The health insurance rates listed below are for calendar year 2016.
2016 Rates and Providers
(click here for 2014)
(click here for 2015)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Northville Township, MI.
Obamacare Providers, Plans and 2016 Rates for Wayne County
Wayne County is in “Rating Area 2” of Michigan.
Currently, there are 11 providers offering 56 plans to Rating Area 2. †
Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.
The table below shows premiums for the following scenarios for:
- Individual
- Couple
- Couple with 1 2 or 3 children
- Individual with 1 2 or 3 children
- A child alone
Each scenario is covered for age
- Age 21, 30, 40, 50
- Age 60 (Individual and Couple only)
For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:
- a summary of plan benefits and costs,
- a plan brochure, and
- a "Provider Directory" -- where you can find out which doctors and hospitals in the Northville Township, MI area accept this insurance coverage as within the plan's "network".
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Blue Cross Blue Shield of Michigan Mutual Insurance CompanyLocal: 1-888-288-2738 | Toll Free: 1-888-288-2738 TTY: 1-800-481-8704 |
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Plan: (PPO) Blue Cross® Premier ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$165.53 $187.88 $211.55 $295.64 $449.25 |
$331.06 $375.76 $423.10 $591.28 $898.50 |
$436.17 $480.87 $528.21 $696.39 |
$541.28 $585.98 $633.32 $801.50 |
$646.39 $691.09 $738.43 $906.61 |
$270.64 $292.99 $316.66 $400.75 |
$375.75 $398.10 $421.77 $505.86 |
$480.86 $503.21 $526.88 $610.97 |
$105.11 |
Plan: (PPO) Blue Cross® Premier BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$212.63 $241.34 $271.74 $379.76 $577.08 |
$425.26 $482.68 $543.48 $759.52 $1154.16 |
$560.28 $617.70 $678.50 $894.54 |
$695.30 $752.72 $813.52 $1029.56 |
$830.32 $887.74 $948.54 $1164.58 |
$347.65 $376.36 $406.76 $514.78 |
$482.67 $511.38 $541.78 $649.80 |
$617.69 $646.40 $676.80 $784.82 |
$135.02 |
Plan: (PPO) Blue Cross® Premier SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$285.18 $323.68 $364.46 $509.33 $773.98 |
$570.36 $647.36 $728.92 $1018.66 $1547.96 |
$751.45 $828.45 $910.01 $1199.75 |
$932.54 $1009.54 $1091.10 $1380.84 |
$1113.63 $1190.63 $1272.19 $1561.93 |
$466.27 $504.77 $545.55 $690.42 |
$647.36 $685.86 $726.64 $871.51 |
$828.45 $866.95 $907.73 $1052.60 |
$181.09 |
Plan: (PPO) Blue Cross® Premier GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$150
: Family:
$300 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$344.30 $390.78 $440.02 $614.92 $934.43 |
$688.60 $781.56 $880.04 $1229.84 $1868.86 |
$907.23 $1000.19 $1098.67 $1448.47 |
$1125.86 $1218.82 $1317.30 $1667.10 |
$1344.49 $1437.45 $1535.93 $1885.73 |
$562.93 $609.41 $658.65 $833.55 |
$781.56 $828.04 $877.28 $1052.18 |
$1000.19 $1046.67 $1095.91 $1270.81 |
$218.63 |
Plan: (PPO) Blue Cross® Premier Bronze SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$202.50 $229.84 $258.80 $361.67 $549.59 |
$405.00 $459.68 $517.60 $723.34 $1099.18 |
$533.59 $588.27 $646.19 $851.93 |
$662.18 $716.86 $774.78 $980.52 |
$790.77 $845.45 $903.37 $1109.11 |
$331.09 $358.43 $387.39 $490.26 |
$459.68 $487.02 $515.98 $618.85 |
$588.27 $615.61 $644.57 $747.44 |
$128.59 |
Plan: (PPO) Blue Cross® Premier Silver SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$263.63 $299.22 $336.92 $470.84 $715.49 |
$527.26 $598.44 $673.84 $941.68 $1430.98 |
$694.67 $765.85 $841.25 $1109.09 |
$862.08 $933.26 $1008.66 $1276.50 |
$1029.49 $1100.67 $1176.07 $1443.91 |
$431.04 $466.63 $504.33 $638.25 |
$598.45 $634.04 $671.74 $805.66 |
$765.86 $801.45 $839.15 $973.07 |
$167.41 |
Plan: (PPO) Blue Cross® Silver with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$299.97 $340.47 $383.36 $535.75 $814.12 |
$599.94 $680.94 $766.72 $1071.50 $1628.24 |
$790.42 $871.42 $957.20 $1261.98 |
$980.90 $1061.90 $1147.68 $1452.46 |
$1171.38 $1252.38 $1338.16 $1642.94 |
$490.45 $530.95 $573.84 $726.23 |
$680.93 $721.43 $764.32 $916.71 |
$871.41 $911.91 $954.80 $1107.19 |
$190.48 |
Plan: (PPO) Blue Cross® Gold with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$150
: Family:
$300 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$359.49 $408.02 $459.43 $642.05 $975.66 |
$718.98 $816.04 $918.86 $1284.10 $1951.32 |
$947.26 $1044.32 $1147.14 $1512.38 |
$1175.54 $1272.60 $1375.42 $1740.66 |
$1403.82 $1500.88 $1603.70 $1968.94 |
$587.77 $636.30 $687.71 $870.33 |
$816.05 $864.58 $915.99 $1098.61 |
$1044.33 $1092.86 $1144.27 $1326.89 |
$228.28 |
Plan: (PPO) Blue Cross® Premier Bronze with Primary Care VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,750
: Family:
$13,500 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$219.03 $248.60 $279.92 $391.19 $594.45 |
$438.06 $497.20 $559.84 $782.38 $1188.90 |
$577.14 $636.28 $698.92 $921.46 |
$716.22 $775.36 $838.00 $1060.54 |
$855.30 $914.44 $977.08 $1199.62 |
$358.11 $387.68 $419.00 $530.27 |
$497.19 $526.76 $558.08 $669.35 |
$636.27 $665.84 $697.16 $808.43 |
$139.08 |
Plan: (PPO) Blue Cross® Premier Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$2,300
: Family:
$4,600 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$293.84 $333.51 $375.53 $524.80 $797.48 |
$587.68 $667.02 $751.06 $1049.60 $1594.96 |
$774.27 $853.61 $937.65 $1236.19 |
$960.86 $1040.20 $1124.24 $1422.78 |
$1147.45 $1226.79 $1310.83 $1609.37 |
$480.43 $520.10 $562.12 $711.39 |
$667.02 $706.69 $748.71 $897.98 |
$853.61 $893.28 $935.30 $1084.57 |
$186.59 |
Plan: (PPO) Blue Cross® Premier Gold ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$364.74 $413.98 $466.14 $651.43 $989.90 |
$729.48 $827.96 $932.28 $1302.86 $1979.80 |
$961.09 $1059.57 $1163.89 $1534.47 |
$1192.70 $1291.18 $1395.50 $1766.08 |
$1424.31 $1522.79 $1627.11 $1997.69 |
$596.35 $645.59 $697.75 $883.04 |
$827.96 $877.20 $929.36 $1114.65 |
$1059.57 $1108.81 $1160.97 $1346.26 |
$231.61 |
Plan: (PPO) Blue Cross® Premier Platinum with Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Platinum | 21 30 40 50 60 |
$441.84 $501.49 $564.67 $789.13 $1199.15 |
$883.68 $1002.98 $1129.34 $1578.26 $2398.30 |
$1164.25 $1283.55 $1409.91 $1858.83 |
$1444.82 $1564.12 $1690.48 $2139.40 |
$1725.39 $1844.69 $1971.05 $2419.97 |
$722.41 $782.06 $845.24 $1069.70 |
$1002.98 $1062.63 $1125.81 $1350.27 |
$1283.55 $1343.20 $1406.38 $1630.84 |
$280.57 |
Plan: (PPO) Blue Cross® Silver Extra with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$2,300
: Family:
$4,600 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$310.43 $352.34 $396.73 $554.43 $842.51 |
$620.86 $704.68 $793.46 $1108.86 $1685.02 |
$817.98 $901.80 $990.58 $1305.98 |
$1015.10 $1098.92 $1187.70 $1503.10 |
$1212.22 $1296.04 $1384.82 $1700.22 |
$507.55 $549.46 $593.85 $751.55 |
$704.67 $746.58 $790.97 $948.67 |
$901.79 $943.70 $988.09 $1145.79 |
$197.12 |
Plan: (PPO) Blue Cross® Gold Extra with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$381.78 $433.32 $487.91 $681.86 $1036.15 |
