12 $2,204.58 |
$1,794.38 $1,931.60 $2,076.98 $2,593.44 |
Toc - Plan #22 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health 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 |
$368.40 $418.13 $470.81 $657.95 $999.82 |
$650.22 $699.95 $752.63 $939.77 |
$932.04 $981.77 $1,034.45 $1,221.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.80 $836.26 $941.62 $1,315.90 $1,999.64 |
$1,018.62 $1,118.08 $1,223.44 $1,597.72 |
$1,300.44 $1,399.90 $1,505.26 $1,879.54 |
Toc - Plan #23 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with CHI Health Silver Enhanced ($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 |
$521.90 $592.34 $666.97 $932.09 $1,416.40 |
$921.14 $991.58 $1,066.21 $1,331.33 |
$1,320.38 $1,390.82 $1,465.45 $1,730.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,043.80 $1,184.68 $1,333.94 $1,864.18 $2,832.80 |
$1,443.04 $1,583.92 $1,733.18 $2,263.42 |
$1,842.28 $1,983.16 $2,132.42 $2,662.66 |
Toc - Plan #24 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with CHI Health 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 |
$504.49 $572.58 $644.72 $901.00 $1,369.15 |
$890.42 $958.51 $1,030.65 $1,286.93 |
$1,276.35 $1,344.44 $1,416.58 $1,672.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,008.98 $1,145.16 $1,289.44 $1,802.00 $2,738.30 |
$1,394.91 $1,531.09 $1,675.37 $2,187.93 |
$1,780.84 $1,917.02 $2,061.30 $2,573.86 |
Toc - Plan #25 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with CHI Health 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 |
$485.08 $550.56 $619.92 $866.34 $1,316.49 |
$856.16 $921.64 $991.00 $1,237.42 |
$1,227.24 $1,292.72 $1,362.08 $1,608.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$970.16 $1,101.12 $1,239.84 $1,732.68 $2,632.98 |
$1,341.24 $1,472.20 $1,610.92 $2,103.76 |
$1,712.32 $1,843.28 $1,982.00 $2,474.84 |
Toc - Plan #26 Medica | ||||||||||||||||||||
Bronze
(EPO) Medica with CHI Health 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 |
$358.63 $407.03 $458.31 $640.49 $973.29 |
$632.97 $681.37 $732.65 $914.83 |
$907.31 $955.71 $1,006.99 $1,189.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$717.26 $814.06 $916.62 $1,280.98 $1,946.58 |
$991.60 $1,088.40 $1,190.96 $1,555.32 |
$1,265.94 $1,362.74 $1,465.30 $1,829.66 |
ADVERTISEMENT
Ambetter from Nebraska Total CareLocal: 1-833-890-0329 | Toll Free: 1-833-890-0329 | TTY: 1-833-890-0329 |
Toc - Plan #27 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.93 $409.65 $461.26 $644.61 $979.54 |
$637.04 $685.76 $737.37 $920.72 |
$913.15 $961.87 $1,013.48 $1,196.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.86 $819.30 $922.52 $1,289.22 $1,959.08 |
$997.97 $1,095.41 $1,198.63 $1,565.33 |
$1,274.08 $1,371.52 $1,474.74 $1,841.44 |
Toc - Plan #28 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.22 $399.75 $450.12 $629.04 $955.89 |
$621.66 $669.19 $719.56 $898.48 |
$891.10 $938.63 $989.00 $1,167.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.44 $799.50 $900.24 $1,258.08 $1,911.78 |
$973.88 $1,068.94 $1,169.68 $1,527.52 |
$1,243.32 $1,338.38 $1,439.12 $1,796.96 |
Toc - Plan #29 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.81 $448.10 $504.56 $705.11 $1,071.49 |
$696.83 $750.12 $806.58 $1,007.13 |
$998.85 $1,052.14 $1,108.60 $1,309.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.62 $896.20 $1,009.12 $1,410.22 $2,142.98 |
