Obamacare 2023 Rates for Douglas County
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Obamacare > Rates > Wisconsin > Douglas County
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HealthPartnersLocal: 1-952-883-5900 | Toll Free: 1-855-813-3887 | TTY: 1-952-883-6060 |
Toc - Plan #1 HealthPartners | ||||||||||||||||||||
Gold
(PPO) Atlas $1,000 w/Copay P-S Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$490.60 $556.83 $626.99 $876.21 $1,331.49 |
$865.91 $932.14 $1,002.30 $1,251.52 |
$1,241.22 $1,307.45 $1,377.61 $1,626.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$981.20 $1,113.66 $1,253.98 $1,752.42 $2,662.98 |
$1,356.51 $1,488.97 $1,629.29 $2,127.73 |
$1,731.82 $1,864.28 $2,004.60 $2,503.04 |
Toc - Plan #2 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Atlas $3,500 Plus Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$441.09 $500.64 $563.71 $787.79 $1,197.12 |
$778.52 $838.07 $901.14 $1,125.22 |
$1,115.95 $1,175.50 $1,238.57 $1,462.65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$882.18 $1,001.28 $1,127.42 $1,575.58 $2,394.24 |
$1,219.61 $1,338.71 $1,464.85 $1,913.01 |
$1,557.04 $1,676.14 $1,802.28 $2,250.44 |
Toc - Plan #3 HealthPartners | ||||||||||||||||||||
Expanded Bronze
(PPO) Atlas $6,250 Plus Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$342.87 $389.16 $438.19 $612.37 $930.55 |
$605.17 $651.46 $700.49 $874.67 |
$867.47 $913.76 $962.79 $1,136.97 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$685.74 $778.32 $876.38 $1,224.74 $1,861.10 |
$948.04 $1,040.62 $1,138.68 $1,487.04 |
$1,210.34 $1,302.92 $1,400.98 $1,749.34 |
Toc - Plan #4 HealthPartners | ||||||||||||||||||||
Catastrophic
(PPO) Atlas $9,100 Catastrophic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$259.84 $294.92 $332.08 $464.07 $705.21 |
$458.62 $493.70 $530.86 $662.85 |
$657.40 $692.48 $729.64 $861.63 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$519.68 $589.84 $664.16 $928.14 $1,410.42 |
$718.46 $788.62 $862.94 $1,126.92 |
$917.24 $987.40 $1,061.72 $1,325.70 |
Toc - Plan #5 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Atlas $3,500 HSA Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$435.86 $494.70 $557.03 $778.45 $1,182.92 |
$769.29 $828.13 $890.46 $1,111.88 |
$1,102.72 $1,161.56 $1,223.89 $1,445.31 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$871.72 $989.40 $1,114.06 $1,556.90 $2,365.84 |
$1,205.15 $1,322.83 $1,447.49 $1,890.33 |
$1,538.58 $1,656.26 $1,780.92 $2,223.76 |
Toc - Plan #6 HealthPartners | ||||||||||||||||||||
Expanded Bronze
(PPO) Atlas $7,500 HSA Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$333.62 $378.66 $426.37 $595.85 $905.44 |
$588.84 $633.88 $681.59 $851.07 |
$844.06 $889.10 $936.81 $1,106.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$667.24 $757.32 $852.74 $1,191.70 $1,810.88 |
$922.46 $1,012.54 $1,107.96 $1,446.92 |
$1,177.68 $1,267.76 $1,363.18 $1,702.14 |
Toc - Plan #7 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Atlas $3,000 w/Copay P-S Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$462.55 $524.99 $591.14 $826.11 $1,255.36 |
$816.40 $878.84 $944.99 $1,179.96 |
$1,170.25 $1,232.69 $1,298.84 $1,533.81 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$925.10 $1,049.98 $1,182.28 $1,652.22 $2,510.72 |
$1,278.95 $1,403.83 $1,536.13 $2,006.07 |
$1,632.80 $1,757.68 $1,889.98 $2,359.92 |
Toc - Plan #8 HealthPartners | ||||||||||||||||||||
Gold
(PPO) Atlas $2,000 w/Copay P-S Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$473.71 $537.66 $605.40 $846.05 $1,285.65 |
$836.10 $900.05 $967.79 $1,208.44 |