$763.56 $866.64 $975.82 $1363.72 $2072.30 |
$1005.99 $1109.07 $1218.25 $1606.15 |
$1248.42 $1351.50 $1460.68 $1848.58 |
$1490.85 $1593.93 $1703.11 $2091.01 |
$624.21 $675.75 $730.34 $924.29 |
$866.64 $918.18 $972.77 $1166.72 |
$1109.07 $1160.61 $1215.20 $1409.15 |
$242.43 |
Plan: (EPO) Blue Cross® Metro Detroit EPO BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$193.50 $219.62 $247.29 $345.59 $525.16 |
$387.00 $439.24 $494.58 $691.18 $1050.32 |
$509.87 $562.11 $617.45 $814.05 |
$632.74 $684.98 $740.32 $936.92 |
$755.61 $807.85 $863.19 $1059.79 |
$316.37 $342.49 $370.16 $468.46 |
$439.24 $465.36 $493.03 $591.33 |
$562.11 $588.23 $615.90 $714.20 |
$122.87 |
Plan: (EPO) Blue Cross® Metro Detroit EPO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$259.52 $294.56 $331.67 $463.50 $704.34 |
$519.04 $589.12 $663.34 $927.00 $1408.68 |
$683.84 $753.92 $828.14 $1091.80 |
$848.64 $918.72 $992.94 $1256.60 |
$1013.44 $1083.52 $1157.74 $1421.40 |
$424.32 $459.36 $496.47 $628.30 |
$589.12 $624.16 $661.27 $793.10 |
$753.92 $788.96 $826.07 $957.90 |
$164.80 |
Plan: (EPO) Blue Cross® Metro Detroit EPO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$2,300
: Family:
$4,600 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$267.40 $303.50 $341.74 $477.58 $725.72 |
$534.80 $607.00 $683.48 $955.16 $1451.44 |
$704.60 $776.80 $853.28 $1124.96 |
$874.40 $946.60 $1023.08 $1294.76 |
$1044.20 $1116.40 $1192.88 $1464.56 |
$437.20 $473.30 $511.54 $647.38 |
$607.00 $643.10 $681.34 $817.18 |
$776.80 $812.90 $851.14 $986.98 |
$169.80 |
Plan: (EPO) Blue Cross® Metro Detroit EPO Gold ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$331.92 $376.73 $424.19 $592.81 $900.83 |
$663.84 $753.46 $848.38 $1185.62 $1801.66 |
$874.61 $964.23 $1059.15 $1396.39 |
$1085.38 $1175.00 $1269.92 $1607.16 |
$1296.15 $1385.77 $1480.69 $1817.93 |
$542.69 $587.50 $634.96 $803.58 |
$753.46 $798.27 $845.73 $1014.35 |
$964.23 $1009.04 $1056.50 $1225.12 |
$210.77 |
ADVERTISEMENT
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||||||||||
Priority Health Insurance Company (PHIC)Local: 1-855-682-5217 | Toll Free: 1-855-682-5217 |
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Plan: (PPO) MyPriority PPO RxPlus Silver 1900Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$1,900
: Family:
$3,800 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$289.01 $328.03 $369.35 $516.17 $784.37 |
$578.02 $656.06 $738.70 $1032.34 $1568.74 |
$761.54 $839.58 $922.22 $1215.86 |
$945.06 $1023.10 $1105.74 $1399.38 |
$1128.58 $1206.62 $1289.26 $1582.90 |
$472.53 $511.55 $552.87 $699.69 |
$656.05 $695.07 $736.39 $883.21 |
$839.57 $878.59 $919.91 $1066.73 |
++ |
Plan: (PPO) MyPriority PPO RxPlus Silver 1800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$1,800
: Family:
$3,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$283.47 $321.74 $362.27 $506.28 $769.34 |
$566.94 $643.48 $724.54 $1012.56 $1538.68 |
$746.94 $823.48 $904.54 $1192.56 |
$926.94 $1003.48 $1084.54 $1372.56 |
$1106.94 $1183.48 $1264.54 $1552.56 |
$463.47 $501.74 $542.27 $686.28 |
$643.47 $681.74 $722.27 $866.28 |
$823.47 $861.74 $902.27 $1046.28 |
$180.00 |
Plan: (PPO) MyPriority PPO HSA Silver 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$283.36 $321.61 $362.13 $506.08 $769.04 |
$566.72 $643.22 $724.26 $1012.16 $1538.08 |
$746.65 $823.15 $904.19 $1192.09 |
$926.58 $1003.08 $1084.12 $1372.02 |
$1106.51 $1183.01 $1264.05 $1551.95 |
$463.29 $501.54 $542.06 $686.01 |
$643.22 $681.47 $721.99 $865.94 |
$823.15 $861.40 $901.92 $1045.87 |
$179.93 |
Plan: (PPO) MyPriority PPO RxPlus Gold 200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$200
: Family:
$400 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$366.25 $415.69 $468.07 $654.12 $994.00 |
$732.50 $831.38 $936.14 $1308.24 $1988.00 |
$965.07 $1063.95 $1168.71 $1540.81 |
$1197.64 $1296.52 $1401.28 $1773.38 |
$1430.21 $1529.09 $1633.85 $2005.95 |
$598.82 $648.26 $700.64 $886.69 |
$831.39 $880.83 $933.21 $1119.26 |
$1063.96 $1113.40 $1165.78 $1351.83 |
$232.57 |
Plan: (PPO) MyPriority PPO RxPlus Bronze 3975Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$3,975
: Family:
$7,950 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$241.99 $274.66 $309.26 $432.19 $656.76 |
$483.98 $549.32 $618.52 $864.38 $1313.52 |
$637.64 $702.98 $772.18 $1018.04 |
$791.30 $856.64 $925.84 $1171.70 |
$944.96 $1010.30 $1079.50 $1325.36 |
$395.65 $428.32 $462.92 $585.85 |
$549.31 $581.98 $616.58 $739.51 |
$702.97 $735.64 $770.24 $893.17 |
$153.66 |
Plan: (PPO) MyPriority PPO RxPlus Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$294.55 $334.31 $376.43 $526.07 $799.41 |
$589.10 $668.62 $752.86 $1052.14 $1598.82 |
$776.14 $855.66 $939.90 $1239.18 |
$963.18 $1042.70 $1126.94 $1426.22 |
$1150.22 $1229.74 $1313.98 $1613.26 |
$481.59 $521.35 $563.47 $713.11 |
$668.63 $708.39 $750.51 $900.15 |
$855.67 $895.43 $937.55 $1087.19 |
$187.04 |
Plan: (PPO) MyPriority PPO HSA Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$215.84 $244.98 $275.84 $385.49 $585.79 |
$431.68 $489.96 $551.68 $770.98 $1171.58 |
$568.74 $627.02 $688.74 $908.04 |
$705.80 $764.08 $825.80 $1045.10 |
$842.86 $901.14 $962.86 $1182.16 |
$352.90 $382.04 $412.90 $522.55 |
$489.96 $519.10 $549.96 $659.61 |
$627.02 $656.16 $687.02 $796.67 |
$137.06 |
Plan: (PPO) MyPriority PPO HSA Gold 1350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health Insurance Company (PHIC))
Deductible: Individual:
$1,350
: Family:
$2,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$339.43 $385.25 $433.79 $606.22 $921.21 |
$678.86 $770.50 $867.58 $1212.44 $1842.42 |
$894.40 $986.04 $1083.12 $1427.98 |
$1109.94 $1201.58 $1298.66 $1643.52 |
$1325.48 $1417.12 $1514.20 $1859.06 |
$554.97 $600.79 $649.33 $821.76 |
$770.51 $816.33 $864.87 $1037.30 |
$986.05 $1031.87 $1080.41 $1252.84 |
$215.54 |
ADVERTISEMENT
|
||||||||||
Priority HealthLocal: 1-855-682-5217 | Toll Free: 1-855-682-5217 |
||||||||||
Plan: (HMO) MyPriority HMO RxPlus Silver 1900Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,900
: Family:
$3,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$242.32 $275.03 $309.68 $432.78 $657.66 |
$484.64 $550.06 $619.36 $865.56 $1315.32 |
$638.51 $703.93 $773.23 $1019.43 |
$792.38 $857.80 $927.10 $1173.30 |
$946.25 $1011.67 $1080.97 $1327.17 |
$396.19 $428.90 $463.55 $586.65 |
$550.06 $582.77 $617.42 $740.52 |
$703.93 $736.64 $771.29 $894.39 |
++ |
Plan: (HMO) MyPriority HMO RxPlus Silver 1800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,800
: Family:
$3,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$236.09 $267.96 $301.72 $421.66 $640.75 |
$472.18 $535.92 $603.44 $843.32 $1281.50 |
$622.10 $685.84 $753.36 $993.24 |
$772.02 $835.76 $903.28 $1143.16 |
$921.94 $985.68 $1053.20 $1293.08 |
$386.01 $417.88 $451.64 $571.58 |
$535.93 $567.80 $601.56 $721.50 |
$685.85 $717.72 $751.48 $871.42 |
$149.92 |
Plan: (HMO) MyPriority HMO HSA Silver 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$237.70 $269.79 $303.78 $424.53 $645.12 |
