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 Titusville, FL.
Obamacare Providers, Plans and 2016 Rates for Brevard County
Brevard County is in “Rating Area 5” of Florida.
Currently, there are 6 providers offering 109 plans to Rating Area 5. †
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 Titusville, FL area accept this insurance coverage as within the plan's "network".
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Blue Cross and Blue Shield of FloridaLocal: 1-855-805-8175 | Toll Free: 1-855-805-8175 |
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Plan: (EPO) BlueOptions Everyday Health 1423Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,500
: Family:
$11,000 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 |
$317.95 $360.87 $406.34 $567.86 $862.92 |
$635.90 $721.74 $812.68 $1135.72 $1725.84 |
$837.80 $923.64 $1014.58 $1337.62 |
$1039.70 $1125.54 $1216.48 $1539.52 |
$1241.60 $1327.44 $1418.38 $1741.42 |
$519.85 $562.77 $608.24 $769.76 |
$721.75 $764.67 $810.14 $971.66 |
$923.65 $966.57 $1012.04 $1173.56 |
$201.90 |
Plan: (EPO) BlueOptions Essential 1419Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$269.53 $305.92 $344.46 $481.38 $731.50 |
$539.06 $611.84 $688.92 $962.76 $1463.00 |
$710.21 $782.99 $860.07 $1133.91 |
$881.36 $954.14 $1031.22 $1305.06 |
$1052.51 $1125.29 $1202.37 $1476.21 |
$440.68 $477.07 $515.61 $652.53 |
$611.83 $648.22 $686.76 $823.68 |
$782.98 $819.37 $857.91 $994.83 |
$171.15 |
Plan: (EPO) BlueOptions Everyday Health 1431Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,000
: Family:
$10,000 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 |
$349.68 $396.89 $446.89 $624.53 $949.03 |
$699.36 $793.78 $893.78 $1249.06 $1898.06 |
$921.41 $1015.83 $1115.83 $1471.11 |
$1143.46 $1237.88 $1337.88 $1693.16 |
$1365.51 $1459.93 $1559.93 $1915.21 |
$571.73 $618.94 $668.94 $846.58 |
$793.78 $840.99 $890.99 $1068.63 |
$1015.83 $1063.04 $1113.04 $1290.68 |
$222.05 |
Plan: (EPO) BlueOptions Everyday Health 1418Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$467.27 $530.35 $597.17 $834.54 $1268.17 |
$934.54 $1060.70 $1194.34 $1669.08 $2536.34 |
$1231.26 $1357.42 $1491.06 $1965.80 |
$1527.98 $1654.14 $1787.78 $2262.52 |
$1824.70 $1950.86 $2084.50 $2559.24 |
$763.99 $827.07 $893.89 $1131.26 |
$1060.71 $1123.79 $1190.61 $1427.98 |
$1357.43 $1420.51 $1487.33 $1724.70 |
$296.72 |
Plan: (EPO) BlueOptions Everyday Health Premier 1418VSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$504.00 $572.04 $644.11 $900.14 $1367.86 |
$1008.00 $1144.08 $1288.22 $1800.28 $2735.72 |
$1328.04 $1464.12 $1608.26 $2120.32 |
$1648.08 $1784.16 $1928.30 $2440.36 |
$1968.12 $2104.20 $2248.34 $2760.40 |
$824.04 $892.08 $964.15 $1220.18 |
$1144.08 $1212.12 $1284.19 $1540.22 |
$1464.12 $1532.16 $1604.23 $1860.26 |
$320.04 |
Plan: (EPO) BlueOptions Everyday Health 1416Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
Bronze | 21 30 40 50 60 |
$298.90 $339.25 $381.99 $533.84 $811.21 |
$597.80 $678.50 $763.98 $1067.68 $1622.42 |
$787.60 $868.30 $953.78 $1257.48 |
$977.40 $1058.10 $1143.58 $1447.28 |
$1167.20 $1247.90 $1333.38 $1637.08 |
$488.70 $529.05 $571.79 $723.64 |
$678.50 $718.85 $761.59 $913.44 |
$868.30 $908.65 $951.39 $1103.24 |
$189.80 |
Plan: (EPO) BlueOptions All Copay 1424Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$485.58 $551.13 $620.57 $867.25 $1317.86 |
$971.16 $1102.26 $1241.14 $1734.50 $2635.72 |
$1279.50 $1410.60 $1549.48 $2042.84 |
$1587.84 $1718.94 $1857.82 $2351.18 |
$1896.18 $2027.28 $2166.16 $2659.52 |
$793.92 $859.47 $928.91 $1175.59 |
$1102.26 $1167.81 $1237.25 $1483.93 |
$1410.60 $1476.15 $1545.59 $1792.27 |
$308.34 |
Plan: (EPO) BlueOptions Everyday Health 1410Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,100
: Family:
$12,200 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 |
$295.93 $335.88 $378.20 $528.53 $803.15 |
$591.86 $671.76 $756.40 $1057.06 $1606.30 |
$779.78 $859.68 $944.32 $1244.98 |
$967.70 $1047.60 $1132.24 $1432.90 |
$1155.62 $1235.52 $1320.16 $1620.82 |
$483.85 $523.80 $566.12 $716.45 |
$671.77 $711.72 $754.04 $904.37 |
$859.69 $899.64 $941.96 $1092.29 |
$187.92 |
Plan: (EPO) BlueOptions All Copay 1505Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
Gold | 21 30 40 50 60 |
$414.26 $470.19 $529.42 $739.87 $1124.30 |
$828.52 $940.38 $1058.84 $1479.74 $2248.60 |
$1091.58 $1203.44 $1321.90 $1742.80 |
$1354.64 $1466.50 $1584.96 $2005.86 |
$1617.70 $1729.56 $1848.02 $2268.92 |
$677.32 $733.25 $792.48 $1002.93 |
$940.38 $996.31 $1055.54 $1265.99 |
$1203.44 $1259.37 $1318.60 $1529.05 |
$263.06 |
Plan: (EPO) BlueSelect Everyday Health 1456Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,500
: Family:
$11,000 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 |
$235.21 $266.96 $300.60 $420.09 $638.36 |
$470.42 $533.92 $601.20 $840.18 $1276.72 |
$619.78 $683.28 $750.56 $989.54 |
$769.14 $832.64 $899.92 $1138.90 |
$918.50 $982.00 $1049.28 $1288.26 |
$384.57 $416.32 $449.96 $569.45 |
$533.93 $565.68 $599.32 $718.81 |
$683.29 $715.04 $748.68 $868.17 |
$149.36 |
Plan: (EPO) BlueSelect Essential 1452Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$198.39 $225.17 $253.54 $354.32 $538.43 |
$396.78 $450.34 $507.08 $708.64 $1076.86 |
$522.76 $576.32 $633.06 $834.62 |
$648.74 $702.30 $759.04 $960.60 |
$774.72 $828.28 $885.02 $1086.58 |
$324.37 $351.15 $379.52 $480.30 |
$450.35 $477.13 $505.50 $606.28 |
$576.33 $603.11 $631.48 $732.26 |
$125.98 |
Plan: (EPO) BlueSelect Everyday Health 1464Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,000
: Family:
$10,000 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 |
$259.28 $294.28 $331.36 $463.07 $703.69 |
$518.56 $588.56 $662.72 $926.14 $1407.38 |
$683.20 $753.20 $827.36 $1090.78 |
$847.84 $917.84 $992.00 $1255.42 |
$1012.48 $1082.48 $1156.64 $1420.06 |
$423.92 $458.92 $496.00 $627.71 |
$588.56 $623.56 $660.64 $792.35 |
$753.20 $788.20 $825.28 $956.99 |
$164.64 |
Plan: (EPO) BlueSelect Everyday Health 1451Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$348.46 $395.50 $445.33 $622.35 $945.72 |
$696.92 $791.00 $890.66 $1244.70 $1891.44 |
$918.19 $1012.27 $1111.93 $1465.97 |
$1139.46 $1233.54 $1333.20 $1687.24 |
$1360.73 $1454.81 $1554.47 $1908.51 |
$569.73 $616.77 $666.60 $843.62 |
$791.00 $838.04 $887.87 $1064.89 |
$1012.27 $1059.31 $1109.14 $1286.16 |
$221.27 |
Plan: (EPO) BlueSelect Everyday Health Premier 1451VSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$375.85 $426.59 $480.34 $671.27 $1020.06 |
$751.70 $853.18 $960.68 $1342.54 $2040.12 |
$990.36 $1091.84 $1199.34 $1581.20 |
$1229.02 $1330.50 $1438.00 $1819.86 |
$1467.68 $1569.16 $1676.66 $2058.52 |
$614.51 $665.25 $719.00 $909.93 |
$853.17 $903.91 $957.66 $1148.59 |
$1091.83 $1142.57 $1196.32 $1387.25 |
$238.66 |