$1,198.49 $1,262.44 $1,330.18 $1,570.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$947.42 $1,075.32 $1,210.80 $1,692.10 $2,571.30 |
$1,309.81 $1,437.71 $1,573.19 $2,054.49 |
$1,672.20 $1,800.10 $1,935.58 $2,416.88 |
Toc - Plan #9 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Atlas $5,800 w/Copay P-S Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$440.97 $500.50 $563.56 $787.57 $1,196.79 |
$778.31 $837.84 $900.90 $1,124.91 |
$1,115.65 $1,175.18 $1,238.24 $1,462.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$881.94 $1,001.00 $1,127.12 $1,575.14 $2,393.58 |
$1,219.28 $1,338.34 $1,464.46 $1,912.48 |
$1,556.62 $1,675.68 $1,801.80 $2,249.82 |
Toc - Plan #10 HealthPartners | ||||||||||||||||||||
Expanded Bronze
(PPO) Atlas $7,500 w/Copay P-S Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
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 |
$347.15 $394.02 $443.66 $620.01 $942.17 |
$612.72 $659.59 $709.23 $885.58 |
$878.29 $925.16 $974.80 $1,151.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$694.30 $788.04 $887.32 $1,240.02 $1,884.34 |
$959.87 $1,053.61 $1,152.89 $1,505.59 |
$1,225.44 $1,319.18 $1,418.46 $1,771.16 |
ADVERTISEMENT
Security Health PlanLocal: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-877-727-2232 |
Toc - Plan #11 Security Health Plan | ||||||||||||||||||||
Catastrophic
(EPO) Select Protection |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$224.68 $255.00 $287.13 $401.27 $609.76 |
$396.55 $426.87 $459.00 $573.14 |
$568.42 $598.74 $630.87 $745.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$449.36 $510.00 $574.26 $802.54 $1,219.52 |
$621.23 $681.87 $746.13 $974.41 |
$793.10 $853.74 $918.00 $1,146.28 |
Toc - Plan #12 Security Health Plan | ||||||||||||||||||||
Bronze
(EPO) Select $9,100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$328.43 $372.76 $419.72 $586.56 $891.34 |
$579.67 $624.00 $670.96 $837.80 |
$830.91 $875.24 $922.20 $1,089.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$656.86 $745.52 $839.44 $1,173.12 $1,782.68 |
$908.10 $996.76 $1,090.68 $1,424.36 |
$1,159.34 $1,248.00 $1,341.92 $1,675.60 |
Toc - Plan #13 Security Health Plan | ||||||||||||||||||||
Silver
(EPO) Select $4,100 HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$559.35 $634.85 $714.83 $998.97 $1,518.04 |
$987.24 $1,062.74 $1,142.72 $1,426.86 |
$1,415.13 $1,490.63 $1,570.61 $1,854.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,118.70 $1,269.70 $1,429.66 $1,997.94 $3,036.08 |
$1,546.59 $1,697.59 $1,857.55 $2,425.83 |
$1,974.48 $2,125.48 $2,285.44 $2,853.72 |
Toc - Plan #14 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Select $6,200 HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$381.28 $432.74 $487.26 $680.94 $1,034.76 |
$672.95 $724.41 $778.93 $972.61 |
$964.62 $1,016.08 $1,070.60 $1,264.28 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$762.56 $865.48 $974.52 $1,361.88 $2,069.52 |
$1,054.23 $1,157.15 $1,266.19 $1,653.55 |
$1,345.90 $1,448.82 $1,557.86 $1,945.22 |
Toc - Plan #15 Security Health Plan | ||||||||||||||||||||
Gold
(EPO) Select $3,500 - 30% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$460.55 $522.71 $588.57 $822.52 $1,249.90 |
$812.86 $875.02 $940.88 $1,174.83 |
$1,165.17 $1,227.33 $1,293.19 $1,527.14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$921.10 $1,045.42 $1,177.14 $1,645.04 $2,499.80 |
$1,273.41 $1,397.73 $1,529.45 $1,997.35 |
$1,625.72 $1,750.04 $1,881.76 $2,349.66 |
Toc - Plan #16 Security Health Plan | ||||||||||||||||||||
Gold
(EPO) Select $2,000 - 25% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$488.98 $554.98 $624.90 $873.30 $1,327.06 |
$863.04 $929.04 $998.96 $1,247.36 |