$475.40 $539.58 $607.56 $849.06 $1290.24 |
$626.34 $690.52 $758.50 $1000.00 |
$777.28 $841.46 $909.44 $1150.94 |
$928.22 $992.40 $1060.38 $1301.88 |
$388.64 $420.73 $454.72 $575.47 |
$539.58 $571.67 $605.66 $726.41 |
$690.52 $722.61 $756.60 $877.35 |
$150.94 |
Plan: (HMO) MyPriority HMO Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$243.55 $276.43 $311.26 $434.98 $660.99 |
$487.10 $552.86 $622.52 $869.96 $1321.98 |
$641.75 $707.51 $777.17 $1024.61 |
$796.40 $862.16 $931.82 $1179.26 |
$951.05 $1016.81 $1086.47 $1333.91 |
$398.20 $431.08 $465.91 $589.63 |
$552.85 $585.73 $620.56 $744.28 |
$707.50 $740.38 $775.21 $898.93 |
$154.65 |
Plan: (HMO) MyPriority HMO RxPlus Gold 200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$200
: Family:
$400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$319.18 $362.27 $407.91 $570.06 $866.25 |
$638.36 $724.54 $815.82 $1140.12 $1732.50 |
$841.04 $927.22 $1018.50 $1342.80 |
$1043.72 $1129.90 $1221.18 $1545.48 |
$1246.40 $1332.58 $1423.86 $1748.16 |
$521.86 $564.95 $610.59 $772.74 |
$724.54 $767.63 $813.27 $975.42 |
$927.22 $970.31 $1015.95 $1178.10 |
$202.68 |
Plan: (HMO) MyPriority HMO RxPlus Bronze 3975Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$3,975
: Family:
$7,950 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$204.04 $231.59 $260.76 $364.42 $553.76 |
$408.08 $463.18 $521.52 $728.84 $1107.52 |
$537.65 $592.75 $651.09 $858.41 |
$667.22 $722.32 $780.66 $987.98 |
$796.79 $851.89 $910.23 $1117.55 |
$333.61 $361.16 $390.33 $493.99 |
$463.18 $490.73 $519.90 $623.56 |
$592.75 $620.30 $649.47 $753.13 |
$129.57 |
Plan: (HMO) MyPriority HMO RxPlus Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$244.56 $277.58 $312.55 $436.78 $663.74 |
$489.12 $555.16 $625.10 $873.56 $1327.48 |
$644.42 $710.46 $780.40 $1028.86 |
$799.72 $865.76 $935.70 $1184.16 |
$955.02 $1021.06 $1091.00 $1339.46 |
$399.86 $432.88 $467.85 $592.08 |
$555.16 $588.18 $623.15 $747.38 |
$710.46 $743.48 $778.45 $902.68 |
$155.30 |
Plan: (HMO) MyPriority HMO HSA Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$181.08 $205.53 $231.42 $323.41 $491.45 |
$362.16 $411.06 $462.84 $646.82 $982.90 |
$477.15 $526.05 $577.83 $761.81 |
$592.14 $641.04 $692.82 $876.80 |
$707.13 $756.03 $807.81 $991.79 |
$296.07 $320.52 $346.41 $438.40 |
$411.06 $435.51 $461.40 $553.39 |
$526.05 $550.50 $576.39 $668.38 |
$114.99 |
Plan: (HMO) MyPriority HMO HSA Gold 1350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,350
: Family:
$2,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$297.31 $337.45 $379.96 $531.00 $806.90 |
$594.62 $674.90 $759.92 $1062.00 $1613.80 |
$783.41 $863.69 $948.71 $1250.79 |
$972.20 $1052.48 $1137.50 $1439.58 |
$1160.99 $1241.27 $1326.29 $1628.37 |
$486.10 $526.24 $568.75 $719.79 |
$674.89 $715.03 $757.54 $908.58 |
$863.68 $903.82 $946.33 $1097.37 |
$188.79 |
Plan: (HMO) MyPriority HMO Bronze 6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$186.49 $211.67 $238.33 $333.07 $506.13 |
$372.98 $423.34 $476.66 $666.14 $1012.26 |
$491.40 $541.76 $595.08 $784.56 |
$609.82 $660.18 $713.50 $902.98 |
$728.24 $778.60 $831.92 $1021.40 |
$304.91 $330.09 $356.75 $451.49 |
$423.33 $448.51 $475.17 $569.91 |
$541.75 $566.93 $593.59 $688.33 |
$118.42 |
Plan: (HMO) MyPriority HMO Holistic Bronze 5200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$5,200
: Family:
$10,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$195.01 $221.34 $249.22 $348.29 $529.26 |
$390.02 $442.68 $498.44 $696.58 $1058.52 |
$513.85 $566.51 $622.27 $820.41 |
$637.68 $690.34 $746.10 $944.24 |
$761.51 $814.17 $869.93 $1068.07 |
$318.84 $345.17 $373.05 $472.12 |
$442.67 $469.00 $496.88 $595.95 |
$566.50 $592.83 $620.71 $719.78 |
$123.83 |
Plan: (HMO) MyPriority HMO Holistic Silver 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$235.81 $267.64 $301.37 $421.16 $639.99 |
$471.62 $535.28 $602.74 $842.32 $1279.98 |
$621.36 $685.02 $752.48 $992.06 |
$771.10 $834.76 $902.22 $1141.80 |
$920.84 $984.50 $1051.96 $1291.54 |
$385.55 $417.38 $451.11 $570.90 |
$535.29 $567.12 $600.85 $720.64 |
$685.03 $716.86 $750.59 $870.38 |
$149.74 |
Plan: (POS) MyPriority POS RxPlus Silver 1800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,800
: Family:
$3,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$240.30 $272.74 $307.10 $429.18 $652.17 |
$480.60 $545.48 $614.20 $858.36 $1304.34 |
$633.19 $698.07 $766.79 $1010.95 |
$785.78 $850.66 $919.38 $1163.54 |
$938.37 $1003.25 $1071.97 $1316.13 |
$392.89 $425.33 $459.69 $581.77 |
$545.48 $577.92 $612.28 $734.36 |
$698.07 $730.51 $764.87 $886.95 |
$152.59 |
Plan: (POS) MyPriority POS Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$248.27 $281.79 $317.29 $443.41 $673.80 |
$496.54 $563.58 $634.58 $886.82 $1347.60 |
$654.19 $721.23 $792.23 $1044.47 |
$811.84 $878.88 $949.88 $1202.12 |
$969.49 $1036.53 $1107.53 $1359.77 |
$405.92 $439.44 $474.94 $601.06 |
$563.57 $597.09 $632.59 $758.71 |
$721.22 $754.74 $790.24 $916.36 |
$157.65 |
Plan: (POS) MyPriority POS RxPlus Gold 200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$200
: Family:
$400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$327.06 $371.21 $417.98 $584.13 $887.64 |
$654.12 $742.42 $835.96 $1168.26 $1775.28 |
$861.80 $950.10 $1043.64 $1375.94 |
$1069.48 $1157.78 $1251.32 $1583.62 |
$1277.16 $1365.46 $1459.00 $1791.30 |
$534.74 $578.89 $625.66 $791.81 |
$742.42 $786.57 $833.34 $999.49 |
$950.10 $994.25 $1041.02 $1207.17 |
$207.68 |
Plan: (POS) MyPriority POS RxPlus Bronze 3975Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$3,975
: Family:
$7,950 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$206.80 $234.72 $264.29 $369.34 $561.26 |
$413.60 $469.44 $528.58 $738.68 $1122.52 |
$544.92 $600.76 $659.90 $870.00 |
$676.24 $732.08 $791.22 $1001.32 |
$807.56 $863.40 $922.54 $1132.64 |
$338.12 $366.04 $395.61 $500.66 |
$469.44 $497.36 $526.93 $631.98 |
$600.76 $628.68 $658.25 $763.30 |
$131.32 |
Plan: (POS) MyPriority POS RxPlus Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$249.76 $283.48 $319.19 $446.07 $677.85 |
$499.52 $566.96 $638.38 $892.14 $1355.70 |
$658.12 $725.56 $796.98 $1050.74 |
$816.72 $884.16 $955.58 $1209.34 |
$975.32 $1042.76 $1114.18 $1367.94 |
$408.36 $442.08 $477.79 $604.67 |
$566.96 $600.68 $636.39 $763.27 |
$725.56 $759.28 $794.99 $921.87 |
$158.60 |
Plan: (POS) MyPriority POS HSA Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$182.58 $207.23 $233.34 $326.09 $495.52 |
$365.16 $414.46 $466.68 $652.18 $991.04 |
$481.10 $530.40 $582.62 $768.12 |
$597.04 $646.34 $698.56 $884.06 |
$712.98 $762.28 $814.50 $1000.00 |
$298.52 $323.17 $349.28 $442.03 |
$414.46 $439.11 $465.22 $557.97 |
$530.40 $555.05 $581.16 $673.91 |
$115.94 |
Plan: (POS) MyPriority POS HSA Gold 1350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,350
: Family:
$2,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$300.70 $341.29 $384.29 $537.05 $816.10 |
$601.40 $682.58 $768.58 $1074.10 $1632.20 |
$792.34 $873.52 $959.52 $1265.04 |