Plan: (EPO) BlueSelect Everyday Health 1449Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
Bronze | 21 30 40 50 60 |
$220.01 $249.71 $281.17 $392.94 $597.11 |
$440.02 $499.42 $562.34 $785.88 $1194.22 |
$579.73 $639.13 $702.05 $925.59 |
$719.44 $778.84 $841.76 $1065.30 |
$859.15 $918.55 $981.47 $1205.01 |
$359.72 $389.42 $420.88 $532.65 |
$499.43 $529.13 $560.59 $672.36 |
$639.14 $668.84 $700.30 $812.07 |
$139.71 |
Plan: (EPO) BlueSelect All Copay 1457Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$364.20 $413.37 $465.45 $650.46 $988.44 |
$728.40 $826.74 $930.90 $1300.92 $1976.88 |
$959.67 $1058.01 $1162.17 $1532.19 |
$1190.94 $1289.28 $1393.44 $1763.46 |
$1422.21 $1520.55 $1624.71 $1994.73 |
$595.47 $644.64 $696.72 $881.73 |
$826.74 $875.91 $927.99 $1113.00 |
$1058.01 $1107.18 $1159.26 $1344.27 |
$231.27 |
Plan: (EPO) BlueSelect Everyday Health 1443Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,100
: Family:
$12,200 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 |
$218.91 $248.46 $279.77 $390.97 $594.12 |
$437.82 $496.92 $559.54 $781.94 $1188.24 |
$576.83 $635.93 $698.55 $920.95 |
$715.84 $774.94 $837.56 $1059.96 |
$854.85 $913.95 $976.57 $1198.97 |
$357.92 $387.47 $418.78 $529.98 |
$496.93 $526.48 $557.79 $668.99 |
$635.94 $665.49 $696.80 $808.00 |
$139.01 |
Plan: (EPO) BlueSelect All Copay 1535Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
Gold | 21 30 40 50 60 |
$312.24 $354.39 $399.04 $557.66 $847.42 |
$624.48 $708.78 $798.08 $1115.32 $1694.84 |
$822.75 $907.05 $996.35 $1313.59 |
$1021.02 $1105.32 $1194.62 $1511.86 |
$1219.29 $1303.59 $1392.89 $1710.13 |
$510.51 $552.66 $597.31 $755.93 |
$708.78 $750.93 $795.58 $954.20 |
$907.05 $949.20 $993.85 $1152.47 |
$198.27 |
ADVERTISEMENT
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Health First Health Plans, Inc.Local: 1-855-443-4735 | Toll Free: 1-855-443-4735 TTY: 1-800-955-8771 |
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Plan: (HMO) Health First Gold HMO 100 1002Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
Gold | 21 30 40 50 60 |
$307.02 $348.46 $392.36 $548.32 $833.23 |
$614.04 $696.92 $784.72 $1096.64 $1666.46 |
$808.99 $891.87 $979.67 $1291.59 |
$1003.94 $1086.82 $1174.62 $1486.54 |
$1198.89 $1281.77 $1369.57 $1681.49 |
$501.97 $543.41 $587.31 $743.27 |
$696.92 $738.36 $782.26 $938.22 |
$891.87 $933.31 $977.21 $1133.17 |
$194.95 |
Plan: (HMO) Health First Gold HMO 90 1005Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$297.02 $337.11 $379.58 $530.46 $806.09 |
$594.04 $674.22 $759.16 $1060.92 $1612.18 |
$782.64 $862.82 $947.76 $1249.52 |
$971.24 $1051.42 $1136.36 $1438.12 |
$1159.84 $1240.02 $1324.96 $1626.72 |
$485.62 $525.71 $568.18 $719.06 |
$674.22 $714.31 $756.78 $907.66 |
$862.82 $902.91 $945.38 $1096.26 |
$188.60 |
Plan: (HMO) Health First Gold HMO 80 1012Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$320.06 $363.26 $409.02 $571.61 $868.62 |
$640.12 $726.52 $818.04 $1143.22 $1737.24 |
$843.35 $929.75 $1021.27 $1346.45 |
$1046.58 $1132.98 $1224.50 $1549.68 |
$1249.81 $1336.21 $1427.73 $1752.91 |
$523.29 $566.49 $612.25 $774.84 |
$726.52 $769.72 $815.48 $978.07 |
$929.75 $972.95 $1018.71 $1181.30 |
$203.23 |
Plan: (HMO) Health First Gold HMO 80 1020Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$314.79 $357.28 $402.29 $562.20 $854.31 |
$629.58 $714.56 $804.58 $1124.40 $1708.62 |
$829.47 $914.45 $1004.47 $1324.29 |
$1029.36 $1114.34 $1204.36 $1524.18 |
$1229.25 $1314.23 $1404.25 $1724.07 |
$514.68 $557.17 $602.18 $762.09 |
$714.57 $757.06 $802.07 $961.98 |
$914.46 $956.95 $1001.96 $1161.87 |
$199.89 |
Plan: (HMO) Health First Gold HMO 80 1024Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
Gold | 21 30 40 50 60 |
$305.36 $346.57 $390.24 $545.36 $828.72 |
$610.72 $693.14 $780.48 $1090.72 $1657.44 |
$804.62 $887.04 $974.38 $1284.62 |
$998.52 $1080.94 $1168.28 $1478.52 |
$1192.42 $1274.84 $1362.18 $1672.42 |
$499.26 $540.47 $584.14 $739.26 |
$693.16 $734.37 $778.04 $933.16 |
$887.06 $928.27 $971.94 $1127.06 |
$193.90 |
Plan: (HMO) Health First Gold HMO 70 1035Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$312.68 $354.88 $399.59 $558.43 $848.59 |
$625.36 $709.76 $799.18 $1116.86 $1697.18 |
$823.91 $908.31 $997.73 $1315.41 |
$1022.46 $1106.86 $1196.28 $1513.96 |
$1221.01 $1305.41 $1394.83 $1712.51 |
$511.23 $553.43 $598.14 $756.98 |
$709.78 $751.98 $796.69 $955.53 |
$908.33 $950.53 $995.24 $1154.08 |
$198.55 |
Plan: (HMO) Health First Silver HMO 100 1046Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$4,400
: Family:
$8,800 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 |
$261.27 $296.53 $333.89 $466.61 $709.06 |
$522.54 $593.06 $667.78 $933.22 $1418.12 |
$688.44 $758.96 $833.68 $1099.12 |
$854.34 $924.86 $999.58 $1265.02 |
$1020.24 $1090.76 $1165.48 $1430.92 |
$427.17 $462.43 $499.79 $632.51 |
$593.07 $628.33 $665.69 $798.41 |
$758.97 $794.23 $831.59 $964.31 |
$165.90 |
Plan: (HMO) Health First Silver HMO 100 1058Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$262.63 $298.07 $335.63 $469.04 $712.75 |
$525.26 $596.14 $671.26 $938.08 $1425.50 |
$692.02 $762.90 $838.02 $1104.84 |
$858.78 $929.66 $1004.78 $1271.60 |
$1025.54 $1096.42 $1171.54 $1438.36 |
$429.39 $464.83 $502.39 $635.80 |
$596.15 $631.59 $669.15 $802.56 |
$762.91 $798.35 $835.91 $969.32 |
$166.76 |
Plan: (HMO) Health First Silver HMO 90 1070Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$3,900
: Family:
$7,800 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 |
$264.16 $299.81 $337.58 $471.77 $716.90 |
$528.32 $599.62 $675.16 $943.54 $1433.80 |
$696.06 $767.36 $842.90 $1111.28 |
$863.80 $935.10 $1010.64 $1279.02 |
$1031.54 $1102.84 $1178.38 $1446.76 |
$431.90 $467.55 $505.32 $639.51 |
$599.64 $635.29 $673.06 $807.25 |
$767.38 $803.03 $840.80 $974.99 |
$167.74 |
Plan: (HMO) Health First Silver HMO 80 1094Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$251.61 $285.57 $321.54 $449.36 $682.84 |
$503.22 $571.14 $643.08 $898.72 $1365.68 |
$662.99 $730.91 $802.85 $1058.49 |
$822.76 $890.68 $962.62 $1218.26 |
$982.53 $1050.45 $1122.39 $1378.03 |
$411.38 $445.34 $481.31 $609.13 |
$571.15 $605.11 $641.08 $768.90 |
$730.92 $764.88 $800.85 $928.67 |
$159.77 |
Plan: (HMO) Health First Silver HMO 80 1110Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$253.49 $287.70 $323.95 $452.72 $687.94 |
$506.98 $575.40 $647.90 $905.44 $1375.88 |
$667.94 $736.36 $808.86 $1066.40 |
$828.90 $897.32 $969.82 $1227.36 |
$989.86 $1058.28 $1130.78 $1388.32 |
$414.45 $448.66 $484.91 $613.68 |
$575.41 $609.62 $645.87 $774.64 |
$736.37 $770.58 $806.83 $935.60 |
$160.96 |
Plan: (HMO) Health First Silver HMO 70 1126Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$256.08 $290.64 $327.26 $457.34 $694.97 |
$512.16 $581.28 $654.52 $914.68 $1389.94 |