$1,091.64 $1,198.22 $1,311.14 $1,712.24 |
$1,393.66 $1,500.24 $1,613.16 $2,014.26 |
Toc - Plan #30 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$427.24 $484.90 $546.00 $763.03 $1,159.49 |
$754.07 $811.73 $872.83 $1,089.86 |
$1,080.90 $1,138.56 $1,199.66 $1,416.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$854.48 $969.80 $1,092.00 $1,526.06 $2,318.98 |
$1,181.31 $1,296.63 $1,418.83 $1,852.89 |
$1,508.14 $1,623.46 $1,745.66 $2,179.72 |
Toc - Plan #31 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Everyday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.22 $480.34 $540.86 $755.86 $1,148.60 |
$746.98 $804.10 $864.62 $1,079.62 |
$1,070.74 $1,127.86 $1,188.38 $1,403.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846.44 $960.68 $1,081.72 $1,511.72 $2,297.20 |
$1,170.20 $1,284.44 $1,405.48 $1,835.48 |
$1,493.96 $1,608.20 $1,729.24 $2,159.24 |
Toc - Plan #32 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463.72 $526.31 $592.62 $828.19 $1,258.52 |
$818.46 $881.05 $947.36 $1,182.93 |
$1,173.20 $1,235.79 $1,302.10 $1,537.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$927.44 $1,052.62 $1,185.24 $1,656.38 $2,517.04 |
$1,282.18 $1,407.36 $1,539.98 $2,011.12 |
$1,636.92 $1,762.10 $1,894.72 $2,365.86 |
Toc - Plan #33 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Bronze
(HMO) CMS Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.96 $357.47 $402.51 $562.50 $854.78 |
$555.90 $598.41 $643.45 $803.44 |
$796.84 $839.35 $884.39 $1,044.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$629.92 $714.94 $805.02 $1,125.00 $1,709.56 |
$870.86 $955.88 $1,045.96 $1,365.94 |
$1,111.80 $1,196.82 $1,286.90 $1,606.88 |
Toc - Plan #34 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$510.55 $579.46 $652.47 $911.82 $1,385.60 |
$901.11 $970.02 $1,043.03 $1,302.38 |
$1,291.67 $1,360.58 $1,433.59 $1,692.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,021.10 $1,158.92 $1,304.94 $1,823.64 $2,771.20 |
$1,411.66 $1,549.48 $1,695.50 $2,214.20 |
$1,802.22 $1,940.04 $2,086.06 $2,604.76 |
Toc - Plan #35 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.04 $391.61 $440.95 $616.22 $936.41 |
$608.99 $655.56 $704.90 $880.17 |
$872.94 $919.51 $968.85 $1,144.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.08 $783.22 $881.90 $1,232.44 $1,872.82 |
$954.03 $1,047.17 $1,145.85 $1,496.39 |
$1,217.98 $1,311.12 $1,409.80 $1,760.34 |
Toc - Plan #36 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.41 $473.75 $533.44 $745.48 $1,132.83 |
$736.72 $793.06 $852.75 $1,064.79 |
$1,056.03 $1,112.37 $1,172.06 $1,384.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$834.82 $947.50 $1,066.88 $1,490.96 $2,265.66 |
$1,154.13 $1,266.81 $1,386.19 $1,810.27 |
$1,473.44 $1,586.12 $1,705.50 $2,129.58 |
Toc - Plan #37 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.41 $498.72 $561.56 $784.77 $1,192.54 |
$775.55 $834.86 $897.70 $1,120.91 |
$1,111.69 $1,171.00 $1,233.84 $1,457.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.82 $997.44 $1,123.12 $1,569.54 $2,385.08 |
$1,214.96 $1,333.58 $1,459.26 $1,905.68 |
$1,551.10 $1,669.72 $1,795.40 $2,241.82 |
Toc - Plan #38 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.53 $374.01 $421.13 $588.52 $894.32 |
$581.61 $626.09 $673.21 $840.60 |
$833.69 $878.17 $925.29 $1,092.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$659.06 $748.02 $842.26 $1,177.04 $1,788.64 |