$983.28 $1064.46 $1150.46 $1455.98 |
$1174.22 $1255.40 $1341.40 $1646.92 |
$491.64 $532.23 $575.23 $727.99 |
$682.58 $723.17 $766.17 $918.93 |
$873.52 $914.11 $957.11 $1109.87 |
$190.94 |
Plan: (POS) MyPriority POS Bronze 6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$187.94 $213.31 $240.19 $335.66 $510.07 |
$375.88 $426.62 $480.38 $671.32 $1020.14 |
$495.22 $545.96 $599.72 $790.66 |
$614.56 $665.30 $719.06 $910.00 |
$733.90 $784.64 $838.40 $1029.34 |
$307.28 $332.65 $359.53 $455.00 |
$426.62 $451.99 $478.87 $574.34 |
$545.96 $571.33 $598.21 $693.68 |
$119.34 |
Plan: (POS) MyPriority POS Holistic Bronze 5200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$5,200
: Family:
$10,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$196.75 $223.31 $251.45 $351.40 $533.98 |
$393.50 $446.62 $502.90 $702.80 $1067.96 |
$518.44 $571.56 $627.84 $827.74 |
$643.38 $696.50 $752.78 $952.68 |
$768.32 $821.44 $877.72 $1077.62 |
$321.69 $348.25 $376.39 $476.34 |
$446.63 $473.19 $501.33 $601.28 |
$571.57 $598.13 $626.27 $726.22 |
++ |
Plan: (POS) MyPriority POS Holistic Silver 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$239.17 $271.46 $305.66 $427.16 $649.11 |
$478.34 $542.92 $611.32 $854.32 $1298.22 |
$630.21 $694.79 $763.19 $1006.19 |
$782.08 $846.66 $915.06 $1158.06 |
$933.95 $998.53 $1066.93 $1309.93 |
$391.04 $423.33 $457.53 $579.03 |
$542.91 $575.20 $609.40 $730.90 |
$694.78 $727.07 $761.27 $882.77 |
$151.87 |
ADVERTISEMENT
|
||||||||||
Harbor Health Plan, Inc.Local: 1-866-420-6782 | Toll Free: 1-866-420-6782 TTY: 1-877-613-2075 |
||||||||||
Plan: (HMO) Harbor Choice GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-420-6782 - Provider Directory for This Plan: (Harbor Health Plan, Inc.)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$232.44 $263.81 $297.05 $415.13 $630.84 |
$464.88 $527.62 $594.10 $830.26 $1261.68 |
$612.47 $675.21 $741.69 $977.85 |
$760.06 $822.80 $889.28 $1125.44 |
$907.65 $970.39 $1036.87 $1273.03 |
$380.03 $411.40 $444.64 $562.72 |
$527.62 $558.99 $592.23 $710.31 |
$675.21 $706.58 $739.82 $857.90 |
$147.59 |
Plan: (HMO) Harbor Choice SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-420-6782 - Provider Directory for This Plan: (Harbor Health Plan, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$176.74 $200.59 $225.87 $315.65 $479.67 |
$353.48 $401.18 $451.74 $631.30 $959.34 |
$465.70 $513.40 $563.96 $743.52 |
$577.92 $625.62 $676.18 $855.74 |
$690.14 $737.84 $788.40 $967.96 |
$288.96 $312.81 $338.09 $427.87 |
$401.18 $425.03 $450.31 $540.09 |
$513.40 $537.25 $562.53 $652.31 |
$112.22 |
Plan: (HMO) Harbor Choice BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-420-6782 - Provider Directory for This Plan: (Harbor Health Plan, Inc.)
Deductible: Individual:
$6,150
: Family:
$12,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$155.15 $176.09 $198.28 $277.09 $421.07 |
$310.30 $352.18 $396.56 $554.18 $842.14 |
$408.82 $450.70 $495.08 $652.70 |
$507.34 $549.22 $593.60 $751.22 |
$605.86 $647.74 $692.12 $849.74 |
$253.67 $274.61 $296.80 $375.61 |
$352.19 $373.13 $395.32 $474.13 |
$450.71 $471.65 $493.84 $572.65 |
$98.52 |
Plan: (HMO) Harbor Choice Plus SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-420-6782 - Provider Directory for This Plan: (Harbor Health Plan, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$199.70 $226.65 $255.21 $356.66 $541.98 |
$399.40 $453.30 $510.42 $713.32 $1083.96 |
$526.20 $580.10 $637.22 $840.12 |
$653.00 $706.90 $764.02 $966.92 |
$779.80 $833.70 $890.82 $1093.72 |
$326.50 $353.45 $382.01 $483.46 |
$453.30 $480.25 $508.81 $610.26 |
$580.10 $607.05 $635.61 $737.06 |
$126.80 |
ADVERTISEMENT
|
||||||||||
Health Alliance Plan (HAP)Local: 1-313-872-8100 | Toll Free: 1-855-948-4427 |
||||||||||
Plan: (HMO) HAP Personal Alliance 2500 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$258.22 $293.08 $330.01 $461.18 $700.81 |
$516.44 $586.16 $660.02 $922.36 $1401.62 |
$680.41 $750.13 $823.99 $1086.33 |
$844.38 $914.10 $987.96 $1250.30 |
$1008.35 $1078.07 $1151.93 $1414.27 |
$422.19 $457.05 $493.98 $625.15 |
$586.16 $621.02 $657.95 $789.12 |
$750.13 $784.99 $821.92 $953.09 |
$163.97 |
Plan: (HMO) HAP Personal Alliance 4500 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$219.42 $249.04 $280.42 $391.88 $595.51 |
$438.84 $498.08 $560.84 $783.76 $1191.02 |
$578.17 $637.41 $700.17 $923.09 |
$717.50 $776.74 $839.50 $1062.42 |
$856.83 $916.07 $978.83 $1201.75 |
$358.75 $388.37 $419.75 $531.21 |
$498.08 $527.70 $559.08 $670.54 |
$637.41 $667.03 $698.41 $809.87 |
$139.33 |
Plan: (HMO) HAP Personal Alliance 3000 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$254.30 $288.63 $325.00 $454.18 $690.17 |
$508.60 $577.26 $650.00 $908.36 $1380.34 |
$670.08 $738.74 $811.48 $1069.84 |
$831.56 $900.22 $972.96 $1231.32 |
$993.04 $1061.70 $1134.44 $1392.80 |
$415.78 $450.11 $486.48 $615.66 |
$577.26 $611.59 $647.96 $777.14 |
$738.74 $773.07 $809.44 $938.62 |
$161.48 |
Plan: (HMO) HAP Personal Alliance 5000 HMO (HSA)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$181.31 $205.79 $231.71 $323.82 $492.08 |
$362.62 $411.58 $463.42 $647.64 $984.16 |
$477.75 $526.71 $578.55 $762.77 |
$592.88 $641.84 $693.68 $877.90 |
$708.01 $756.97 $808.81 $993.03 |
$296.44 $320.92 $346.84 $438.95 |
$411.57 $436.05 $461.97 $554.08 |
$526.70 $551.18 $577.10 $669.21 |
$115.13 |
Plan: (HMO) HAP Personal Alliance 6850C HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$156.37 $177.48 $199.84 $279.28 $424.39 |
$312.74 $354.96 $399.68 $558.56 $848.78 |
$412.03 $454.25 $498.97 $657.85 |
$511.32 $553.54 $598.26 $757.14 |
$610.61 $652.83 $697.55 $856.43 |
$255.66 $276.77 $299.13 $378.57 |
$354.95 $376.06 $398.42 $477.86 |
$454.24 $475.35 $497.71 $577.15 |
$99.29 |
Plan: (HMO) HAP Personal Alliance 3500 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$239.05 $271.32 $305.51 $426.94 $648.78 |
$478.10 $542.64 $611.02 $853.88 $1297.56 |
$629.90 $694.44 $762.82 $1005.68 |
$781.70 $846.24 $914.62 $1157.48 |
$933.50 $998.04 $1066.42 $1309.28 |
$390.85 $423.12 $457.31 $578.74 |
$542.65 $574.92 $609.11 $730.54 |
$694.45 $726.72 $760.91 $882.34 |
$151.80 |
Plan: (HMO) HAP Personal Alliance 6850 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$206.95 $234.89 $264.48 $369.61 $561.66 |
$413.90 $469.78 $528.96 $739.22 $1123.32 |
$545.31 $601.19 $660.37 $870.63 |
$676.72 $732.60 $791.78 $1002.04 |
$808.13 $864.01 $923.19 $1133.45 |
$338.36 $366.30 $395.89 $501.02 |
$469.77 $497.71 $527.30 $632.43 |
$601.18 $629.12 $658.71 $763.84 |
$131.41 |
Plan: (HMO) HAP Personal Alliance 1500 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$254.30 $288.63 $325.00 $454.18 $690.17 |
$508.60 $577.26 $650.00 $908.36 $1380.34 |
$670.08 $738.74 $811.48 $1069.84 |
$831.56 $900.22 $972.96 $1231.32 |
$993.04 $1061.70 $1134.44 $1392.80 |
$415.78 $450.11 $486.48 $615.66 |
$577.26 $611.59 $647.96 $777.14 |
$738.74 $773.07 $809.44 $938.62 |
$161.48 |
Plan: (HMO) HAP Personal Alliance 2500 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$219.19 $248.78 $280.12 $391.47 $594.88 |