$674.76 $743.88 $817.12 $1077.28 |
$837.36 $906.48 $979.72 $1239.88 |
$999.96 $1069.08 $1142.32 $1402.48 |
$418.68 $453.24 $489.86 $619.94 |
$581.28 $615.84 $652.46 $782.54 |
$743.88 $778.44 $815.06 $945.14 |
$162.60 |
Plan: (HMO) Health First Silver HMO 70 1158Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$253.05 $287.20 $323.39 $451.93 $686.75 |
$506.10 $574.40 $646.78 $903.86 $1373.50 |
$666.78 $735.08 $807.46 $1064.54 |
$827.46 $895.76 $968.14 $1225.22 |
$988.14 $1056.44 $1128.82 $1385.90 |
$413.73 $447.88 $484.07 $612.61 |
$574.41 $608.56 $644.75 $773.29 |
$735.09 $769.24 $805.43 $933.97 |
$160.68 |
Plan: (HMO) Health First Bronze HMO 100 1251Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$211.17 $239.67 $269.86 $377.13 $573.09 |
$422.34 $479.34 $539.72 $754.26 $1146.18 |
$556.43 $613.43 $673.81 $888.35 |
$690.52 $747.52 $807.90 $1022.44 |
$824.61 $881.61 $941.99 $1156.53 |
$345.26 $373.76 $403.95 $511.22 |
$479.35 $507.85 $538.04 $645.31 |
$613.44 $641.94 $672.13 $779.40 |
$134.09 |
Plan: (HMO) Health First Bronze HMO 90 1254Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$225.78 $256.25 $288.53 $403.23 $612.74 |
$451.56 $512.50 $577.06 $806.46 $1225.48 |
$594.92 $655.86 $720.42 $949.82 |
$738.28 $799.22 $863.78 $1093.18 |
$881.64 $942.58 $1007.14 $1236.54 |
$369.14 $399.61 $431.89 $546.59 |
$512.50 $542.97 $575.25 $689.95 |
$655.86 $686.33 $718.61 $833.31 |
$143.36 |
Plan: (HMO) Health First Bronze HMO 70 1261Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
Bronze | 21 30 40 50 60 |
$211.35 $239.87 $270.09 $377.45 $573.58 |
$422.70 $479.74 $540.18 $754.90 $1147.16 |
$556.90 $613.94 $674.38 $889.10 |
$691.10 $748.14 $808.58 $1023.30 |
$825.30 $882.34 $942.78 $1157.50 |
$345.55 $374.07 $404.29 $511.65 |
$479.75 $508.27 $538.49 $645.85 |
$613.95 $642.47 $672.69 $780.05 |
$134.20 |
Plan: (HMO) Health First Bronze HMO 70 1265Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$5,300
: Family:
$10,600 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 |
Bronze | 21 30 40 50 60 |
$208.58 $236.73 $266.55 $372.51 $566.06 |
$417.16 $473.46 $533.10 $745.02 $1132.12 |
$549.60 $605.90 $665.54 $877.46 |
$682.04 $738.34 $797.98 $1009.90 |
$814.48 $870.78 $930.42 $1142.34 |
$341.02 $369.17 $398.99 $504.95 |
$473.46 $501.61 $531.43 $637.39 |
$605.90 $634.05 $663.87 $769.83 |
$132.44 |
Plan: (HMO) Health First Catastrophic HMO 1268Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$197.79 $224.48 $252.76 $353.24 $536.77 |
$395.58 $448.96 $505.52 $706.48 $1073.54 |
$521.17 $574.55 $631.11 $832.07 |
$646.76 $700.14 $756.70 $957.66 |
$772.35 $825.73 $882.29 $1083.25 |
$323.38 $350.07 $378.35 $478.83 |
$448.97 $475.66 $503.94 $604.42 |
$574.56 $601.25 $629.53 $730.01 |
$125.59 |
Plan: (HMO) Health First Platinum HMO 100 1300Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$360.30 $408.93 $460.45 $643.48 $977.83 |
$720.60 $817.86 $920.90 $1286.96 $1955.66 |
$949.38 $1046.64 $1149.68 $1515.74 |
$1178.16 $1275.42 $1378.46 $1744.52 |
$1406.94 $1504.20 $1607.24 $1973.30 |
$589.08 $637.71 $689.23 $872.26 |
$817.86 $866.49 $918.01 $1101.04 |
$1046.64 $1095.27 $1146.79 $1329.82 |
$228.78 |
Plan: (HMO) Health First Platinum HMO 90 1301Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
Platinum | 21 30 40 50 60 |
$360.53 $409.19 $460.74 $643.89 $978.45 |
$721.06 $818.38 $921.48 $1287.78 $1956.90 |
$949.99 $1047.31 $1150.41 $1516.71 |
$1178.92 $1276.24 $1379.34 $1745.64 |
$1407.85 $1505.17 $1608.27 $1974.57 |
$589.46 $638.12 $689.67 $872.82 |
$818.39 $867.05 $918.60 $1101.75 |
$1047.32 $1095.98 $1147.53 $1330.68 |
$228.93 |
Plan: (HMO) Health First Platinum HMO 80 1302Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$450
: Family:
$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 |
Platinum | 21 30 40 50 60 |
$360.06 $408.66 $460.14 $643.05 $977.18 |
$720.12 $817.32 $920.28 $1286.10 $1954.36 |
$948.75 $1045.95 $1148.91 $1514.73 |
$1177.38 $1274.58 $1377.54 $1743.36 |
$1406.01 $1503.21 $1606.17 $1971.99 |
$588.69 $637.29 $688.77 $871.68 |
$817.32 $865.92 $917.40 $1100.31 |
$1045.95 $1094.55 $1146.03 $1328.94 |
$228.63 |
Plan: (POS) Health First Gold POS 100 1003Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
Gold | 21 30 40 50 60 |
$315.70 $358.31 $403.45 $563.82 $856.78 |
$631.40 $716.62 $806.90 $1127.64 $1713.56 |
$831.86 $917.08 $1007.36 $1328.10 |
$1032.32 $1117.54 $1207.82 $1528.56 |
$1232.78 $1318.00 $1408.28 $1729.02 |
$516.16 $558.77 $603.91 $764.28 |
$716.62 $759.23 $804.37 $964.74 |
$917.08 $959.69 $1004.83 $1165.20 |
$200.46 |
Plan: (POS) Health First Gold POS 90 1006Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$306.80 $348.21 $392.08 $547.93 $832.63 |
$613.60 $696.42 $784.16 $1095.86 $1665.26 |
$808.41 $891.23 $978.97 $1290.67 |
$1003.22 $1086.04 $1173.78 $1485.48 |
$1198.03 $1280.85 $1368.59 $1680.29 |
$501.61 $543.02 $586.89 $742.74 |
$696.42 $737.83 $781.70 $937.55 |
$891.23 $932.64 $976.51 $1132.36 |
$194.81 |
Plan: (POS) Health First Gold POS 80 1013Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$328.35 $372.67 $419.62 $586.42 $891.11 |
$656.70 $745.34 $839.24 $1172.84 $1782.22 |
$865.20 $953.84 $1047.74 $1381.34 |
$1073.70 $1162.34 $1256.24 $1589.84 |
$1282.20 $1370.84 $1464.74 $1798.34 |
$536.85 $581.17 $628.12 $794.92 |
$745.35 $789.67 $836.62 $1003.42 |
$953.85 $998.17 $1045.12 $1211.92 |
$208.50 |
Plan: (POS) Health First Gold POS 80 1025Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
Gold | 21 30 40 50 60 |
$312.58 $354.77 $399.46 $558.25 $848.31 |
$625.16 $709.54 $798.92 $1116.50 $1696.62 |
$823.64 $908.02 $997.40 $1314.98 |
$1022.12 $1106.50 $1195.88 $1513.46 |
$1220.60 $1304.98 $1394.36 $1711.94 |
$511.06 $553.25 $597.94 $756.73 |
$709.54 $751.73 $796.42 $955.21 |
$908.02 $950.21 $994.90 $1153.69 |
$198.48 |
Plan: (POS) Health First Gold POS 70 1036Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$322.48 $366.00 $412.12 $575.93 $875.18 |
$644.96 $732.00 $824.24 $1151.86 $1750.36 |
$849.73 $936.77 $1029.01 $1356.63 |
$1054.50 $1141.54 $1233.78 $1561.40 |
$1259.27 $1346.31 $1438.55 $1766.17 |
$527.25 $570.77 $616.89 $780.70 |
$732.02 $775.54 $821.66 $985.47 |
$936.79 $980.31 $1026.43 $1190.24 |
$204.77 |
Plan: (POS) Health First Silver POS 100 1050Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$4,400
: Family:
$8,800 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 |
$267.49 $303.59 $341.84 $477.72 $725.94 |
$534.98 $607.18 $683.68 $955.44 $1451.88 |
$704.83 $777.03 $853.53 $1125.29 |
$874.68 $946.88 $1023.38 $1295.14 |
$1044.53 $1116.73 $1193.23 $1464.99 |
$437.34 $473.44 $511.69 $647.57 |
$607.19 $643.29 $681.54 $817.42 |
$777.04 $813.14 $851.39 $987.27 |
$169.85 |
Plan: (POS) Health First Silver POS 90 1074Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$3,900