$1,237.10 $1,303.10 $1,373.02 $1,621.42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$977.96 $1,109.96 $1,249.80 $1,746.60 $2,654.12 |
$1,352.02 $1,484.02 $1,623.86 $2,120.66 |
$1,726.08 $1,858.08 $1,997.92 $2,494.72 |
Toc - Plan #17 Security Health Plan | ||||||||||||||||||||
Silver
(EPO) Select $5,800 - 40% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$484.77 $550.20 $619.52 $865.78 $1,315.63 |
$855.61 $921.04 $990.36 $1,236.62 |
$1,226.45 $1,291.88 $1,361.20 $1,607.46 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$969.54 $1,100.40 $1,239.04 $1,731.56 $2,631.26 |
$1,340.38 $1,471.24 $1,609.88 $2,102.40 |
$1,711.22 $1,842.08 $1,980.72 $2,473.24 |
Toc - Plan #18 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Select $7,500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$335.66 $380.96 $428.96 $599.47 $910.95 |
$592.43 $637.73 $685.73 $856.24 |
$849.20 $894.50 $942.50 $1,113.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$671.32 $761.92 $857.92 $1,198.94 $1,821.90 |
$928.09 $1,018.69 $1,114.69 $1,455.71 |
$1,184.86 $1,275.46 $1,371.46 $1,712.48 |
Toc - Plan #19 Security Health Plan | ||||||||||||||||||||
Gold
(HMO) Premier $2,000 - 25% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$562.57 $638.50 $718.95 $1,004.73 $1,526.78 |
$992.93 $1,068.86 $1,149.31 $1,435.09 |
$1,423.29 $1,499.22 $1,579.67 $1,865.45 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,125.14 $1,277.00 $1,437.90 $2,009.46 $3,053.56 |
$1,555.50 $1,707.36 $1,868.26 $2,439.82 |
$1,985.86 $2,137.72 $2,298.62 $2,870.18 |
Toc - Plan #20 Security Health Plan | ||||||||||||||||||||
Gold
(HMO) Premier $3,500 - 30% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$529.85 $601.37 $677.14 $946.30 $1,438.00 |
$935.18 $1,006.70 $1,082.47 $1,351.63 |
$1,340.51 $1,412.03 $1,487.80 $1,756.96 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,059.70 $1,202.74 $1,354.28 $1,892.60 $2,876.00 |
$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 #21 Security Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier $5,800 - 40% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$557.72 $633.00 $712.75 $996.07 $1,513.63 |
$984.37 $1,059.65 $1,139.40 $1,422.72 |
$1,411.02 $1,486.30 $1,566.05 $1,849.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,115.44 $1,266.00 $1,425.50 $1,992.14 $3,027.26 |
$1,542.09 $1,692.65 $1,852.15 $2,418.79 |
$1,968.74 $2,119.30 $2,278.80 $2,845.44 |
Toc - Plan #22 Security Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier $4,100 HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
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 |
$643.52 $730.39 $822.41 $1,149.31 $1,746.49 |
$1,135.81 $1,222.68 $1,314.70 $1,641.60 |
$1,628.10 $1,714.97 $1,806.99 $2,133.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,287.04 $1,460.78 $1,644.82 $2,298.62 $3,492.98 |
$1,779.33 $1,953.07 $2,137.11 $2,790.91 |
$2,271.62 $2,445.36 $2,629.40 $3,283.20 |
Toc - Plan #23 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Premier $6,200 HDHP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$438.66 $497.86 $560.59 $783.42 $1,190.49 |
$774.22 $833.42 $896.15 $1,118.98 |
$1,109.78 $1,168.98 $1,231.71 $1,454.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$877.32 $995.72 $1,121.18 $1,566.84 $2,380.98 |
$1,212.88 $1,331.28 $1,456.74 $1,902.40 |
$1,548.44 $1,666.84 $1,792.30 $2,237.96 |
Toc - Plan #24 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Premier $7,500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386.17 $438.29 $493.52 $689.69 $1,048.05 |
$681.58 $733.70 $788.93 $985.10 |
$976.99 $1,029.11 $1,084.34 $1,280.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772.34 $876.58 $987.04 $1,379.38 $2,096.10 |