$438.38 $497.56 $560.24 $782.94 $1189.76 |
$577.57 $636.75 $699.43 $922.13 |
$716.76 $775.94 $838.62 $1061.32 |
$855.95 $915.13 $977.81 $1200.51 |
$358.38 $387.97 $419.31 $530.66 |
$497.57 $527.16 $558.50 $669.85 |
$636.76 $666.35 $697.69 $809.04 |
$139.19 |
Plan: (HMO) HAP Personal Alliance 3000 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$216.19 $245.38 $276.29 $386.12 $586.74 |
$432.38 $490.76 $552.58 $772.24 $1173.48 |
$569.66 $628.04 $689.86 $909.52 |
$706.94 $765.32 $827.14 $1046.80 |
$844.22 $902.60 $964.42 $1184.08 |
$353.47 $382.66 $413.57 $523.40 |
$490.75 $519.94 $550.85 $660.68 |
$628.03 $657.22 $688.13 $797.96 |
$137.28 |
Plan: (HMO) HAP Personal Alliance 4500 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$183.85 $208.67 $234.96 $328.36 $498.97 |
$367.70 $417.34 $469.92 $656.72 $997.94 |
$484.44 $534.08 $586.66 $773.46 |
$601.18 $650.82 $703.40 $890.20 |
$717.92 $767.56 $820.14 $1006.94 |
$300.59 $325.41 $351.70 $445.10 |
$417.33 $442.15 $468.44 $561.84 |
$534.07 $558.89 $585.18 $678.58 |
$116.74 |
Plan: (HMO) HAP Personal Alliance 5000 HMO (HSA) Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$154.29 $175.12 $197.18 $275.56 $418.74 |
$308.58 $350.24 $394.36 $551.12 $837.48 |
$406.55 $448.21 $492.33 $649.09 |
$504.52 $546.18 $590.30 $747.06 |
$602.49 $644.15 $688.27 $845.03 |
$252.26 $273.09 $295.15 $373.53 |
$350.23 $371.06 $393.12 $471.50 |
$448.20 $469.03 $491.09 $569.47 |
$97.97 |
Plan: (HMO) HAP Personal Alliance 6850C HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$133.04 $151.00 $170.03 $237.61 $361.07 |
$266.08 $302.00 $340.06 $475.22 $722.14 |
$350.56 $386.48 $424.54 $559.70 |
$435.04 $470.96 $509.02 $644.18 |
$519.52 $555.44 $593.50 $728.66 |
$217.52 $235.48 $254.51 $322.09 |
$302.00 $319.96 $338.99 $406.57 |
$386.48 $404.44 $423.47 $491.05 |
$84.48 |
Plan: (HMO) HAP Personal Alliance 3500 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$203.25 $230.69 $259.75 $363.00 $551.62 |
$406.50 $461.38 $519.50 $726.00 $1103.24 |
$535.56 $590.44 $648.56 $855.06 |
$664.62 $719.50 $777.62 $984.12 |
$793.68 $848.56 $906.68 $1113.18 |
$332.31 $359.75 $388.81 $492.06 |
$461.37 $488.81 $517.87 $621.12 |
$590.43 $617.87 $646.93 $750.18 |
$129.06 |
Plan: (HMO) HAP Personal Alliance 6850 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$176.00 $199.76 $224.93 $314.34 $477.66 |
$352.00 $399.52 $449.86 $628.68 $955.32 |
$463.76 $511.28 $561.62 $740.44 |
$575.52 $623.04 $673.38 $852.20 |
$687.28 $734.80 $785.14 $963.96 |
$287.76 $311.52 $336.69 $426.10 |
$399.52 $423.28 $448.45 $537.86 |
$511.28 $535.04 $560.21 $649.62 |
$111.76 |
ADVERTISEMENT
|
||||||||||
Molina Healthcare of Michigan, Inc.Local: 1-888-560-4087 | Toll Free: 1-888-560-4087 TTY: 1-888-665-4629 |
||||||||||
Plan: (HMO) Molina Marketplace Gold PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$231.40 $262.64 $295.73 $413.28 $628.02 |
$462.80 $525.28 $591.46 $826.56 $1256.04 |
$609.74 $672.22 $738.40 $973.50 |
$756.68 $819.16 $885.34 $1120.44 |
$903.62 $966.10 $1032.28 $1267.38 |
$378.34 $409.58 $442.67 $560.22 |
$525.28 $556.52 $589.61 $707.16 |
$672.22 $703.46 $736.55 $854.10 |
$146.94 |
Plan: (HMO) Molina Marketplace Silver PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$179.51 $203.75 $229.42 $320.61 $487.20 |
$359.02 $407.50 $458.84 $641.22 $974.40 |
$473.01 $521.49 $572.83 $755.21 |
$587.00 $635.48 $686.82 $869.20 |
$700.99 $749.47 $800.81 $983.19 |
$293.50 $317.74 $343.41 $434.60 |
$407.49 $431.73 $457.40 $548.59 |
$521.48 $545.72 $571.39 $662.58 |
$113.99 |
Plan: (HMO) Molina Marketplace Bronze PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$145.37 $164.99 $185.78 $259.62 $394.52 |
$290.74 $329.98 $371.56 $519.24 $789.04 |
$383.05 $422.29 $463.87 $611.55 |
$475.36 $514.60 $556.18 $703.86 |
$567.67 $606.91 $648.49 $796.17 |
$237.68 $257.30 $278.09 $351.93 |
$329.99 $349.61 $370.40 $444.24 |
$422.30 $441.92 $462.71 $536.55 |
$92.31 |
ADVERTISEMENT
|
||||||||||
Consumers Mutual Insurance of MichiganLocal: 1-877-371-9112 | Toll Free: 1-877-371-9112 |
||||||||||
Plan: (PPO) Consumers Mutual Gold $1000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$413.99 $469.87 $529.07 $739.38 $1123.56 |
$827.98 $939.74 $1058.14 $1478.76 $2247.12 |
$1090.86 $1202.62 $1321.02 $1741.64 |
$1353.74 $1465.50 $1583.90 $2004.52 |
$1616.62 $1728.38 $1846.78 $2267.40 |
$676.87 $732.75 $791.95 $1002.26 |
$939.75 $995.63 $1054.83 $1265.14 |
$1202.63 $1258.51 $1317.71 $1528.02 |
$262.88 |
Plan: (PPO) Consumers Mutual Silver Choice PlusSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$354.08 $401.88 $452.51 $632.38 $960.97 |
$708.16 $803.76 $905.02 $1264.76 $1921.94 |
$933.00 $1028.60 $1129.86 $1489.60 |
$1157.84 $1253.44 $1354.70 $1714.44 |
$1382.68 $1478.28 $1579.54 $1939.28 |
$578.92 $626.72 $677.35 $857.22 |
$803.76 $851.56 $902.19 $1082.06 |
$1028.60 $1076.40 $1127.03 $1306.90 |
$224.84 |
Plan: (PPO) Consumers Mutual Generation YSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$258.24 $293.10 $330.03 $461.21 $700.86 |
$516.48 $586.20 $660.06 $922.42 $1401.72 |
$680.46 $750.18 $824.04 $1086.40 |
$844.44 $914.16 $988.02 $1250.38 |
$1008.42 $1078.14 $1152.00 $1414.36 |
$422.22 $457.08 $494.01 $625.19 |
$586.20 $621.06 $657.99 $789.17 |
$750.18 $785.04 $821.97 $953.15 |
++ |
Plan: (PPO) Consumers Mutual Gold $500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$412.43 $468.10 $527.08 $736.59 $1119.33 |
$824.86 $936.20 $1054.16 $1473.18 $2238.66 |
$1086.75 $1198.09 $1316.05 $1735.07 |
$1348.64 $1459.98 $1577.94 $1996.96 |
$1610.53 $1721.87 $1839.83 $2258.85 |
$674.32 $729.99 $788.97 $998.48 |
$936.21 $991.88 $1050.86 $1260.37 |
$1198.10 $1253.77 $1312.75 $1522.26 |
$261.89 |
Plan: (PPO) Consumers Mutual Silver ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$342.31 $388.52 $437.47 $611.36 $929.02 |
$684.62 $777.04 $874.94 $1222.72 $1858.04 |
$901.98 $994.40 $1092.30 $1440.08 |
$1119.34 $1211.76 $1309.66 $1657.44 |
$1336.70 $1429.12 $1527.02 $1874.80 |
$559.67 $605.88 $654.83 $828.72 |
$777.03 $823.24 $872.19 $1046.08 |
$994.39 $1040.60 $1089.55 $1263.44 |
$217.36 |
Plan: (PPO) Consumers Mutual Bronze $3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$264.06 $299.70 $337.46 $471.61 $716.65 |
$528.12 $599.40 $674.92 $943.22 $1433.30 |
$695.79 $767.07 $842.59 $1110.89 |
$863.46 $934.74 $1010.26 $1278.56 |
$1031.13 $1102.41 $1177.93 $1446.23 |
$431.73 $467.37 $505.13 $639.28 |
$599.40 $635.04 $672.80 $806.95 |
$767.07 $802.71 $840.47 $974.62 |
$167.67 |
Plan: (PPO) Consumers Mutual Bronze $6350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$264.03 $299.67 $337.43 $471.55 $716.57 |
$528.06 $599.34 $674.86 $943.10 $1433.14 |
$695.71 $766.99 $842.51 $1110.75 |
$863.36 $934.64 $1010.16 $1278.40 |
$1031.01 $1102.29 $1177.81 $1446.05 |
$431.68 $467.32 $505.08 $639.20 |
$599.33 $634.97 $672.73 $806.85 |
$766.98 $802.62 $840.38 $974.50 |
$167.65 |