: Family:
$7,800 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 |
$269.54 $305.92 $344.46 $481.38 $731.50 |
$539.08 $611.84 $688.92 $962.76 $1463.00 |
$710.23 $782.99 $860.07 $1133.91 |
$881.38 $954.14 $1031.22 $1305.06 |
$1052.53 $1125.29 $1202.37 $1476.21 |
$440.69 $477.07 $515.61 $652.53 |
$611.84 $648.22 $686.76 $823.68 |
$782.99 $819.37 $857.91 $994.83 |
$171.15 |
Plan: (POS) Health First Silver POS 80 1098Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
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 |
$258.81 $293.74 $330.75 $462.22 $702.38 |
$517.62 $587.48 $661.50 $924.44 $1404.76 |
$681.96 $751.82 $825.84 $1088.78 |
$846.30 $916.16 $990.18 $1253.12 |
$1010.64 $1080.50 $1154.52 $1417.46 |
$423.15 $458.08 $495.09 $626.56 |
$587.49 $622.42 $659.43 $790.90 |
$751.83 $786.76 $823.77 $955.24 |
$164.34 |
Plan: (POS) Health First Silver POS 70 1130Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$261.03 $296.26 $333.58 $466.18 $708.41 |
$522.06 $592.52 $667.16 $932.36 $1416.82 |
$687.81 $758.27 $832.91 $1098.11 |
$853.56 $924.02 $998.66 $1263.86 |
$1019.31 $1089.77 $1164.41 $1429.61 |
$426.78 $462.01 $499.33 $631.93 |
$592.53 $627.76 $665.08 $797.68 |
$758.28 $793.51 $830.83 $963.43 |
$165.75 |
Plan: (POS) Health First Silver POS 70 1162Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$259.88 $294.95 $332.11 $464.13 $705.29 |
$519.76 $589.90 $664.22 $928.26 $1410.58 |
$684.78 $754.92 $829.24 $1093.28 |
$849.80 $919.94 $994.26 $1258.30 |
$1014.82 $1084.96 $1159.28 $1423.32 |
$424.90 $459.97 $497.13 $629.15 |
$589.92 $624.99 $662.15 $794.17 |
$754.94 $790.01 $827.17 $959.19 |
$165.02 |
Plan: (POS) Health First Bronze POS 100 1252Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$216.47 $245.68 $276.64 $386.60 $587.47 |
$432.94 $491.36 $553.28 $773.20 $1174.94 |
$570.39 $628.81 $690.73 $910.65 |
$707.84 $766.26 $828.18 $1048.10 |
$845.29 $903.71 $965.63 $1185.55 |
$353.92 $383.13 $414.09 $524.05 |
$491.37 $520.58 $551.54 $661.50 |
$628.82 $658.03 $688.99 $798.95 |
$137.45 |
Plan: (POS) Health First Bronze POS 70 1262Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
Bronze | 21 30 40 50 60 |
$216.98 $246.26 $277.29 $387.51 $588.86 |
$433.96 $492.52 $554.58 $775.02 $1177.72 |
$571.74 $630.30 $692.36 $912.80 |
$709.52 $768.08 $830.14 $1050.58 |
$847.30 $905.86 $967.92 $1188.36 |
$354.76 $384.04 $415.07 $525.29 |
$492.54 $521.82 $552.85 $663.07 |
$630.32 $659.60 $690.63 $800.85 |
$137.78 |
Plan: (POS) Health First Bronze POS 70 1266Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.)
Deductible: Individual:
$5,300
: Family:
$10,600 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 |
Bronze | 21 30 40 50 60 |
$213.79 $242.64 $273.21 $381.81 $580.20 |
$427.58 $485.28 $546.42 $763.62 $1160.40 |
$563.33 $621.03 $682.17 $899.37 |
$699.08 $756.78 $817.92 $1035.12 |
$834.83 $892.53 $953.67 $1170.87 |
$349.54 $378.39 $408.96 $517.56 |
$485.29 $514.14 $544.71 $653.31 |
$621.04 $649.89 $680.46 $789.06 |
$135.75 |
Plan: (POS) Health First Catastrophic POS 1269Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, 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 |
$202.27 $229.57 $258.49 $361.24 $548.93 |
$404.54 $459.14 $516.98 $722.48 $1097.86 |
$532.98 $587.58 $645.42 $850.92 |
$661.42 $716.02 $773.86 $979.36 |
$789.86 $844.46 $902.30 $1107.80 |
$330.71 $358.01 $386.93 $489.68 |
$459.15 $486.45 $515.37 $618.12 |
$587.59 $614.89 $643.81 $746.56 |
$128.44 |
ADVERTISEMENT
|
||||||||||
Health Options, Inc.Local: 1-855-805-8175 | Toll Free: 1-855-805-8175 |
||||||||||
Plan: (HMO) BlueCare Everyday Health 1490Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, 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 |
Silver | 21 30 40 50 60 |
$270.31 $306.80 $345.46 $482.77 $733.62 |
$540.62 $613.60 $690.92 $965.54 $1467.24 |
$712.27 $785.25 $862.57 $1137.19 |
$883.92 $956.90 $1034.22 $1308.84 |
$1055.57 $1128.55 $1205.87 $1480.49 |
$441.96 $478.45 $517.11 $654.42 |
$613.61 $650.10 $688.76 $826.07 |
$785.26 $821.75 $860.41 $997.72 |
$171.65 |
Plan: (HMO) BlueCare Essential 1486Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, 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 |
Bronze | 21 30 40 50 60 |
$230.31 $261.40 $294.34 $411.33 $625.06 |
$460.62 $522.80 $588.68 $822.66 $1250.12 |
$606.87 $669.05 $734.93 $968.91 |
$753.12 $815.30 $881.18 $1115.16 |
$899.37 $961.55 $1027.43 $1261.41 |
$376.56 $407.65 $440.59 $557.58 |
$522.81 $553.90 $586.84 $703.83 |
$669.06 $700.15 $733.09 $850.08 |
$146.25 |
Plan: (HMO) BlueCare Everyday Health 1498Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, 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 |
Silver | 21 30 40 50 60 |
$305.45 $346.69 $390.37 $545.53 $828.99 |
$610.90 $693.38 $780.74 $1091.06 $1657.98 |
$804.86 $887.34 $974.70 $1285.02 |
$998.82 $1081.30 $1168.66 $1478.98 |
$1192.78 $1275.26 $1362.62 $1672.94 |
$499.41 $540.65 $584.33 $739.49 |
$693.37 $734.61 $778.29 $933.45 |
$887.33 $928.57 $972.25 $1127.41 |
$193.96 |
Plan: (HMO) BlueCare Everyday Health 1485Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$396.26 $449.76 $506.42 $707.72 $1075.45 |
$792.52 $899.52 $1012.84 $1415.44 $2150.90 |
$1044.15 $1151.15 $1264.47 $1667.07 |
$1295.78 $1402.78 $1516.10 $1918.70 |
$1547.41 $1654.41 $1767.73 $2170.33 |
$647.89 $701.39 $758.05 $959.35 |
$899.52 $953.02 $1009.68 $1210.98 |
$1151.15 $1204.65 $1261.31 $1462.61 |
$251.63 |
Plan: (HMO) BlueCare Everyday Health 1483Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
$262.91 $298.40 $336.00 $469.56 $713.54 |
$525.82 $596.80 $672.00 $939.12 $1427.08 |
$692.77 $763.75 $838.95 $1106.07 |
$859.72 $930.70 $1005.90 $1273.02 |
$1026.67 $1097.65 $1172.85 $1439.97 |
$429.86 $465.35 $502.95 $636.51 |
$596.81 $632.30 $669.90 $803.46 |
$763.76 $799.25 $836.85 $970.41 |
$166.95 |
Plan: (HMO) BlueCare All Copay 1491Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, 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 |
Platinum | 21 30 40 50 60 |
$412.55 $468.24 $527.24 $736.81 $1119.66 |
$825.10 $936.48 $1054.48 $1473.62 $2239.32 |
$1087.07 $1198.45 $1316.45 $1735.59 |
$1349.04 $1460.42 $1578.42 $1997.56 |
$1611.01 $1722.39 $1840.39 $2259.53 |
$674.52 $730.21 $789.21 $998.78 |
$936.49 $992.18 $1051.18 $1260.75 |
$1198.46 $1254.15 $1313.15 $1522.72 |
$261.97 |
Plan: (HMO) BlueCare Everyday Health 1477Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$6,100
: Family:
$12,200 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 |
$259.17 $294.16 $331.22 $462.88 $703.39 |
$518.34 $588.32 $662.44 $925.76 $1406.78 |
$682.91 $752.89 $827.01 $1090.33 |
$847.48 $917.46 $991.58 $1254.90 |
$1012.05 $1082.03 $1156.15 $1419.47 |
$423.74 $458.73 $495.79 $627.45 |