$1,067.75 $1,171.99 $1,282.45 $1,674.79 |
$1,363.16 $1,467.40 $1,577.86 $1,970.20 |
Toc - Plan #25 Security Health Plan | ||||||||||||||||||||
Bronze
(HMO) Premier $9,100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.86 $428.86 $482.89 $674.83 $1,025.48 |
$666.91 $717.91 $771.94 $963.88 |
$955.96 $1,006.96 $1,060.99 $1,252.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.72 $857.72 $965.78 $1,349.66 $2,050.96 |
$1,044.77 $1,146.77 $1,254.83 $1,638.71 |
$1,333.82 $1,435.82 $1,543.88 $1,927.76 |
Toc - Plan #26 Security Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) Premier Protection |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$258.50 $293.38 $330.34 $461.65 $701.53 |
$456.24 $491.12 $528.08 $659.39 |
$653.98 $688.86 $725.82 $857.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$517.00 $586.76 $660.68 $923.30 $1,403.06 |
$714.74 $784.50 $858.42 $1,121.04 |
$912.48 $982.24 $1,056.16 $1,318.78 |
ADVERTISEMENT
MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-947-3529 |
Toc - Plan #27 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Individual Choice 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 |
$342.41 $388.63 $437.59 $611.53 $929.28 |
$604.35 $650.57 $699.53 $873.47 |
$866.29 $912.51 $961.47 $1,135.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$684.82 $777.26 $875.18 $1,223.06 $1,858.56 |
$946.76 $1,039.20 $1,137.12 $1,485.00 |
$1,208.70 $1,301.14 $1,399.06 $1,746.94 |
Toc - Plan #28 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Individual Choice 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 |
$390.02 $442.67 $498.44 $696.56 $1,058.50 |
$688.38 $741.03 $796.80 $994.92 |
$986.74 $1,039.39 $1,095.16 $1,293.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.04 $885.34 $996.88 $1,393.12 $2,117.00 |
$1,078.40 $1,183.70 $1,295.24 $1,691.48 |
$1,376.76 $1,482.06 $1,593.60 $1,989.84 |
Toc - Plan #29 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Medica Individual Choice 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 |
$218.73 $248.25 $279.53 $390.64 $593.61 |
$386.05 $415.57 $446.85 $557.96 |
$553.37 $582.89 $614.17 $725.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$437.46 $496.50 $559.06 $781.28 $1,187.22 |
$604.78 $663.82 $726.38 $948.60 |
$772.10 $831.14 $893.70 $1,115.92 |
Toc - Plan #30 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Individual Choice Silver Share ($0 Virtual Care with Designated Providers + $5 Preferred Generic Drugs) |
||||||||||||||||||||
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 |
$447.86 $508.30 $572.35 $799.85 $1,215.45 |
$790.46 $850.90 $914.95 $1,142.45 |
$1,133.06 $1,193.50 $1,257.55 $1,485.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$895.72 $1,016.60 $1,144.70 $1,599.70 $2,430.90 |
$1,238.32 $1,359.20 $1,487.30 $1,942.30 |
$1,580.92 $1,701.80 $1,829.90 $2,284.90 |
Toc - Plan #31 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Individual Choice 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 |
$351.18 $398.58 $448.80 $627.19 $953.08 |
$619.83 $667.23 $717.45 $895.84 |
$888.48 $935.88 $986.10 $1,164.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.36 $797.16 $897.60 $1,254.38 $1,906.16 |
$971.01 $1,065.81 $1,166.25 $1,523.03 |
$1,239.66 $1,334.46 $1,434.90 $1,791.68 |
Toc - Plan #32 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Individual Choice 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 |
$447.36 $507.74 $571.71 $798.96 $1,214.10 |
$789.58 $849.96 $913.93 $1,141.18 |
$1,131.80 $1,192.18 $1,256.15 $1,483.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$894.72 $1,015.48 $1,143.42 $1,597.92 $2,428.20 |