$911.14 $1,000.10 $1,094.34 $1,429.12 |
$1,163.22 $1,252.18 $1,346.42 $1,681.20 |
Toc - Plan #39 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.72 $476.37 $536.39 $749.60 $1,139.09 |
$740.80 $797.45 $857.47 $1,070.68 |
$1,061.88 $1,118.53 $1,178.55 $1,391.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.44 $952.74 $1,072.78 $1,499.20 $2,278.18 |
$1,160.52 $1,273.82 $1,393.86 $1,820.28 |
$1,481.60 $1,594.90 $1,714.94 $2,141.36 |
Toc - Plan #40 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.73 $478.65 $538.95 $753.18 $1,144.54 |
$744.34 $801.26 $861.56 $1,075.79 |
$1,066.95 $1,123.87 $1,184.17 $1,398.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$843.46 $957.30 $1,077.90 $1,506.36 $2,289.08 |
$1,166.07 $1,279.91 $1,400.51 $1,828.97 |
$1,488.68 $1,602.52 $1,723.12 $2,151.58 |
Toc - Plan #41 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.58 $504.59 $568.16 $794.01 $1,206.57 |
$784.68 $844.69 $908.26 $1,134.11 |
$1,124.78 $1,184.79 $1,248.36 $1,474.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$889.16 $1,009.18 $1,136.32 $1,588.02 $2,413.14 |
$1,229.26 $1,349.28 $1,476.42 $1,928.12 |
$1,569.36 $1,689.38 $1,816.52 $2,268.22 |
Toc - Plan #42 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.07 $498.33 $561.12 $784.16 $1,191.61 |
$774.95 $834.21 $897.00 $1,120.04 |
$1,110.83 $1,170.09 $1,232.88 $1,455.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.14 $996.66 $1,122.24 $1,568.32 $2,383.22 |
$1,214.02 $1,332.54 $1,458.12 $1,904.20 |
$1,549.90 $1,668.42 $1,794.00 $2,240.08 |
Toc - Plan #43 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.75 $426.46 $480.19 $671.07 $1,019.75 |
$663.19 $713.90 $767.63 $958.51 |
$950.63 $1,001.34 $1,055.07 $1,245.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.50 $852.92 $960.38 $1,342.14 $2,039.50 |
$1,038.94 $1,140.36 $1,247.82 $1,629.58 |
$1,326.38 $1,427.80 $1,535.26 $1,917.02 |
Toc - Plan #44 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.67 $416.16 $468.60 $654.86 $995.12 |
$647.17 $696.66 $749.10 $935.36 |
$927.67 $977.16 $1,029.60 $1,215.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.34 $832.32 $937.20 $1,309.72 $1,990.24 |
$1,013.84 $1,112.82 $1,217.70 $1,590.22 |
$1,294.34 $1,393.32 $1,498.20 $1,870.72 |
Toc - Plan #45 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.02 $466.49 $525.27 $734.06 $1,115.47 |
$725.44 $780.91 $839.69 $1,048.48 |
$1,039.86 $1,095.33 $1,154.11 $1,362.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.04 $932.98 $1,050.54 $1,468.12 $2,230.94 |
$1,136.46 $1,247.40 $1,364.96 $1,782.54 |
$1,450.88 $1,561.82 $1,679.38 $2,096.96 |
Toc - Plan #46 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.77 $504.81 $568.41 $794.35 $1,207.09 |
$785.01 $845.05 $908.65 $1,134.59 |
$1,125.25 $1,185.29 $1,248.89 $1,474.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$889.54 $1,009.62 $1,136.82 $1,588.70 $2,414.18 |
$1,229.78 $1,349.86 $1,477.06 $1,928.94 |
$1,570.02 $1,690.10 $1,817.30 $2,269.18 |
Toc - Plan #47 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$482.76 $547.92 $616.95 $862.19 $1,310.17 |
$852.06 $917.22 $986.25 $1,231.49 |
$1,221.36 $1,286.52 $1,355.55 $1,600.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$965.52 $1,095.84 $1,233.90 $1,724.38 $2,620.34 |
$1,334.82 $1,465.14 $1,603.20 $2,093.68 |