$588.31 $623.30 $660.36 $792.02 |
$752.88 $787.87 $824.93 $956.59 |
$164.57 |
Plan: (HMO) BlueCare All Copay 1565Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, 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 |
$359.78 $408.35 $459.80 $642.57 $976.44 |
$719.56 $816.70 $919.60 $1285.14 $1952.88 |
$948.02 $1045.16 $1148.06 $1513.60 |
$1176.48 $1273.62 $1376.52 $1742.06 |
$1404.94 $1502.08 $1604.98 $1970.52 |
$588.24 $636.81 $688.26 $871.03 |
$816.70 $865.27 $916.72 $1099.49 |
$1045.16 $1093.73 $1145.18 $1327.95 |
$228.46 |
ADVERTISEMENT
|
||||||||||
Florida Health Care Plan, Inc.Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 TTY: 1-800-955-8771 |
||||||||||
Plan: (HMO) Gym Access IND Essential Plus Catastrophic HMO 36Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
$169.08 $191.90 $216.08 $301.97 $458.87 |
$338.16 $383.80 $432.16 $603.94 $917.74 |
$445.52 $491.16 $539.52 $711.30 |
$552.88 $598.52 $646.88 $818.66 |
$660.24 $705.88 $754.24 $926.02 |
$276.44 $299.26 $323.44 $409.33 |
$383.80 $406.62 $430.80 $516.69 |
$491.16 $513.98 $538.16 $624.05 |
$107.36 |
Plan: (HMO) IND Essential Plus Catastrophic HMO 36Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
$166.75 $189.27 $213.11 $297.82 $452.57 |
$333.50 $378.54 $426.22 $595.64 $905.14 |
$439.39 $484.43 $532.11 $701.53 |
$545.28 $590.32 $638.00 $807.42 |
$651.17 $696.21 $743.89 $913.31 |
$272.64 $295.16 $319.00 $403.71 |
$378.53 $401.05 $424.89 $509.60 |
$484.42 $506.94 $530.78 $615.49 |
$105.89 |
Plan: (POS) Gym Access IND Essential Plus Catastrophic POS 37Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
$187.74 $213.08 $239.93 $335.30 $509.51 |
$375.48 $426.16 $479.86 $670.60 $1019.02 |
$494.69 $545.37 $599.07 $789.81 |
$613.90 $664.58 $718.28 $909.02 |
$733.11 $783.79 $837.49 $1028.23 |
$306.95 $332.29 $359.14 $454.51 |
$426.16 $451.50 $478.35 $573.72 |
$545.37 $570.71 $597.56 $692.93 |
$119.21 |
Plan: (POS) IND Essential Plus Catastrophic POS 37Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
$185.18 $210.18 $236.66 $330.73 $502.58 |
$370.36 $420.36 $473.32 $661.46 $1005.16 |
$487.95 $537.95 $590.91 $779.05 |
$605.54 $655.54 $708.50 $896.64 |
$723.13 $773.13 $826.09 $1014.23 |
$302.77 $327.77 $354.25 $448.32 |
$420.36 $445.36 $471.84 $565.91 |
$537.95 $562.95 $589.43 $683.50 |
$117.59 |
Plan: (HMO) Gym Access IND Essential Plus Silver HMO 53Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,700
: Family:
$3,400 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 |
Silver | 21 30 40 50 60 |
$244.30 $277.28 $312.22 $436.32 $663.04 |
$488.60 $554.56 $624.44 $872.64 $1326.08 |
$643.73 $709.69 $779.57 $1027.77 |
$798.86 $864.82 $934.70 $1182.90 |
$953.99 $1019.95 $1089.83 $1338.03 |
$399.43 $432.41 $467.35 $591.45 |
$554.56 $587.54 $622.48 $746.58 |
$709.69 $742.67 $777.61 $901.71 |
$155.13 |
Plan: (HMO) IND Essential Plus Silver HMO 53Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,700
: Family:
$3,400 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 |
Silver | 21 30 40 50 60 |
$241.05 $273.59 $308.06 $430.51 $654.20 |
$482.10 $547.18 $616.12 $861.02 $1308.40 |
$635.16 $700.24 $769.18 $1014.08 |
$788.22 $853.30 $922.24 $1167.14 |
$941.28 $1006.36 $1075.30 $1320.20 |
$394.11 $426.65 $461.12 $583.57 |
$547.17 $579.71 $614.18 $736.63 |
$700.23 $732.77 $767.24 $889.69 |
$153.06 |
Plan: (HMO) Gym Access IND Essential Plus Bronze HMO 41Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Bronze | 21 30 40 50 60 |
$185.47 $210.51 $237.04 $331.26 $503.38 |
$370.94 $421.02 $474.08 $662.52 $1006.76 |
$488.72 $538.80 $591.86 $780.30 |
$606.50 $656.58 $709.64 $898.08 |
$724.28 $774.36 $827.42 $1015.86 |
$303.25 $328.29 $354.82 $449.04 |
$421.03 $446.07 $472.60 $566.82 |
$538.81 $563.85 $590.38 $684.60 |
$117.78 |
Plan: (HMO) IND Essential Plus Bronze HMO 41Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Bronze | 21 30 40 50 60 |
$182.95 $207.65 $233.81 $326.74 $496.52 |
$365.90 $415.30 $467.62 $653.48 $993.04 |
$482.07 $531.47 $583.79 $769.65 |
$598.24 $647.64 $699.96 $885.82 |
$714.41 $763.81 $816.13 $1001.99 |
$299.12 $323.82 $349.98 $442.91 |
$415.29 $439.99 $466.15 $559.08 |
$531.46 $556.16 $582.32 $675.25 |
$116.17 |
Plan: (HMO) Gym Access IND Essential Plus Gold HMO 63Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$287.88 $326.75 $367.91 $514.16 $781.32 |
$575.76 $653.50 $735.82 $1028.32 $1562.64 |
$758.57 $836.31 $918.63 $1211.13 |
$941.38 $1019.12 $1101.44 $1393.94 |
$1124.19 $1201.93 $1284.25 $1576.75 |
$470.69 $509.56 $550.72 $696.97 |
$653.50 $692.37 $733.53 $879.78 |
$836.31 $875.18 $916.34 $1062.59 |
$182.81 |
Plan: (HMO) IND Essential Plus Gold HMO 63Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$284.08 $322.43 $363.06 $507.37 $771.00 |
$568.16 $644.86 $726.12 $1014.74 $1542.00 |
$748.55 $825.25 $906.51 $1195.13 |
$928.94 $1005.64 $1086.90 $1375.52 |
$1109.33 $1186.03 $1267.29 $1555.91 |
$464.47 $502.82 $543.45 $687.76 |
$644.86 $683.21 $723.84 $868.15 |
$825.25 $863.60 $904.23 $1048.54 |
$180.39 |
Plan: (HMO) Gym Access IND Essential Plus Platinum HMO 65Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$343.45 $389.82 $438.93 $613.41 $932.13 |
$686.90 $779.64 $877.86 $1226.82 $1864.26 |
$904.99 $997.73 $1095.95 $1444.91 |
$1123.08 $1215.82 $1314.04 $1663.00 |
$1341.17 $1433.91 $1532.13 $1881.09 |
$561.54 $607.91 $657.02 $831.50 |
$779.63 $826.00 $875.11 $1049.59 |
$997.72 $1044.09 $1093.20 $1267.68 |
$218.09 |
Plan: (HMO) IND Essential Plus Platinum HMO 65Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$338.96 $384.72 $433.20 $605.39 $919.95 |
$677.92 $769.44 $866.40 $1210.78 $1839.90 |
$893.16 $984.68 $1081.64 $1426.02 |
$1108.40 $1199.92 $1296.88 $1641.26 |
$1323.64 $1415.16 $1512.12 $1856.50 |
$554.20 $599.96 $648.44 $820.63 |
$769.44 $815.20 $863.68 $1035.87 |
$984.68 $1030.44 $1078.92 $1251.11 |
$215.24 |
Plan: (POS) Gym Access IND Essential Plus Silver POS 54Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$271.83 $308.53 $347.40 $485.49 $737.74 |
$543.66 $617.06 $694.80 $970.98 $1475.48 |
$716.27 $789.67 $867.41 $1143.59 |
$888.88 $962.28 $1040.02 $1316.20 |
$1061.49 $1134.89 $1212.63 $1488.81 |
$444.44 $481.14 $520.01 $658.10 |
$617.05 $653.75 $692.62 $830.71 |
$789.66 $826.36 $865.23 $1003.32 |
$172.61 |
Plan: (POS) IND Essential Plus Silver POS 54Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$268.23 $304.44 $342.79 $479.05 $727.97 |
$536.46 $608.88 $685.58 $958.10 $1455.94 |
$706.78 $779.20 $855.90 $1128.42 |
$877.10 $949.52 $1026.22 $1298.74 |
$1047.42 $1119.84 $1196.54 $1469.06 |
$438.55 $474.76 $513.11 $649.37 |
$608.87 $645.08 $683.43 $819.69 |
$779.19 $815.40 $853.75 $990.01 |
$170.32 |
Plan: (POS) Gym Access IND Essential Plus Bronze POS 42Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Bronze | 21 30 40 50 60 |