$1,236.94 $1,357.70 $1,485.64 $1,940.14 |
$1,579.16 $1,699.92 $1,827.86 $2,282.36 |
Toc - Plan #33 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Individual Choice 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 |
$431.68 $489.95 $551.68 $770.97 $1,171.56 |
$761.91 $820.18 $881.91 $1,101.20 |
$1,092.14 $1,150.41 $1,212.14 $1,431.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$863.36 $979.90 $1,103.36 $1,541.94 $2,343.12 |
$1,193.59 $1,310.13 $1,433.59 $1,872.17 |
$1,523.82 $1,640.36 $1,763.82 $2,202.40 |
Toc - Plan #34 Medica | ||||||||||||||||||||
Bronze
(EPO) Medica Individual Choice 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 |
$334.15 $379.24 $427.02 $596.77 $906.84 |
$589.76 $634.85 $682.63 $852.38 |
$845.37 $890.46 $938.24 $1,107.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668.30 $758.48 $854.04 $1,193.54 $1,813.68 |
$923.91 $1,014.09 $1,109.65 $1,449.15 |
$1,179.52 $1,269.70 $1,365.26 $1,704.76 |
Toc - Plan #35 Medica | ||||||||||||||||||||
Gold
(EPO) Essentia Choice Care with Medica Gold Copay ($0 Virtual Care with Designated Providers + $0 Preferred Generic Drugs) |
||||||||||||||||||||
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 |
$389.80 $442.41 $498.15 $696.17 $1,057.89 |
$687.99 $740.60 $796.34 $994.36 |
$986.18 $1,038.79 $1,094.53 $1,292.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.60 $884.82 $996.30 $1,392.34 $2,115.78 |
$1,077.79 $1,183.01 $1,294.49 $1,690.53 |
$1,375.98 $1,481.20 $1,592.68 $1,988.72 |
Toc - Plan #36 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Essentia Choice Care with Medica 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 |
$297.91 $338.11 $380.71 $532.04 $808.49 |
$525.80 $566.00 $608.60 $759.93 |
$753.69 $793.89 $836.49 $987.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$595.82 $676.22 $761.42 $1,064.08 $1,616.98 |
$823.71 $904.11 $989.31 $1,291.97 |
$1,051.60 $1,132.00 $1,217.20 $1,519.86 |
Toc - Plan #37 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Essentia Choice Care with Medica 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 |
$339.33 $385.13 $433.65 $606.02 $920.91 |
$598.91 $644.71 $693.23 $865.60 |
$858.49 $904.29 $952.81 $1,125.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$678.66 $770.26 $867.30 $1,212.04 $1,841.82 |
$938.24 $1,029.84 $1,126.88 $1,471.62 |
$1,197.82 $1,289.42 $1,386.46 $1,731.20 |
Toc - Plan #38 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Essentia Choice Care with Medica 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 |
$190.30 $215.98 $243.19 $339.86 $516.45 |
$335.87 $361.55 $388.76 $485.43 |
$481.44 $507.12 $534.33 $631.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$380.60 $431.96 $486.38 $679.72 $1,032.90 |
$526.17 $577.53 $631.95 $825.29 |
$671.74 $723.10 $777.52 $970.86 |
Toc - Plan #39 Medica | ||||||||||||||||||||
Silver
(EPO) Essentia Choice Care with Medica Silver Share ($0 Virtual Care with Designated Providers + $5 Preferred Generic Drugs) |
||||||||||||||||||||
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 |
$389.64 $442.23 $497.95 $695.88 $1,057.46 |
$687.71 $740.30 $796.02 $993.95 |
$985.78 $1,038.37 $1,094.09 $1,292.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.28 $884.46 $995.90 $1,391.76 $2,114.92 |
$1,077.35 $1,182.53 $1,293.97 $1,689.83 |
$1,375.42 $1,480.60 $1,592.04 $1,987.90 |
Toc - Plan #40 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Essentia Choice Care with Medica 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 |
$305.53 $346.77 $390.46 $545.67 $829.19 |
$539.26 $580.50 $624.19 $779.40 |