$1,704.12 $1,834.44 $1,972.50 $2,462.98 |
Toc - Plan #48 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$531.50 $603.24 $679.25 $949.25 $1,442.47 |
$938.09 $1,009.83 $1,085.84 $1,355.84 |
$1,344.68 $1,416.42 $1,492.43 $1,762.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,063.00 $1,206.48 $1,358.50 $1,898.50 $2,884.94 |
$1,469.59 $1,613.07 $1,765.09 $2,305.09 |
$1,876.18 $2,019.66 $2,171.68 $2,711.68 |
Toc - Plan #49 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Everyday Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.59 $500.06 $563.07 $786.88 $1,195.74 |
$777.64 $837.11 $900.12 $1,123.93 |
$1,114.69 $1,174.16 $1,237.17 $1,460.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$881.18 $1,000.12 $1,126.14 $1,573.76 $2,391.48 |
$1,218.23 $1,337.17 $1,463.19 $1,910.81 |
$1,555.28 $1,674.22 $1,800.24 $2,247.86 |
Toc - Plan #50 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.06 $389.36 $438.41 $612.68 $931.03 |
$605.49 $651.79 $700.84 $875.11 |
$867.92 $914.22 $963.27 $1,137.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.12 $778.72 $876.82 $1,225.36 $1,862.06 |
$948.55 $1,041.15 $1,139.25 $1,487.79 |
$1,210.98 $1,303.58 $1,401.68 $1,750.22 |
Toc - Plan #51 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.95 $495.92 $558.40 $780.37 $1,185.84 |
$771.21 $830.18 $892.66 $1,114.63 |
$1,105.47 $1,164.44 $1,226.92 $1,448.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$873.90 $991.84 $1,116.80 $1,560.74 $2,371.68 |
$1,208.16 $1,326.10 $1,451.06 $1,895.00 |
$1,542.42 $1,660.36 $1,785.32 $2,229.26 |
Toc - Plan #52 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.04 $498.30 $561.08 $784.10 $1,191.52 |
$774.90 $834.16 $896.94 $1,119.96 |
$1,110.76 $1,170.02 $1,232.80 $1,455.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.08 $996.60 $1,122.16 $1,568.20 $2,383.04 |
$1,213.94 $1,332.46 $1,458.02 $1,904.06 |
$1,549.80 $1,668.32 $1,793.88 $2,239.92 |
Toc - Plan #53 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.83 $525.30 $591.49 $826.60 $1,256.10 |
$816.89 $879.36 $945.55 $1,180.66 |
$1,170.95 $1,233.42 $1,299.61 $1,534.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$925.66 $1,050.60 $1,182.98 $1,653.20 $2,512.20 |
$1,279.72 $1,404.66 $1,537.04 $2,007.26 |
$1,633.78 $1,758.72 $1,891.10 $2,361.32 |
Toc - Plan #54 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$457.09 $518.79 $584.15 $816.35 $1,240.53 |
$806.76 $868.46 $933.82 $1,166.02 |
$1,156.43 $1,218.13 $1,283.49 $1,515.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$914.18 $1,037.58 $1,168.30 $1,632.70 $2,481.06 |
$1,263.85 $1,387.25 $1,517.97 $1,982.37 |
$1,613.52 $1,736.92 $1,867.64 $2,332.04 |
Toc - Plan #55 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Virtual Access Bronze - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.03 $395.00 $444.77 $621.56 $944.52 |
$614.26 $661.23 $711.00 $887.79 |
$880.49 $927.46 $977.23 $1,154.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.06 $790.00 $889.54 $1,243.12 $1,889.04 |
$962.29 $1,056.23 $1,155.77 $1,509.35 |
$1,228.52 $1,322.46 $1,422.00 $1,775.58 |
Toc - Plan #56 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.84 $474.24 $533.98 $746.24 $1,133.99 |
$737.48 $793.88 $853.62 $1,065.88 |
$1,057.12 $1,113.52 $1,173.26 $1,385.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.68 $948.48 $1,067.96 $1,492.48 $2,267.98 |