$206.61 $234.50 $264.05 $369.01 $560.74 |
$413.22 $469.00 $528.10 $738.02 $1121.48 |
$544.42 $600.20 $659.30 $869.22 |
$675.62 $731.40 $790.50 $1000.42 |
$806.82 $862.60 $921.70 $1131.62 |
$337.81 $365.70 $395.25 $500.21 |
$469.01 $496.90 $526.45 $631.41 |
$600.21 $628.10 $657.65 $762.61 |
$131.20 |
Plan: (POS) IND Essential Plus Bronze POS 42Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Bronze | 21 30 40 50 60 |
$203.82 $231.34 $260.48 $364.02 $553.17 |
$407.64 $462.68 $520.96 $728.04 $1106.34 |
$537.07 $592.11 $650.39 $857.47 |
$666.50 $721.54 $779.82 $986.90 |
$795.93 $850.97 $909.25 $1116.33 |
$333.25 $360.77 $389.91 $493.45 |
$462.68 $490.20 $519.34 $622.88 |
$592.11 $619.63 $648.77 $752.31 |
$129.43 |
Plan: (POS) Gym Access IND Essential Plus Gold POS 64Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,600
: Family:
$3,200 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 |
Gold | 21 30 40 50 60 |
$328.65 $373.02 $420.02 $586.98 $891.97 |
$657.30 $746.04 $840.04 $1173.96 $1783.94 |
$865.99 $954.73 $1048.73 $1382.65 |
$1074.68 $1163.42 $1257.42 $1591.34 |
$1283.37 $1372.11 $1466.11 $1800.03 |
$537.34 $581.71 $628.71 $795.67 |
$746.03 $790.40 $837.40 $1004.36 |
$954.72 $999.09 $1046.09 $1213.05 |
$208.69 |
Plan: (POS) IND Essential Plus Gold POS 64Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,600
: Family:
$3,200 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 |
Gold | 21 30 40 50 60 |
$324.35 $368.14 $414.52 $579.29 $880.28 |
$648.70 $736.28 $829.04 $1158.58 $1760.56 |
$854.66 $942.24 $1035.00 $1364.54 |
$1060.62 $1148.20 $1240.96 $1570.50 |
$1266.58 $1354.16 $1446.92 $1776.46 |
$530.31 $574.10 $620.48 $785.25 |
$736.27 $780.06 $826.44 $991.21 |
$942.23 $986.02 $1032.40 $1197.17 |
$205.96 |
Plan: (POS) Gym Access IND Essential Plus Platinum POS 66Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$379.81 $431.09 $485.40 $678.34 $1030.81 |
$759.62 $862.18 $970.80 $1356.68 $2061.62 |
$1000.80 $1103.36 $1211.98 $1597.86 |
$1241.98 $1344.54 $1453.16 $1839.04 |
$1483.16 $1585.72 $1694.34 $2080.22 |
$620.99 $672.27 $726.58 $919.52 |
$862.17 $913.45 $967.76 $1160.70 |
$1103.35 $1154.63 $1208.94 $1401.88 |
$241.18 |
Plan: (POS) IND Essential Plus Platinum POS 66Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$374.87 $425.48 $479.08 $669.52 $1017.40 |
$749.74 $850.96 $958.16 $1339.04 $2034.80 |
$987.78 $1089.00 $1196.20 $1577.08 |
$1225.82 $1327.04 $1434.24 $1815.12 |
$1463.86 $1565.08 $1672.28 $2053.16 |
$612.91 $663.52 $717.12 $907.56 |
$850.95 $901.56 $955.16 $1145.60 |
$1088.99 $1139.60 $1193.20 $1383.64 |
$238.04 |
Plan: (HMO) Gym Access IND Platinum HMO 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$336.84 $382.32 $430.48 $601.60 $914.19 |
$673.68 $764.64 $860.96 $1203.20 $1828.38 |
$887.57 $978.53 $1074.85 $1417.09 |
$1101.46 $1192.42 $1288.74 $1630.98 |
$1315.35 $1406.31 $1502.63 $1844.87 |
$550.73 $596.21 $644.37 $815.49 |
$764.62 $810.10 $858.26 $1029.38 |
$978.51 $1023.99 $1072.15 $1243.27 |
$213.89 |
Plan: (HMO) IND Platinum HMO 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$332.43 $377.31 $424.85 $593.73 $902.23 |
$664.86 $754.62 $849.70 $1187.46 $1804.46 |
$875.96 $965.72 $1060.80 $1398.56 |
$1087.06 $1176.82 $1271.90 $1609.66 |
$1298.16 $1387.92 $1483.00 $1820.76 |
$543.53 $588.41 $635.95 $804.83 |
$754.63 $799.51 $847.05 $1015.93 |
$965.73 $1010.61 $1058.15 $1227.03 |
$211.10 |
Plan: (POS) Gym Access Platinum POS 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$372.28 $422.54 $475.77 $664.89 $1010.37 |
$744.56 $845.08 $951.54 $1329.78 $2020.74 |
$980.96 $1081.48 $1187.94 $1566.18 |
$1217.36 $1317.88 $1424.34 $1802.58 |
$1453.76 $1554.28 $1660.74 $2038.98 |
$608.68 $658.94 $712.17 $901.29 |
$845.08 $895.34 $948.57 $1137.69 |
$1081.48 $1131.74 $1184.97 $1374.09 |
$236.40 |
Plan: (POS) IND Platinum POS 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$367.43 $417.03 $469.58 $656.23 $997.21 |
$734.86 $834.06 $939.16 $1312.46 $1994.42 |
$968.18 $1067.38 $1172.48 $1545.78 |
$1201.50 $1300.70 $1405.80 $1779.10 |
$1434.82 $1534.02 $1639.12 $2012.42 |
$600.75 $650.35 $702.90 $889.55 |
$834.07 $883.67 $936.22 $1122.87 |
$1067.39 $1116.99 $1169.54 $1356.19 |
$233.32 |
Plan: (HMO) Gym Access IND Gold HMO 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Gold | 21 30 40 50 60 |
$295.11 $334.95 $377.15 $527.07 $800.93 |
$590.22 $669.90 $754.30 $1054.14 $1601.86 |
$777.62 $857.30 $941.70 $1241.54 |
$965.02 $1044.70 $1129.10 $1428.94 |
$1152.42 $1232.10 $1316.50 $1616.34 |
$482.51 $522.35 $564.55 $714.47 |
$669.91 $709.75 $751.95 $901.87 |
$857.31 $897.15 $939.35 $1089.27 |
$187.40 |
Plan: (HMO) IND Gold HMO 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Gold | 21 30 40 50 60 |
$291.22 $330.53 $372.18 $520.11 $790.36 |
$582.44 $661.06 $744.36 $1040.22 $1580.72 |
$767.36 $845.98 $929.28 $1225.14 |
$952.28 $1030.90 $1114.20 $1410.06 |
$1137.20 $1215.82 $1299.12 $1594.98 |
$476.14 $515.45 $557.10 $705.03 |
$661.06 $700.37 $742.02 $889.95 |
$845.98 $885.29 $926.94 $1074.87 |
$184.92 |
Plan: (POS) Gym Access IND Gold POS 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Gold | 21 30 40 50 60 |
$326.38 $370.44 $417.11 $582.91 $885.79 |
$652.76 $740.88 $834.22 $1165.82 $1771.58 |
$860.01 $948.13 $1041.47 $1373.07 |
$1067.26 $1155.38 $1248.72 $1580.32 |
$1274.51 $1362.63 $1455.97 $1787.57 |
$533.63 $577.69 $624.36 $790.16 |
$740.88 $784.94 $831.61 $997.41 |
$948.13 $992.19 $1038.86 $1204.66 |
$207.25 |
Plan: (POS) IND Gold POS 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Gold | 21 30 40 50 60 |
$322.10 $365.58 $411.64 $575.27 $874.17 |
$644.20 $731.16 $823.28 $1150.54 $1748.34 |
$848.73 $935.69 $1027.81 $1355.07 |
$1053.26 $1140.22 $1232.34 $1559.60 |
$1257.79 $1344.75 $1436.87 $1764.13 |
$526.63 $570.11 $616.17 $779.80 |
$731.16 $774.64 $820.70 $984.33 |
$935.69 $979.17 $1025.23 $1188.86 |
$204.53 |
Plan: (HMO) Gym Access IND Silver HMO 6400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
Silver | 21 30 40 50 60 |
$264.95 $300.72 $338.61 $473.20 $719.07 |
$529.90 $601.44 $677.22 $946.40 $1438.14 |
$698.14 $769.68 $845.46 $1114.64 |
$866.38 $937.92 $1013.70 $1282.88 |
$1034.62 $1106.16 $1181.94 $1451.12 |
$433.19 $468.96 $506.85 $641.44 |
$601.43 $637.20 $675.09 $809.68 |
$769.67 $805.44 $843.33 $977.92 |
$168.24 |
Plan: (HMO) IND Silver HMO 6400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
Silver | 21 30 40 50 60 |
$261.44 $296.73 $334.12 $466.92 $709.54 |
$522.88 $593.46 $668.24 $933.84 $1419.08 |
$688.89 $759.47 $834.25 $1099.85 |
$854.90 $925.48 $1000.26 $1265.86 |
$1020.91 $1091.49 $1166.27 $1431.87 |
$427.45 $462.74 $500.13 $632.93 |
$593.46 $628.75 $666.14 $798.94 |
$759.47 $794.76 $832.15 $964.95 |
$166.01 |