$772.99 $814.23 $857.92 $1,013.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$611.06 $693.54 $780.92 $1,091.34 $1,658.38 |
$844.79 $927.27 $1,014.65 $1,325.07 |
$1,078.52 $1,161.00 $1,248.38 $1,558.80 |
Toc - Plan #41 Medica | ||||||||||||||||||||
Gold
(EPO) Essentia Choice Care with Medica 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 |
$389.21 $441.74 $497.39 $695.11 $1,056.28 |
$686.95 $739.48 $795.13 $992.85 |
$984.69 $1,037.22 $1,092.87 $1,290.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$778.42 $883.48 $994.78 $1,390.22 $2,112.56 |
$1,076.16 $1,181.22 $1,292.52 $1,687.96 |
$1,373.90 $1,478.96 $1,590.26 $1,985.70 |
Toc - Plan #42 Medica | ||||||||||||||||||||
Silver
(EPO) Essentia Choice Care with Medica 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 |
$375.57 $426.26 $479.97 $670.75 $1,019.27 |
$662.87 $713.56 $767.27 $958.05 |
$950.17 $1,000.86 $1,054.57 $1,245.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.14 $852.52 $959.94 $1,341.50 $2,038.54 |
$1,038.44 $1,139.82 $1,247.24 $1,628.80 |
$1,325.74 $1,427.12 $1,534.54 $1,916.10 |
Toc - Plan #43 Medica | ||||||||||||||||||||
Bronze
(EPO) Essentia Choice Care with Medica 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 |
$290.71 $329.95 $371.52 $519.19 $788.97 |
$513.10 $552.34 $593.91 $741.58 |
$735.49 $774.73 $816.30 $963.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$581.42 $659.90 $743.04 $1,038.38 $1,577.94 |
$803.81 $882.29 $965.43 $1,260.77 |
$1,026.20 $1,104.68 $1,187.82 $1,483.16 |
ADVERTISEMENT
Anthem Blue Cross and Blue ShieldLocal: 1-855-748-1813 | Toll Free: 1-855-748-1813 |
Toc - Plan #44 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 0 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.32 $472.52 $532.06 $743.55 $1,129.89 |
$734.80 $791.00 $850.54 $1,062.03 |
$1,053.28 $1,109.48 $1,169.02 $1,380.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.64 $945.04 $1,064.12 $1,487.10 $2,259.78 |
$1,151.12 $1,263.52 $1,382.60 $1,805.58 |
$1,469.60 $1,582.00 $1,701.08 $2,124.06 |
Toc - Plan #45 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403.66 $458.15 $515.88 $720.94 $1,095.53 |
$712.46 $766.95 $824.68 $1,029.74 |
$1,021.26 $1,075.75 $1,133.48 $1,338.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$807.32 $916.30 $1,031.76 $1,441.88 $2,191.06 |
$1,116.12 $1,225.10 $1,340.56 $1,750.68 |
$1,424.92 $1,533.90 $1,649.36 $2,059.48 |
Toc - Plan #46 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 6550 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$396.43 $449.95 $506.64 $708.02 $1,075.91 |
$699.70 $753.22 $809.91 $1,011.29 |
$1,002.97 $1,056.49 $1,113.18 $1,314.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$792.86 $899.90 $1,013.28 $1,416.04 $2,151.82 |
$1,096.13 $1,203.17 $1,316.55 $1,719.31 |
$1,399.40 $1,506.44 $1,619.82 $2,022.58 |
Toc - Plan #47 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 9100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.76 $426.49 $480.22 $671.11 $1,019.81 |
$663.22 $713.95 $767.68 $958.57 |
$950.68 $1,001.41 $1,055.14 $1,246.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.52 $852.98 $960.44 $1,342.22 $2,039.62 |
$1,038.98 $1,140.44 $1,247.90 $1,629.68 |
$1,326.44 $1,427.90 $1,535.36 $1,917.14 |
Toc - Plan #48 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 0% for HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.61 $449.02 $505.59 $706.56 $1,073.69 |
$698.25 $751.66 $808.23 $1,009.20 |
$1,000.89 $1,054.30 $1,110.87 $1,311.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$791.22 $898.04 $1,011.18 $1,413.12 $2,147.38 |
$1,093.86 $1,200.68 $1,313.82 $1,715.76 |