$1,155.32 $1,268.12 $1,387.60 $1,812.12 |
$1,474.96 $1,587.76 $1,707.24 $2,131.76 |
Toc - Plan #57 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$456.63 $518.26 $583.56 $815.52 $1,239.27 |
$805.94 $867.57 $932.87 $1,164.83 |
$1,155.25 $1,216.88 $1,282.18 $1,514.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$913.26 $1,036.52 $1,167.12 $1,631.04 $2,478.54 |
$1,262.57 $1,385.83 $1,516.43 $1,980.35 |
$1,611.88 $1,735.14 $1,865.74 $2,329.66 |
ADVERTISEMENT
Blue Cross and Blue Shield of NebraskaLocal: 1-888-592-8960 | Toll Free: 1-888-592-8960 | TTY: 1-800-821-4791 |
Toc - Plan #58 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) Nebraska HeartlandBlue Bronze HSA 6000 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$486.62 $552.31 $621.90 $869.10 $1,320.68 |
$858.88 $924.57 $994.16 $1,241.36 |
$1,231.14 $1,296.83 $1,366.42 $1,613.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$973.24 $1,104.62 $1,243.80 $1,738.20 $2,641.36 |
$1,345.50 $1,476.88 $1,616.06 $2,110.46 |
$1,717.76 $1,849.14 $1,988.32 $2,482.72 |
Toc - Plan #59 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Bronze
(EPO) Nebraska HeartlandBlue Bronze 0% Coinsurance 9100 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.44 $503.31 $566.72 $791.99 $1,203.50 |
$782.67 $842.54 $905.95 $1,131.22 |
$1,121.90 $1,181.77 $1,245.18 $1,470.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$886.88 $1,006.62 $1,133.44 $1,583.98 $2,407.00 |
$1,226.11 $1,345.85 $1,472.67 $1,923.21 |
$1,565.34 $1,685.08 $1,811.90 $2,262.44 |
Toc - Plan #60 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) Nebraska HeartlandBlue Bronze $0 PCP Visit 8100 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$468.50 $531.75 $598.74 $836.74 $1,271.50 |
$826.90 $890.15 $957.14 $1,195.14 |
$1,185.30 $1,248.55 $1,315.54 $1,553.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$937.00 $1,063.50 $1,197.48 $1,673.48 $2,543.00 |
$1,295.40 $1,421.90 $1,555.88 $2,031.88 |
$1,653.80 $1,780.30 $1,914.28 $2,390.28 |
Toc - Plan #61 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) Nebraska HeartlandBlue Bronze $0 Mental Health Visit 7750 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.24 $523.51 $589.46 $823.77 $1,251.80 |
$814.09 $876.36 $942.31 $1,176.62 |
$1,166.94 $1,229.21 $1,295.16 $1,529.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.48 $1,047.02 $1,178.92 $1,647.54 $2,503.60 |
$1,275.33 $1,399.87 $1,531.77 $2,000.39 |
$1,628.18 $1,752.72 $1,884.62 $2,353.24 |
Toc - Plan #62 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Bronze
(EPO) Nebraska HeartlandBlue Bronze Standard Deductible 9100 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.44 $503.31 $566.72 $791.99 $1,203.50 |
$782.67 $842.54 $905.95 $1,131.22 |
$1,121.90 $1,181.77 $1,245.18 $1,470.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$886.88 $1,006.62 $1,133.44 $1,583.98 $2,407.00 |
$1,226.11 $1,345.85 $1,472.67 $1,923.21 |
$1,565.34 $1,685.08 $1,811.90 $2,262.44 |
Toc - Plan #63 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) Nebraska HeartlandBlue Bronze Standard Copay 7500 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.56 $515.92 $580.92 $811.84 $1,233.67 |
$802.30 $863.66 $928.66 $1,159.58 |
$1,150.04 $1,211.40 $1,276.40 $1,507.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.12 $1,031.84 $1,161.84 $1,623.68 $2,467.34 |