Plan: (PPO) CO-OPtions® Gold, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$424.16 $481.42 $542.07 $757.54 $1151.17 |
$848.32 $962.84 $1084.14 $1515.08 $2302.34 |
$1117.66 $1232.18 $1353.48 $1784.42 |
$1387.00 $1501.52 $1622.82 $2053.76 |
$1656.34 $1770.86 $1892.16 $2323.10 |
$693.50 $750.76 $811.41 $1026.88 |
$962.84 $1020.10 $1080.75 $1296.22 |
$1232.18 $1289.44 $1350.09 $1565.56 |
$269.34 |
Plan: (PPO) CO-OPtions® Silver, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-371-9112 - Provider Directory for This Plan: (Consumers Mutual Insurance of Michigan)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$353.37 $401.07 $451.60 $631.11 $959.04 |
$706.74 $802.14 $903.20 $1262.22 $1918.08 |
$931.12 $1026.52 $1127.58 $1486.60 |
$1155.50 $1250.90 $1351.96 $1710.98 |
$1379.88 $1475.28 $1576.34 $1935.36 |
$577.75 $625.45 $675.98 $855.49 |
$802.13 $849.83 $900.36 $1079.87 |
$1026.51 $1074.21 $1124.74 $1304.25 |
$224.38 |
ADVERTISEMENT
|
||||||||||
Humana Medical Plan of Michigan, Inc.Local: 1-877-720-4854 | Toll Free: 1-877-720-4854 TTY: 711 |
||||||||||
Plan: (HMO) Humana Basic 6850/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$103.60 $117.59 $132.40 $185.03 $281.17 |
$207.20 $235.18 $264.80 $370.06 $562.34 |
$272.99 $300.97 $330.59 $435.85 |
$338.78 $366.76 $396.38 $501.64 |
$404.57 $432.55 $462.17 $567.43 |
$169.39 $183.38 $198.19 $250.82 |
$235.18 $249.17 $263.98 $316.61 |
$300.97 $314.96 $329.77 $382.40 |
$65.79 |
Plan: (HMO) Humana Bronze 6450/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$139.25 $158.05 $177.96 $248.70 $377.92 |
$278.50 $316.10 $355.92 $497.40 $755.84 |
$366.92 $404.52 $444.34 $585.82 |
$455.34 $492.94 $532.76 $674.24 |
$543.76 $581.36 $621.18 $762.66 |
$227.67 $246.47 $266.38 $337.12 |
$316.09 $334.89 $354.80 $425.54 |
$404.51 $423.31 $443.22 $513.96 |
$88.42 |
Plan: (HMO) Humana Silver 3800/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$3,800
: Family:
$7,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$164.23 $186.40 $209.89 $293.31 $445.72 |
$328.46 $372.80 $419.78 $586.62 $891.44 |
$432.75 $477.09 $524.07 $690.91 |
$537.04 $581.38 $628.36 $795.20 |
$641.33 $685.67 $732.65 $899.49 |
$268.52 $290.69 $314.18 $397.60 |
$372.81 $394.98 $418.47 $501.89 |
$477.10 $499.27 $522.76 $606.18 |
$104.29 |
Plan: (HMO) Humana Gold 2250/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$2,250
: Family:
$4,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$195.13 $221.47 $249.38 $348.50 $529.58 |
$390.26 $442.94 $498.76 $697.00 $1059.16 |
$514.17 $566.85 $622.67 $820.91 |
$638.08 $690.76 $746.58 $944.82 |
$761.99 $814.67 $870.49 $1068.73 |
$319.04 $345.38 $373.29 $472.41 |
$442.95 $469.29 $497.20 $596.32 |
$566.86 $593.20 $621.11 $720.23 |
$123.91 |
Plan: (HMO) Humana Platinum 500/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Platinum | 21 30 40 50 60 |
$232.52 $263.91 $297.16 $415.28 $631.06 |
$465.04 $527.82 $594.32 $830.56 $1262.12 |
$612.69 $675.47 $741.97 $978.21 |
$760.34 $823.12 $889.62 $1125.86 |
$907.99 $970.77 $1037.27 $1273.51 |
$380.17 $411.56 $444.81 $562.93 |
$527.82 $559.21 $592.46 $710.58 |
$675.47 $706.86 $740.11 $858.23 |
$147.65 |
ADVERTISEMENT
|
||||||||||
Total Health Care USA, Inc.Local: 1-313-871-2000 x350 | Toll Free: 1-800-826-2862 TTY: 1-800-649-3777 |
||||||||||
Plan: (HMO) Total HMO StandardSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$227.87 $258.64 $291.22 $406.98 $618.45 |
$455.74 $517.28 $582.44 $813.96 $1236.90 |
$600.44 $661.98 $727.14 $958.66 |
$745.14 $806.68 $871.84 $1103.36 |
$889.84 $951.38 $1016.54 $1248.06 |
$372.57 $403.34 $435.92 $551.68 |
$517.27 $548.04 $580.62 $696.38 |
$661.97 $692.74 $725.32 $841.08 |
$144.70 |
Plan: (HMO) Totally YouSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, Inc.)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$195.60 $222.01 $249.98 $349.34 $530.86 |
$391.20 $444.02 $499.96 $698.68 $1061.72 |
$515.41 $568.23 $624.17 $822.89 |
$639.62 $692.44 $748.38 $947.10 |
$763.83 $816.65 $872.59 $1071.31 |
$319.81 $346.22 $374.19 $473.55 |
$444.02 $470.43 $498.40 $597.76 |
$568.23 $594.64 $622.61 $721.97 |
$124.21 |
ADVERTISEMENT
|
||||||||||
Alliance Health and Life Insurance CompanyLocal: 1-313-872-8100 | Toll Free: 1-855-948-4427 |
||||||||||
Plan: (PPO) HAP Personal Alliance 1500 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$334.81 $380.01 $427.89 $597.97 $908.67 |
$669.62 $760.02 $855.78 $1195.94 $1817.34 |
$882.22 $972.62 $1068.38 $1408.54 |
$1094.82 $1185.22 $1280.98 $1621.14 |
$1307.42 $1397.82 $1493.58 $1833.74 |
$547.41 $592.61 $640.49 $810.57 |
$760.01 $805.21 $853.09 $1023.17 |
$972.61 $1017.81 $1065.69 $1235.77 |
$212.60 |
Plan: (PPO) HAP Personal Alliance 3000 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$275.98 $313.24 $352.70 $492.90 $749.01 |
$551.96 $626.48 $705.40 $985.80 $1498.02 |
$727.21 $801.73 $880.65 $1161.05 |
$902.46 $976.98 $1055.90 $1336.30 |
$1077.71 $1152.23 $1231.15 $1511.55 |
$451.23 $488.49 $527.95 $668.15 |
$626.48 $663.74 $703.20 $843.40 |
$801.73 $838.99 $878.45 $1018.65 |
$175.25 |
Plan: (PPO) HAP Personal Alliance 5000 PPO (HSA)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$197.80 $224.50 $252.79 $353.27 $536.83 |
$395.60 $449.00 $505.58 $706.54 $1073.66 |
$521.20 $574.60 $631.18 $832.14 |
$646.80 $700.20 $756.78 $957.74 |
$772.40 $825.80 $882.38 $1083.34 |
$323.40 $350.10 $378.39 $478.87 |
$449.00 $475.70 $503.99 $604.47 |
$574.60 $601.30 $629.59 $730.07 |
$125.60 |
Plan: (PPO) HAP Personal Alliance 6850C PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$171.80 $194.99 $219.56 $306.83 $466.27 |
$343.60 $389.98 $439.12 $613.66 $932.54 |
$452.69 $499.07 $548.21 $722.75 |
$561.78 $608.16 $657.30 $831.84 |
$670.87 $717.25 $766.39 $940.93 |
$280.89 $304.08 $328.65 $415.92 |
$389.98 $413.17 $437.74 $525.01 |
$499.07 $522.26 $546.83 $634.10 |
$109.09 |
Plan: (PPO) HAP Personal Alliance 2500 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$282.23 $320.33 $360.69 $504.06 $765.97 |
$564.46 $640.66 $721.38 $1008.12 $1531.94 |
$743.68 $819.88 $900.60 $1187.34 |
$922.90 $999.10 $1079.82 $1366.56 |
$1102.12 $1178.32 $1259.04 $1545.78 |
$461.45 $499.55 $539.91 $683.28 |
$640.67 $678.77 $719.13 $862.50 |
$819.89 $857.99 $898.35 $1041.72 |
$179.22 |
Plan: (PPO) HAP Personal Alliance 4500 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$237.08 $269.09 $302.99 $423.42 $643.44 |
$474.16 $538.18 $605.98 $846.84 $1286.88 |
$624.71 $688.73 $756.53 $997.39 |
$775.26 $839.28 $907.08 $1147.94 |
$925.81 $989.83 $1057.63 $1298.49 |
$387.63 $419.64 $453.54 $573.97 |
$538.18 $570.19 $604.09 $724.52 |
$688.73 $720.74 $754.64 $875.07 |
$150.55 |
Plan: (PPO) HAP Personal Alliance 3500 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$262.29 $297.70 $335.21 $468.45 $711.86 |
$524.58 $595.40 $670.42 $936.90 $1423.72 |
$691.13 $761.95 $836.97 $1103.45 |
$857.68 $928.50 $1003.52 $1270.00 |
$1024.23 $1095.05 $1170.07 $1436.55 |
$428.84 $464.25 $501.76 $635.00 |
$595.39 $630.80 $668.31 $801.55 |