Plan: (HMO) Gym Access IND Silver HMO 6600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$244.45 $277.45 $312.41 $436.59 $663.44 |
$488.90 $554.90 $624.82 $873.18 $1326.88 |
$644.13 $710.13 $780.05 $1028.41 |
$799.36 $865.36 $935.28 $1183.64 |
$954.59 $1020.59 $1090.51 $1338.87 |
$399.68 $432.68 $467.64 $591.82 |
$554.91 $587.91 $622.87 $747.05 |
$710.14 $743.14 $778.10 $902.28 |
$155.23 |
Plan: (HMO) IND Silver HMO 6600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$241.19 $273.75 $308.24 $430.76 $654.59 |
$482.38 $547.50 $616.48 $861.52 $1309.18 |
$635.54 $700.66 $769.64 $1014.68 |
$788.70 $853.82 $922.80 $1167.84 |
$941.86 $1006.98 $1075.96 $1321.00 |
$394.35 $426.91 $461.40 $583.92 |
$547.51 $580.07 $614.56 $737.08 |
$700.67 $733.23 $767.72 $890.24 |
$153.16 |
Plan: (HMO) Gym Access IND Bronze HMO 6850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
Bronze | 21 30 40 50 60 |
$190.13 $215.80 $242.99 $339.57 $516.01 |
$380.26 $431.60 $485.98 $679.14 $1032.02 |
$500.99 $552.33 $606.71 $799.87 |
$621.72 $673.06 $727.44 $920.60 |
$742.45 $793.79 $848.17 $1041.33 |
$310.86 $336.53 $363.72 $460.30 |
$431.59 $457.26 $484.45 $581.03 |
$552.32 $577.99 $605.18 $701.76 |
$120.73 |
Plan: (HMO) IND Bronze HMO 6850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, 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 |
Bronze | 21 30 40 50 60 |
$187.55 $212.86 $239.68 $334.96 $509.00 |
$375.10 $425.72 $479.36 $669.92 $1018.00 |
$494.19 $544.81 $598.45 $789.01 |
$613.28 $663.90 $717.54 $908.10 |
$732.37 $782.99 $836.63 $1027.19 |
$306.64 $331.95 $358.77 $454.05 |
$425.73 $451.04 $477.86 $573.14 |
$544.82 $570.13 $596.95 $692.23 |
$119.09 |
Plan: (HMO) Gym Access IND Bronze HMO HSA 4700/6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$4,700
: Family:
$9,400 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 |
$191.49 $217.34 $244.73 $342.00 $519.71 |
$382.98 $434.68 $489.46 $684.00 $1039.42 |
$504.58 $556.28 $611.06 $805.60 |
$626.18 $677.88 $732.66 $927.20 |
$747.78 $799.48 $854.26 $1048.80 |
$313.09 $338.94 $366.33 $463.60 |
$434.69 $460.54 $487.93 $585.20 |
$556.29 $582.14 $609.53 $706.80 |
$121.60 |
Plan: (HMO) IND Bronze HMO HSA 4700/6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$4,700
: Family:
$9,400 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 |
$188.89 $214.39 $241.40 $337.36 $512.65 |
$377.78 $428.78 $482.80 $674.72 $1025.30 |
$497.73 $548.73 $602.75 $794.67 |
$617.68 $668.68 $722.70 $914.62 |
$737.63 $788.63 $842.65 $1034.57 |
$308.84 $334.34 $361.35 $457.31 |
$428.79 $454.29 $481.30 $577.26 |
$548.74 $574.24 $601.25 $697.21 |
$119.95 |
Plan: (HMO) Gym Access IND Bronze HMO HSA 6000/6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$188.90 $214.40 $241.42 $337.38 $512.68 |
$377.80 $428.80 $482.84 $674.76 $1025.36 |
$497.75 $548.75 $602.79 $794.71 |
$617.70 $668.70 $722.74 $914.66 |
$737.65 $788.65 $842.69 $1034.61 |
$308.85 $334.35 $361.37 $457.33 |
$428.80 $454.30 $481.32 $577.28 |
$548.75 $574.25 $601.27 $697.23 |
$119.95 |
Plan: (HMO) IND Bronze HMO HSA 6000/6450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$186.33 $211.49 $238.13 $332.79 $505.71 |
$372.66 $422.98 $476.26 $665.58 $1011.42 |
$490.98 $541.30 $594.58 $783.90 |
$609.30 $659.62 $712.90 $902.22 |
$727.62 $777.94 $831.22 $1020.54 |
$304.65 $329.81 $356.45 $451.11 |
$422.97 $448.13 $474.77 $569.43 |
$541.29 $566.45 $593.09 $687.75 |
$118.32 |
Plan: (HMO) IND Bronze HMO BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
$194.91 $221.22 $249.09 $348.10 $528.98 |
$389.82 $442.44 $498.18 $696.20 $1057.96 |
$513.59 $566.21 $621.95 $819.97 |
$637.36 $689.98 $745.72 $943.74 |
$761.13 $813.75 $869.49 $1067.51 |
$318.68 $344.99 $372.86 $471.87 |
$442.45 $468.76 $496.63 $595.64 |
$566.22 $592.53 $620.40 $719.41 |
$123.77 |
Plan: (HMO) Gym Access IND Bronze HMO BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
$197.58 $224.26 $252.51 $352.88 $536.24 |
$395.16 $448.52 $505.02 $705.76 $1072.48 |
$520.63 $573.99 $630.49 $831.23 |
$646.10 $699.46 $755.96 $956.70 |
$771.57 $824.93 $881.43 $1082.17 |
$323.05 $349.73 $377.98 $478.35 |
$448.52 $475.20 $503.45 $603.82 |
$573.99 $600.67 $628.92 $729.29 |
$125.47 |
Plan: (POS) IND Bronze POS BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
$216.15 $245.33 $276.24 $386.04 $586.63 |
$432.30 $490.66 $552.48 $772.08 $1173.26 |
$569.56 $627.92 $689.74 $909.34 |
$706.82 $765.18 $827.00 $1046.60 |
$844.08 $902.44 $964.26 $1183.86 |
$353.41 $382.59 $413.50 $523.30 |
$490.67 $519.85 $550.76 $660.56 |
$627.93 $657.11 $688.02 $797.82 |
$137.26 |
Plan: (POS) Gym Access IND Bronze POS BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 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 |
$219.09 $248.67 $280.00 $391.30 $594.62 |
$438.18 $497.34 $560.00 $782.60 $1189.24 |
$577.30 $636.46 $699.12 $921.72 |
$716.42 $775.58 $838.24 $1060.84 |
$855.54 $914.70 $977.36 $1199.96 |
$358.21 $387.79 $419.12 $530.42 |
$497.33 $526.91 $558.24 $669.54 |
$636.45 $666.03 $697.36 $808.66 |
$139.12 |
Plan: (HMO) IND Silver HMO BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$232.61 $264.01 $297.27 $415.43 $631.29 |
$465.22 $528.02 $594.54 $830.86 $1262.58 |
$612.92 $675.72 $742.24 $978.56 |
$760.62 $823.42 $889.94 $1126.26 |
$908.32 $971.12 $1037.64 $1273.96 |
$380.31 $411.71 $444.97 $563.13 |
$528.01 $559.41 $592.67 $710.83 |
$675.71 $707.11 $740.37 $858.53 |
$147.70 |
Plan: (HMO) Gym Access IND Silver HMO BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$235.75 $267.58 $301.29 $421.06 $639.84 |
$471.50 $535.16 $602.58 $842.12 $1279.68 |
$621.20 $684.86 $752.28 $991.82 |
$770.90 $834.56 $901.98 $1141.52 |
$920.60 $984.26 $1051.68 $1291.22 |
$385.45 $417.28 $450.99 $570.76 |
$535.15 $566.98 $600.69 $720.46 |
$684.85 $716.68 $750.39 $870.16 |
$149.70 |
Plan: (POS) IND Silver POS BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$257.62 $292.40 $329.24 $460.11 $699.18 |
$515.24 $584.80 $658.48 $920.22 $1398.36 |
$678.83 $748.39 $822.07 $1083.81 |
$842.42 $911.98 $985.66 $1247.40 |
$1006.01 $1075.57 $1149.25 $1410.99 |
$421.21 $455.99 $492.83 $623.70 |
$584.80 $619.58 $656.42 $787.29 |
$748.39 $783.17 $820.01 $950.88 |
$163.59 |
Plan: (POS) Gym Access IND Silver POS BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Silver | 21 30 40 50 60 |
$261.09 $296.33 $333.67 $466.30 $708.59 |
$522.18 $592.66 $667.34 $932.60 $1417.18 |
$687.97 $758.45 $833.13 $1098.39 |
$853.76 $924.24 $998.92 $1264.18 |
$1019.55 $1090.03 $1164.71 $1429.97 |
$426.88 $462.12 $499.46 $632.09 |
$592.67 $627.91 $665.25 $797.88 |
$758.46 $793.70 $831.04 $963.67 |
$165.79 |
Plan: (HMO) IND Silver HMO BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
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 |
Silver | 21 30 40 50 60 |