$1,396.50 $1,503.32 $1,616.46 $2,018.40 |
Toc - Plan #49 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Blue Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$513.18 $582.46 $655.84 $916.54 $1,392.77 |
$905.76 $975.04 $1,048.42 $1,309.12 |
$1,298.34 $1,367.62 $1,441.00 $1,701.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,026.36 $1,164.92 $1,311.68 $1,833.08 $2,785.54 |
$1,418.94 $1,557.50 $1,704.26 $2,225.66 |
$1,811.52 $1,950.08 $2,096.84 $2,618.24 |
Toc - Plan #50 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$495.47 $562.36 $633.21 $884.91 $1,344.71 |
$874.50 $941.39 $1,012.24 $1,263.94 |
$1,253.53 $1,320.42 $1,391.27 $1,642.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$990.94 $1,124.72 $1,266.42 $1,769.82 $2,689.42 |
$1,369.97 $1,503.75 $1,645.45 $2,148.85 |
$1,749.00 $1,882.78 $2,024.48 $2,527.88 |
Toc - Plan #51 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 4100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$501.42 $569.11 $640.81 $895.54 $1,360.85 |
$885.01 $952.70 $1,024.40 $1,279.13 |
$1,268.60 $1,336.29 $1,407.99 $1,662.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,002.84 $1,138.22 $1,281.62 $1,791.08 $2,721.70 |
$1,386.43 $1,521.81 $1,665.21 $2,174.67 |
$1,770.02 $1,905.40 $2,048.80 $2,558.26 |
Toc - Plan #52 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 5300 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$492.55 $559.04 $629.48 $879.69 $1,336.78 |
$869.35 $935.84 $1,006.28 $1,256.49 |
$1,246.15 $1,312.64 $1,383.08 $1,633.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$985.10 $1,118.08 $1,258.96 $1,759.38 $2,673.56 |
$1,361.90 $1,494.88 $1,635.76 $2,136.18 |
$1,738.70 $1,871.68 $2,012.56 $2,512.98 |
Toc - Plan #53 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 9100/0% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.29 $427.09 $480.90 $672.05 $1,021.25 |
$664.15 $714.95 $768.76 $959.91 |
$952.01 $1,002.81 $1,056.62 $1,247.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$752.58 $854.18 $961.80 $1,344.10 $2,042.50 |
$1,040.44 $1,142.04 $1,249.66 $1,631.96 |
$1,328.30 $1,429.90 $1,537.52 $1,919.82 |
Toc - Plan #54 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 7500/50% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.00 $464.22 $522.70 $730.47 $1,110.03 |
$721.89 $777.11 $835.59 $1,043.36 |
$1,034.78 $1,090.00 $1,148.48 $1,356.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$818.00 $928.44 $1,045.40 $1,460.94 $2,220.06 |
$1,130.89 $1,241.33 $1,358.29 $1,773.83 |
$1,443.78 $1,554.22 $1,671.18 $2,086.72 |
Toc - Plan #55 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 5800/40% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$488.36 $554.29 $624.12 $872.21 $1,325.41 |
$861.96 $927.89 $997.72 $1,245.81 |
$1,235.56 $1,301.49 $1,371.32 $1,619.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$976.72 $1,108.58 $1,248.24 $1,744.42 $2,650.82 |
$1,350.32 $1,482.18 $1,621.84 $2,118.02 |
$1,723.92 $1,855.78 $1,995.44 $2,491.62 |
Toc - Plan #56 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Blue Preferred/Broad 2000/25% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$513.55 $582.88 $656.32 $917.20 $1,393.77 |
$906.42 $975.75 $1,049.19 $1,310.07 |
$1,299.29 $1,368.62 $1,442.06 $1,702.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,027.10 $1,165.76 $1,312.64 $1,834.40 $2,787.54 |
$1,419.97 $1,558.63 $1,705.51 $2,227.27 |
$1,812.84 $1,951.50 $2,098.38 $2,620.14 |
‡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 Douglas County here.
Douglas County is in “Rating Area 5” of Wisconsin.
Currently, there are 56 plans offered in Rating Area 5.