$761.94 $797.35 $834.86 $968.10 |
$166.55 |
Plan: (PPO) HAP Personal Alliance 6850 PPOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Alliance Health and Life Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$226.33 $256.88 $289.25 $404.23 $614.26 |
$452.66 $513.76 $578.50 $808.46 $1228.52 |
$596.38 $657.48 $722.22 $952.18 |
$740.10 $801.20 $865.94 $1095.90 |
$883.82 $944.92 $1009.66 $1239.62 |
$370.05 $400.60 $432.97 $547.95 |
$513.77 $544.32 $576.69 $691.67 |
$657.49 $688.04 $720.41 $835.39 |
$143.72 |
ADVERTISEMENT
|
||||||||||
UnitedHealthcare Community Plan, Inc.Local: 1-877-887-0448 | Toll Free: 1-877-887-0448 |
||||||||||
Plan: (HMO) Gold Compass 1000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$247.14 $280.50 $315.84 $441.39 $670.73 |
$494.28 $561.00 $631.68 $882.78 $1341.46 |
$651.21 $717.93 $788.61 $1039.71 |
$808.14 $874.86 $945.54 $1196.64 |
$965.07 $1031.79 $1102.47 $1353.57 |
$404.07 $437.43 $472.77 $598.32 |
$561.00 $594.36 $629.70 $755.25 |
$717.93 $751.29 $786.63 $912.18 |
$156.93 |
Plan: (HMO) Gold Compass 500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$245.84 $279.03 $314.18 $439.07 $667.21 |
$491.68 $558.06 $628.36 $878.14 $1334.42 |
$647.79 $714.17 $784.47 $1034.25 |
$803.90 $870.28 $940.58 $1190.36 |
$960.01 $1026.39 $1096.69 $1346.47 |
$401.95 $435.14 $470.29 $595.18 |
$558.06 $591.25 $626.40 $751.29 |
$714.17 $747.36 $782.51 $907.40 |
$156.11 |
Plan: (HMO) Silver Compass HSA 3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$205.05 $232.73 $262.05 $366.21 $556.50 |
$410.10 $465.46 $524.10 $732.42 $1113.00 |
$540.31 $595.67 $654.31 $862.63 |
$670.52 $725.88 $784.52 $992.84 |
$800.73 $856.09 $914.73 $1123.05 |
$335.26 $362.94 $392.26 $496.42 |
$465.47 $493.15 $522.47 $626.63 |
$595.68 $623.36 $652.68 $756.84 |
$130.21 |
Plan: (HMO) Silver Compass 2000 1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$213.47 $242.28 $272.81 $381.25 $579.34 |
$426.94 $484.56 $545.62 $762.50 $1158.68 |
$562.49 $620.11 $681.17 $898.05 |
$698.04 $755.66 $816.72 $1033.60 |
$833.59 $891.21 $952.27 $1169.15 |
$349.02 $377.83 $408.36 $516.80 |
$484.57 $513.38 $543.91 $652.35 |
$620.12 $648.93 $679.46 $787.90 |
$135.55 |
Plan: (HMO) Silver Compass 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$215.19 $244.24 $275.02 $384.33 $584.03 |
$430.38 $488.48 $550.04 $768.66 $1168.06 |
$567.03 $625.13 $686.69 $905.31 |
$703.68 $761.78 $823.34 $1041.96 |
$840.33 $898.43 $959.99 $1178.61 |
$351.84 $380.89 $411.67 $520.98 |
$488.49 $517.54 $548.32 $657.63 |
$625.14 $654.19 $684.97 $794.28 |
$136.65 |
Plan: (HMO) Silver Compass 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$216.70 $245.96 $276.95 $387.03 $588.13 |
$433.40 $491.92 $553.90 $774.06 $1176.26 |
$571.01 $629.53 $691.51 $911.67 |
$708.62 $767.14 $829.12 $1049.28 |
$846.23 $904.75 $966.73 $1186.89 |
$354.31 $383.57 $414.56 $524.64 |
$491.92 $521.18 $552.17 $662.25 |
$629.53 $658.79 $689.78 $799.86 |
$137.61 |
Plan: (HMO) Silver Compass 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$221.67 $251.59 $283.29 $395.90 $601.60 |
$443.34 $503.18 $566.58 $791.80 $1203.20 |
$584.10 $643.94 $707.34 $932.56 |
$724.86 $784.70 $848.10 $1073.32 |
$865.62 $925.46 $988.86 $1214.08 |
$362.43 $392.35 $424.05 $536.66 |
$503.19 $533.11 $564.81 $677.42 |
$643.95 $673.87 $705.57 $818.18 |
$140.76 |
Plan: (HMO) Bronze Compass HSA 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$178.93 $203.09 $228.67 $319.57 $485.62 |
$357.86 $406.18 $457.34 $639.14 $971.24 |
$471.48 $519.80 $570.96 $752.76 |
$585.10 $633.42 $684.58 $866.38 |
$698.72 $747.04 $798.20 $980.00 |
$292.55 $316.71 $342.29 $433.19 |
$406.17 $430.33 $455.91 $546.81 |
$519.79 $543.95 $569.53 $660.43 |
$113.62 |
Plan: (HMO) Bronze Compass 6500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$6,500
: Family:
$13,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$188.64 $214.11 $241.09 $336.92 $511.98 |
$377.28 $428.22 $482.18 $673.84 $1023.96 |
$497.07 $548.01 $601.97 $793.63 |
$616.86 $667.80 $721.76 $913.42 |
$736.65 $787.59 $841.55 $1033.21 |
$308.43 $333.90 $360.88 $456.71 |
$428.22 $453.69 $480.67 $576.50 |
$548.01 $573.48 $600.46 $696.29 |
$119.79 |
Plan: (HMO) Gold Compass 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0448 - Provider Directory for This Plan: (UnitedHealthcare Community Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$243.25 $276.09 $310.87 $434.45 $660.18 |
$486.50 $552.18 $621.74 $868.90 $1320.36 |
$640.96 $706.64 $776.20 $1023.36 |
$795.42 $861.10 $930.66 $1177.82 |
$949.88 $1015.56 $1085.12 $1332.28 |
$397.71 $430.55 $465.33 $588.91 |
$552.17 $585.01 $619.79 $743.37 |
$706.63 $739.47 $774.25 $897.83 |
$154.46 |
ADVERTISEMENT
|
||||||||||
McLaren Health Plan CommunityLocal: 1-888-327-0671 | Toll Free: 1-888-327-0671 TTY: 1-800-356-3232 |
||||||||||
Plan: (HMO) McLaren Rewards PlatinumSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Platinum | 21 30 40 50 60 |
$358.08 $406.41 $457.61 $639.51 $971.79 |
$716.16 $812.82 $915.22 $1279.02 $1943.58 |
$943.53 $1040.19 $1142.59 $1506.39 |
$1170.90 $1267.56 $1369.96 $1733.76 |
$1398.27 $1494.93 $1597.33 $1961.13 |
$585.45 $633.78 $684.98 $866.88 |
$812.82 $861.15 $912.35 $1094.25 |
$1040.19 $1088.52 $1139.72 $1321.62 |
$227.37 |
Plan: (HMO) McLaren Rewards GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$307.15 $348.60 $392.53 $548.55 $833.58 |
$614.30 $697.20 $785.06 $1097.10 $1667.16 |
$809.33 $892.23 $980.09 $1292.13 |
$1004.36 $1087.26 $1175.12 $1487.16 |
$1199.39 $1282.29 $1370.15 $1682.19 |
$502.18 $543.63 $587.56 $743.58 |
$697.21 $738.66 $782.59 $938.61 |
$892.24 $933.69 $977.62 $1133.64 |
$195.03 |
Plan: (HMO) McLaren Rewards SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$2,100
: Family:
$4,200 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$253.23 $287.40 $323.61 $452.25 $687.23 |
$506.46 $574.80 $647.22 $904.50 $1374.46 |
$667.25 $735.59 $808.01 $1065.29 |
$828.04 $896.38 $968.80 $1226.08 |
$988.83 $1057.17 $1129.59 $1386.87 |
$414.02 $448.19 $484.40 $613.04 |
$574.81 $608.98 $645.19 $773.83 |
$735.60 $769.77 $805.98 $934.62 |
$160.79 |
Plan: (HMO) McLaren Young Adult/CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$178.38 $202.45 $227.95 $318.56 $484.08 |
$356.76 $404.90 $455.90 $637.12 $968.16 |
$470.02 $518.16 $569.16 $750.38 |
$583.28 $631.42 $682.42 $863.64 |
$696.54 $744.68 $795.68 $976.90 |
$291.64 $315.71 $341.21 $431.82 |
$404.90 $428.97 $454.47 $545.08 |
$518.16 $542.23 $567.73 $658.34 |
$113.26 |
Plan: (HMO) McLaren BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$210.08 $238.43 $268.47 $375.18 $570.13 |
$420.16 $476.86 $536.94 $750.36 $1140.26 |
$553.55 $610.25 $670.33 $883.75 |
$686.94 $743.64 $803.72 $1017.14 |
$820.33 $877.03 $937.11 $1150.53 |
$343.47 $371.82 $401.86 $508.57 |
$476.86 $505.21 $535.25 $641.96 |
$610.25 $638.60 $668.64 $775.35 |
$133.39 |
ADVERTISEMENT
|
||||||||||
Blue Care Network of MichiganLocal: 1-800-662-6667 | Toll Free: 1-800-662-6667 TTY: 1-800-257-9980 |