$1,256.86 $1,379.58 $1,509.58 $1,971.42 |
$1,604.60 $1,727.32 $1,857.32 $2,319.16 |
Toc - Plan #64 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) Nebraska HeartlandBlue Silver $0 Deductible 9100 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$645.12 $732.21 $824.46 $1,152.18 $1,750.85 |
$1,138.63 $1,225.72 $1,317.97 $1,645.69 |
$1,632.14 $1,719.23 $1,811.48 $2,139.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,290.24 $1,464.42 $1,648.92 $2,304.36 $3,501.70 |
$1,783.75 $1,957.93 $2,142.43 $2,797.87 |
$2,277.26 $2,451.44 $2,635.94 $3,291.38 |
Toc - Plan #65 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) Nebraska HeartlandBlue Silver $0 PCP Visit 5000 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$579.84 $658.12 $741.04 $1,035.60 $1,573.69 |
$1,023.42 $1,101.70 $1,184.62 $1,479.18 |
$1,467.00 $1,545.28 $1,628.20 $1,922.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,159.68 $1,316.24 $1,482.08 $2,071.20 $3,147.38 |
$1,603.26 $1,759.82 $1,925.66 $2,514.78 |
$2,046.84 $2,203.40 $2,369.24 $2,958.36 |
Toc - Plan #66 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) Nebraska HeartlandBlue Silver $0 Mental Health Visit 6000 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$585.37 $664.39 $748.10 $1,045.46 $1,588.68 |
$1,033.17 $1,112.19 $1,195.90 $1,493.26 |
$1,480.97 $1,559.99 $1,643.70 $1,941.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,170.74 $1,328.78 $1,496.20 $2,090.92 $3,177.36 |
$1,618.54 $1,776.58 $1,944.00 $2,538.72 |
$2,066.34 $2,224.38 $2,391.80 $2,986.52 |
Toc - Plan #67 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) Nebraska HeartlandBlue Silver Standard 5800 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$579.78 $658.05 $740.95 $1,035.48 $1,573.51 |
$1,023.31 $1,101.58 $1,184.48 $1,479.01 |
$1,466.84 $1,545.11 $1,628.01 $1,922.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,159.56 $1,316.10 $1,481.90 $2,070.96 $3,147.02 |
$1,603.09 $1,759.63 $1,925.43 $2,514.49 |
$2,046.62 $2,203.16 $2,368.96 $2,958.02 |
Toc - Plan #68 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) Nebraska HeartlandBlue Gold $0 PCP Visit 1500 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$622.82 $706.90 $795.97 $1,112.36 $1,690.34 |
$1,099.28 $1,183.36 $1,272.43 $1,588.82 |
$1,575.74 $1,659.82 $1,748.89 $2,065.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,245.64 $1,413.80 $1,591.94 $2,224.72 $3,380.68 |
$1,722.10 $1,890.26 $2,068.40 $2,701.18 |
$2,198.56 $2,366.72 $2,544.86 $3,177.64 |
Toc - Plan #69 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) Nebraska HeartlandBlue Gold $0 Deductible NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$676.53 $767.87 $864.61 $1,208.29 $1,836.11 |
$1,194.08 $1,285.42 $1,382.16 $1,725.84 |
$1,711.63 $1,802.97 $1,899.71 $2,243.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,353.06 $1,535.74 $1,729.22 $2,416.58 $3,672.22 |
$1,870.61 $2,053.29 $2,246.77 $2,934.13 |
$2,388.16 $2,570.84 $2,764.32 $3,451.68 |
Toc - Plan #70 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) Nebraska HeartlandBlue Gold Standard 2000 NB |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$615.43 $698.52 $786.52 $1,099.17 $1,670.29 |
$1,086.24 $1,169.33 $1,257.33 $1,569.98 |