||||||||||
Plan: (HMO) Blue Cross® Select ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$140.40 $159.35 $179.43 $250.75 $381.05 |
$280.80 $318.70 $358.86 $501.50 $762.10 |
$369.95 $407.85 $448.01 $590.65 |
$459.10 $497.00 $537.16 $679.80 |
$548.25 $586.15 $626.31 $768.95 |
$229.55 $248.50 $268.58 $339.90 |
$318.70 $337.65 $357.73 $429.05 |
$407.85 $426.80 $446.88 $518.20 |
$89.15 |
Plan: (HMO) Blue Cross® Select SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$1,650
: Family:
$3,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$216.62 $245.86 $276.84 $386.88 $587.91 |
$433.24 $491.72 $553.68 $773.76 $1175.82 |
$570.79 $629.27 $691.23 $911.31 |
$708.34 $766.82 $828.78 $1048.86 |
$845.89 $904.37 $966.33 $1186.41 |
$354.17 $383.41 $414.39 $524.43 |
$491.72 $520.96 $551.94 $661.98 |
$629.27 $658.51 $689.49 $799.53 |
$137.55 |
Plan: (HMO) Blue Cross® Select GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$250
: Family:
$500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$280.70 $318.59 $358.73 $501.33 $761.82 |
$561.40 $637.18 $717.46 $1002.66 $1523.64 |
$739.64 $815.42 $895.70 $1180.90 |
$917.88 $993.66 $1073.94 $1359.14 |
$1096.12 $1171.90 $1252.18 $1537.38 |
$458.94 $496.83 $536.97 $679.57 |
$637.18 $675.07 $715.21 $857.81 |
$815.42 $853.31 $893.45 $1036.05 |
$178.24 |
Plan: (HMO) Blue Cross® Metro Detroit HMO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$1,650
: Family:
$3,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$197.15 $223.77 $251.96 $352.11 $535.07 |
$394.30 $447.54 $503.92 $704.22 $1070.14 |
$519.49 $572.73 $629.11 $829.41 |
$644.68 $697.92 $754.30 $954.60 |
$769.87 $823.11 $879.49 $1079.79 |
$322.34 $348.96 $377.15 $477.30 |
$447.53 $474.15 $502.34 $602.49 |
$572.72 $599.34 $627.53 $727.68 |
$125.19 |
Plan: (HMO) Blue Cross® Select Silver SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$202.57 $229.92 $258.88 $361.79 $549.77 |
$405.14 $459.84 $517.76 $723.58 $1099.54 |
$533.77 $588.47 $646.39 $852.21 |
$662.40 $717.10 $775.02 $980.84 |
$791.03 $845.73 $903.65 $1109.47 |
$331.20 $358.55 $387.51 $490.42 |
$459.83 $487.18 $516.14 $619.05 |
$588.46 $615.81 $644.77 $747.68 |
$128.63 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Silver SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$184.36 $209.25 $235.61 $329.27 $500.35 |
$368.72 $418.50 $471.22 $658.54 $1000.70 |
$485.79 $535.57 $588.29 $775.61 |
$602.86 $652.64 $705.36 $892.68 |
$719.93 $769.71 $822.43 $1009.75 |
$301.43 $326.32 $352.68 $446.34 |
$418.50 $443.39 $469.75 $563.41 |
$535.57 $560.46 $586.82 $680.48 |
$117.07 |
Plan: (HMO) Blue Cross® Select BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$167.16 $189.73 $213.63 $298.55 $453.67 |
$334.32 $379.46 $427.26 $597.10 $907.34 |
$440.47 $485.61 $533.41 $703.25 |
$546.62 $591.76 $639.56 $809.40 |
$652.77 $697.91 $745.71 $915.55 |
$273.31 $295.88 $319.78 $404.70 |
$379.46 $402.03 $425.93 $510.85 |
$485.61 $508.18 $532.08 $617.00 |
$106.15 |
Plan: (HMO) Blue Cross® Preferred BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$182.27 $206.88 $232.94 $325.53 $494.68 |
$364.54 $413.76 $465.88 $651.06 $989.36 |
$480.28 $529.50 $581.62 $766.80 |
$596.02 $645.24 $697.36 $882.54 |
$711.76 $760.98 $813.10 $998.28 |
$298.01 $322.62 $348.68 $441.27 |
$413.75 $438.36 $464.42 $557.01 |
$529.49 $554.10 $580.16 $672.75 |
$115.74 |
Plan: (HMO) Blue Cross® Metro Detroit HMO BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$152.13 $172.67 $194.42 $271.70 $412.88 |
$304.26 $345.34 $388.84 $543.40 $825.76 |
$400.86 $441.94 $485.44 $640.00 |
$497.46 $538.54 $582.04 $736.60 |
$594.06 $635.14 $678.64 $833.20 |
$248.73 $269.27 $291.02 $368.30 |
$345.33 $365.87 $387.62 $464.90 |
$441.93 $462.47 $484.22 $561.50 |
$96.60 |
Plan: (HMO) Blue Cross® Select Bronze SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$161.40 $183.19 $206.27 $288.26 $438.04 |
$322.80 $366.38 $412.54 $576.52 $876.08 |
$425.29 $468.87 $515.03 $679.01 |
$527.78 $571.36 $617.52 $781.50 |
$630.27 $673.85 $720.01 $883.99 |
$263.89 $285.68 $308.76 $390.75 |
$366.38 $388.17 $411.25 $493.24 |
$468.87 $490.66 $513.74 $595.73 |
$102.49 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Bronze SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$146.90 $166.73 $187.74 $262.36 $398.69 |
$293.80 $333.46 $375.48 $524.72 $797.38 |
$387.08 $426.74 $468.76 $618.00 |
$480.36 $520.02 $562.04 $711.28 |
$573.64 $613.30 $655.32 $804.56 |
$240.18 $260.01 $281.02 $355.64 |
$333.46 $353.29 $374.30 $448.92 |
$426.74 $446.57 $467.58 $542.20 |
$93.28 |
Plan: (HMO) Blue Cross® Select Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$2,250
: Family:
$4,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$225.11 $255.50 $287.69 $402.05 $610.95 |
$450.22 $511.00 $575.38 $804.10 $1221.90 |
$593.16 $653.94 $718.32 $947.04 |
$736.10 $796.88 $861.26 $1089.98 |
$879.04 $939.82 $1004.20 $1232.92 |
$368.05 $398.44 $430.63 $544.99 |
$510.99 $541.38 $573.57 $687.93 |
$653.93 $684.32 $716.51 $830.87 |
$142.94 |
Plan: (HMO) Blue Cross® Preferred Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$2,250
: Family:
$4,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$245.47 $278.61 $313.71 $438.41 $666.21 |
$490.94 $557.22 $627.42 $876.82 $1332.42 |
$646.81 $713.09 $783.29 $1032.69 |
$802.68 $868.96 $939.16 $1188.56 |
$958.55 $1024.83 $1095.03 $1344.43 |
$401.34 $434.48 $469.58 $594.28 |
$557.21 $590.35 $625.45 $750.15 |
$713.08 $746.22 $781.32 $906.02 |
$155.87 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$2,250
: Family:
$4,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$204.87 $232.53 $261.82 $365.90 $556.02 |
$409.74 $465.06 $523.64 $731.80 $1112.04 |
$539.83 $595.15 $653.73 $861.89 |
$669.92 $725.24 $783.82 $991.98 |
$800.01 $855.33 $913.91 $1122.07 |
$334.96 $362.62 $391.91 $495.99 |
$465.05 $492.71 $522.00 $626.08 |
$595.14 $622.80 $652.09 $756.17 |
$130.09 |
Plan: (HMO) Blue Cross® Select Gold ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$775
: Family:
$1,550 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$291.02 $330.31 $371.92 $519.76 $789.83 |
$582.04 $660.62 $743.84 $1039.52 $1579.66 |
$766.84 $845.42 $928.64 $1224.32 |
$951.64 $1030.22 $1113.44 $1409.12 |
$1136.44 $1215.02 $1298.24 $1593.92 |
$475.82 $515.11 $556.72 $704.56 |
$660.62 $699.91 $741.52 $889.36 |
$845.42 $884.71 $926.32 $1074.16 |
$184.80 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Gold ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$775
: Family:
$1,550 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$264.85 $300.60 $338.48 $473.02 $718.80 |
$529.70 $601.20 $676.96 $946.04 $1437.60 |
$697.88 $769.38 $845.14 $1114.22 |
$866.06 $937.56 $1013.32 $1282.40 |
$1034.24 $1105.74 $1181.50 $1450.58 |
$433.03 $468.78 $506.66 $641.20 |
$601.21 $636.96 $674.84 $809.38 |
$769.39 $805.14 $843.02 $977.56 |
$168.18 |
†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.
‡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 Wayne County here.