$1,557.05 $1,640.14 $1,728.14 $2,040.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,230.86 $1,397.04 $1,573.04 $2,198.34 $3,340.58 |
$1,701.67 $1,867.85 $2,043.85 $2,669.15 |
$2,172.48 $2,338.66 $2,514.66 $3,139.96 |
ADVERTISEMENT
Oscar Insurance CompanyLocal: | Toll Free: |
Toc - Plan #71 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$498.76 $566.08 $637.40 $890.77 $1,353.61 |
$880.30 $947.62 $1,018.94 $1,272.31 |
$1,261.84 $1,329.16 $1,400.48 $1,653.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$997.52 $1,132.16 $1,274.80 $1,781.54 $2,707.22 |
$1,379.06 $1,513.70 $1,656.34 $2,163.08 |
$1,760.60 $1,895.24 $2,037.88 $2,544.62 |
Toc - Plan #72 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$590.27 $669.95 $754.35 $1,054.21 $1,601.97 |
$1,041.82 $1,121.50 $1,205.90 $1,505.76 |
$1,493.37 $1,573.05 $1,657.45 $1,957.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,180.54 $1,339.90 $1,508.70 $2,108.42 $3,203.94 |
$1,632.09 $1,791.45 $1,960.25 $2,559.97 |
$2,083.64 $2,243.00 $2,411.80 $3,011.52 |
Toc - Plan #73 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$645.88 $733.06 $825.42 $1,153.52 $1,752.89 |
$1,139.97 $1,227.15 $1,319.51 $1,647.61 |
$1,634.06 $1,721.24 $1,813.60 $2,141.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,291.76 $1,466.12 $1,650.84 $2,307.04 $3,505.78 |
$1,785.85 $1,960.21 $2,144.93 $2,801.13 |
$2,279.94 $2,454.30 $2,639.02 $3,295.22 |
Toc - Plan #74 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.44 $489.67 $551.37 $770.53 $1,170.90 |
$761.48 $819.71 $881.41 $1,100.57 |
$1,091.52 $1,149.75 $1,211.45 $1,430.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$862.88 $979.34 $1,102.74 $1,541.06 $2,341.80 |
$1,192.92 $1,309.38 $1,432.78 $1,871.10 |
$1,522.96 $1,639.42 $1,762.82 $2,201.14 |
Toc - Plan #75 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$529.85 $601.37 $677.14 $946.30 $1,437.99 |
$935.18 $1,006.70 $1,082.47 $1,351.63 |
$1,340.51 $1,412.03 $1,487.80 $1,756.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,059.70 $1,202.74 $1,354.28 $1,892.60 $2,875.98 |
$1,465.03 $1,608.07 $1,759.61 $2,297.93 |
$1,870.36 $2,013.40 $2,164.94 $2,703.26 |
Toc - Plan #76 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$636.43 $722.34 $813.35 $1,136.65 $1,727.25 |
$1,123.29 $1,209.20 $1,300.21 $1,623.51 |
$1,610.15 $1,696.06 $1,787.07 $2,110.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,272.86 $1,444.68 $1,626.70 $2,273.30 $3,454.50 |
$1,759.72 $1,931.54 $2,113.56 $2,760.16 |
$2,246.58 $2,418.40 $2,600.42 $3,247.02 |
Toc - Plan #77 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $0 PCP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$528.63 $599.98 $675.58 $944.11 $1,434.67 |
$933.02 $1,004.37 $1,079.97 $1,348.50 |
$1,337.41 $1,408.76 $1,484.36 $1,752.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,057.26 $1,199.96 $1,351.16 $1,888.22 $2,869.34 |
$1,461.65 $1,604.35 $1,755.55 $2,292.61 |
$1,866.04 $2,008.74 $2,159.94 $2,697.00 |
Toc - Plan #78 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4700 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$539.31 $612.11 $689.23 $963.19 $1,463.66 |
$951.87 $1,024.67 $1,101.79 $1,375.75 |
$1,364.43 $1,437.23 $1,514.35 $1,788.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,078.62 $1,224.22 $1,378.46 $1,926.38 $2,927.32 |
$1,491.18 $1,636.78 $1,791.02 $2,338.94 |
$1,903.74 $2,049.34 $2,203.58 $2,751.50 |
Toc - Plan #79 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$621.16 $705.00 $793.83 $1,109.37 $1,685.80 |
$1,096.34 $1,180.18 $1,269.01 $1,584.55 |
$1,571.52 $1,655.36 $1,744.19 $2,059.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,242.32 $1,410.00 $1,587.66 $2,218.74 $3,371.60 |
$1,717.50 $1,885.18 $2,062.84 $2,693.92 |
$2,192.68 $2,360.36 $2,538.02 $3,169.10 |
Toc - Plan #80 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$649.20 $736.83 $829.66 $1,159.45 $1,761.90 |
$1,145.83 $1,233.46 $1,326.29 $1,656.08 |
$1,642.46 $1,730.09 $1,822.92 $2,152.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,298.40 $1,473.66 $1,659.32 $2,318.90 $3,523.80 |
$1,795.03 $1,970.29 $2,155.95 $2,815.53 |
$2,291.66 $2,466.92 $2,652.58 $3,312.16 |
Toc - Plan #81 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$655.63 $744.13 $837.89 $1,170.94 $1,779.36 |
$1,157.18 $1,245.68 $1,339.44 $1,672.49 |
$1,658.73 $1,747.23 $1,840.99 $2,174.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,311.26 $1,488.26 $1,675.78 $2,341.88 $3,558.72 |
$1,812.81 $1,989.81 $2,177.33 $2,843.43 |
$2,314.36 $2,491.36 $2,678.88 $3,344.98 |
Toc - Plan #82 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- For Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$638.75 $724.97 $816.31 $1,140.79 $1,733.53 |
$1,127.38 $1,213.60 $1,304.94 $1,629.42 |
$1,616.01 $1,702.23 $1,793.57 $2,118.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,277.50 $1,449.94 $1,632.62 $2,281.58 $3,467.06 |
$1,766.13 $1,938.57 $2,121.25 $2,770.21 |
$2,254.76 $2,427.20 $2,609.88 $3,258.84 |
Toc - Plan #83 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$526.50 $597.57 $672.85 $940.31 $1,428.89 |
$929.26 $1,000.33 $1,075.61 $1,343.07 |
$1,332.02 $1,403.09 $1,478.37 $1,745.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,053.00 $1,195.14 $1,345.70 $1,880.62 $2,857.78 |
$1,455.76 $1,597.90 $1,748.46 $2,283.38 |
$1,858.52 $2,000.66 $2,151.22 $2,686.14 |
Toc - Plan #84 Oscar Insurance Company | ||||||||||||||||||||
Bronze
(EPO) Bronze Simple- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$476.10 $540.36 $608.44 $850.29 $1,292.10 |
$840.31 $904.57 $972.65 $1,214.50 |
$1,204.52 $1,268.78 $1,336.86 $1,578.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$952.20 $1,080.72 $1,216.88 $1,700.58 $2,584.20 |
$1,316.41 $1,444.93 $1,581.09 $2,064.79 |
$1,680.62 $1,809.14 $1,945.30 $2,429.00 |
Toc - Plan #85 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$627.36 $712.04 $801.75 $1,120.44 $1,702.62 |
$1,107.28 $1,191.96 $1,281.67 $1,600.36 |
$1,587.20 $1,671.88 $1,761.59 $2,080.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,254.72 $1,424.08 $1,603.50 $2,240.88 $3,405.24 |
$1,734.64 $1,904.00 $2,083.42 $2,720.80 |
$2,214.56 $2,383.92 $2,563.34 $3,200.72 |
Toc - Plan #86 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$605.30 $687.01 $773.56 $1,081.05 $1,642.76 |
$1,068.35 $1,150.06 $1,236.61 $1,544.10 |
$1,531.40 $1,613.11 $1,699.66 $2,007.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,210.60 $1,374.02 $1,547.12 $2,162.10 $3,285.52 |
$1,673.65 $1,837.07 $2,010.17 $2,625.15 |
$2,136.70 $2,300.12 $2,473.22 $3,088.20 |
‡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 Hamilton County here.
Hamilton County is in “Rating Area 3” of Nebraska.
Currently, there are 86 plans offered in Rating Area 3.