$240.11 $272.53 $306.86 $428.84 $651.66 |
$480.22 $545.06 $613.72 $857.68 $1303.32 |
$632.69 $697.53 $766.19 $1010.15 |
$785.16 $850.00 $918.66 $1162.62 |
$937.63 $1002.47 $1071.13 $1315.09 |
$392.58 $425.00 $459.33 $581.31 |
$545.05 $577.47 $611.80 $733.78 |
$697.52 $729.94 $764.27 $886.25 |
$152.47 |
Plan: (HMO) Gym Access IND Silver HMO BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
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 |
Silver | 21 30 40 50 60 |
$243.36 $276.21 $311.01 $434.64 $660.47 |
$486.72 $552.42 $622.02 $869.28 $1320.94 |
$641.25 $706.95 $776.55 $1023.81 |
$795.78 $861.48 $931.08 $1178.34 |
$950.31 $1016.01 $1085.61 $1332.87 |
$397.89 $430.74 $465.54 $589.17 |
$552.42 $585.27 $620.07 $743.70 |
$706.95 $739.80 $774.60 $898.23 |
$154.53 |
Plan: (POS) IND Silver POS BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
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 |
Silver | 21 30 40 50 60 |
$265.87 $301.77 $339.79 $474.85 $721.58 |
$531.74 $603.54 $679.58 $949.70 $1443.16 |
$700.57 $772.37 $848.41 $1118.53 |
$869.40 $941.20 $1017.24 $1287.36 |
$1038.23 $1110.03 $1186.07 $1456.19 |
$434.70 $470.60 $508.62 $643.68 |
$603.53 $639.43 $677.45 $812.51 |
$772.36 $808.26 $846.28 $981.34 |
$168.83 |
Plan: (POS) Gym Access IND Silver POS BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
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 |
Silver | 21 30 40 50 60 |
$269.45 $305.82 $344.35 $481.23 $731.27 |
$538.90 $611.64 $688.70 $962.46 $1462.54 |
$710.00 $782.74 $859.80 $1133.56 |
$881.10 $953.84 $1030.90 $1304.66 |
$1052.20 $1124.94 $1202.00 $1475.76 |
$440.55 $476.92 $515.45 $652.33 |
$611.65 $648.02 $686.55 $823.43 |
$782.75 $819.12 $857.65 $994.53 |
$171.10 |
Plan: (HMO) IND Gold HMO BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$320.70 $363.99 $409.85 $572.76 $870.37 |
$641.40 $727.98 $819.70 $1145.52 $1740.74 |
$845.04 $931.62 $1023.34 $1349.16 |
$1048.68 $1135.26 $1226.98 $1552.80 |
$1252.32 $1338.90 $1430.62 $1756.44 |
$524.34 $567.63 $613.49 $776.40 |
$727.98 $771.27 $817.13 $980.04 |
$931.62 $974.91 $1020.77 $1183.68 |
$203.64 |
Plan: (HMO) Gym Access IND Gold HMO BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$324.95 $368.82 $415.29 $580.37 $881.93 |
$649.90 $737.64 $830.58 $1160.74 $1763.86 |
$856.25 $943.99 $1036.93 $1367.09 |
$1062.60 $1150.34 $1243.28 $1573.44 |
$1268.95 $1356.69 $1449.63 $1779.79 |
$531.30 $575.17 $621.64 $786.72 |
$737.65 $781.52 $827.99 $993.07 |
$944.00 $987.87 $1034.34 $1199.42 |
$206.35 |
Plan: (POS) IND Gold POS BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$355.98 $404.04 $454.94 $635.78 $966.13 |
$711.96 $808.08 $909.88 $1271.56 $1932.26 |
$938.01 $1034.13 $1135.93 $1497.61 |
$1164.06 $1260.18 $1361.98 $1723.66 |
$1390.11 $1486.23 $1588.03 $1949.71 |
$582.03 $630.09 $680.99 $861.83 |
$808.08 $856.14 $907.04 $1087.88 |
$1034.13 $1082.19 $1133.09 $1313.93 |
$226.05 |
Plan: (POS) Gym Access IND Gold POS BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
$360.69 $409.38 $460.96 $644.18 $978.90 |
$721.38 $818.76 $921.92 $1288.36 $1957.80 |
$950.42 $1047.80 $1150.96 $1517.40 |
$1179.46 $1276.84 $1380.00 $1746.44 |
$1408.50 $1505.88 $1609.04 $1975.48 |
$589.73 $638.42 $690.00 $873.22 |
$818.77 $867.46 $919.04 $1102.26 |
$1047.81 $1096.50 $1148.08 $1331.30 |
$229.04 |
Plan: (HMO) IND Platinum HMO BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$321.06 $364.40 $410.31 $573.40 $871.34 |
$642.12 $728.80 $820.62 $1146.80 $1742.68 |
$845.99 $932.67 $1024.49 $1350.67 |
$1049.86 $1136.54 $1228.36 $1554.54 |
$1253.73 $1340.41 $1432.23 $1758.41 |
$524.93 $568.27 $614.18 $777.27 |
$728.80 $772.14 $818.05 $981.14 |
$932.67 $976.01 $1021.92 $1185.01 |
$203.87 |
Plan: (HMO) Gym Access IND Platinum HMO BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$325.32 $369.24 $415.76 $581.02 $882.92 |
$650.64 $738.48 $831.52 $1162.04 $1765.84 |
$857.22 $945.06 $1038.10 $1368.62 |
$1063.80 $1151.64 $1244.68 $1575.20 |
$1270.38 $1358.22 $1451.26 $1781.78 |
$531.90 $575.82 $622.34 $787.60 |
$738.48 $782.40 $828.92 $994.18 |
$945.06 $988.98 $1035.50 $1200.76 |
$206.58 |
Plan: (POS) IND Platinum POS BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$356.37 $404.49 $455.45 $636.49 $967.20 |
$712.74 $808.98 $910.90 $1272.98 $1934.40 |
$939.04 $1035.28 $1137.20 $1499.28 |
$1165.34 $1261.58 $1363.50 $1725.58 |
$1391.64 $1487.88 $1589.80 $1951.88 |
$582.67 $630.79 $681.75 $862.79 |
$808.97 $857.09 $908.05 $1089.09 |
$1035.27 $1083.39 $1134.35 $1315.39 |
$226.30 |
Plan: (POS) Gym Access IND Platinum POS BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$361.09 $409.83 $461.47 $644.90 $979.99 |
$722.18 $819.66 $922.94 $1289.80 $1959.98 |
$951.47 $1048.95 $1152.23 $1519.09 |
$1180.76 $1278.24 $1381.52 $1748.38 |
$1410.05 $1507.53 $1610.81 $1977.67 |
$590.38 $639.12 $690.76 $874.19 |
$819.67 $868.41 $920.05 $1103.48 |
$1048.96 $1097.70 $1149.34 $1332.77 |
$229.29 |
Plan: (HMO) IND Platinum HMO BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$338.32 $383.99 $432.37 $604.23 $918.19 |
$676.64 $767.98 $864.74 $1208.46 $1836.38 |
$891.47 $982.81 $1079.57 $1423.29 |
$1106.30 $1197.64 $1294.40 $1638.12 |
$1321.13 $1412.47 $1509.23 $1852.95 |
$553.15 $598.82 $647.20 $819.06 |
$767.98 $813.65 $862.03 $1033.89 |
$982.81 $1028.48 $1076.86 $1248.72 |
$214.83 |
Plan: (HMO) Gym Access IND Platinum HMO BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$342.80 $389.08 $438.10 $612.24 $930.36 |
$685.60 $778.16 $876.20 $1224.48 $1860.72 |
$903.28 $995.84 $1093.88 $1442.16 |
$1120.96 $1213.52 $1311.56 $1659.84 |
$1338.64 $1431.20 $1529.24 $1877.52 |
$560.48 $606.76 $655.78 $829.92 |
$778.16 $824.44 $873.46 $1047.60 |
$995.84 $1042.12 $1091.14 $1265.28 |
$217.68 |
Plan: (POS) IND Platinum POS BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$375.44 $426.13 $479.82 $670.54 $1018.96 |
$750.88 $852.26 $959.64 $1341.08 $2037.92 |
$989.29 $1090.67 $1198.05 $1579.49 |
$1227.70 $1329.08 $1436.46 $1817.90 |
$1466.11 $1567.49 $1674.87 $2056.31 |
$613.85 $664.54 $718.23 $908.95 |
$852.26 $902.95 $956.64 $1147.36 |
$1090.67 $1141.36 $1195.05 $1385.77 |
$238.41 |
Plan: (POS) Gym Access IND Platinum POS BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$380.39 $431.74 $486.14 $679.38 $1032.38 |
$760.78 $863.48 $972.28 $1358.76 $2064.76 |
$1002.33 $1105.03 $1213.83 $1600.31 |
$1243.88 $1346.58 $1455.38 $1841.86 |
$1485.43 $1588.13 $1696.93 $2083.41 |
$621.94 $673.29 $727.69 $920.93 |
$863.49 $914.84 $969.24 $1162.48 |
$1105.04 $1156.39 $1210.79 $1404.03 |
$241.55 |
Plan: (HMO) IND Platinum HMO 91Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$250
: Family:
$750 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 |
$330.31 $374.90 $422.13 $589.93 $896.46 |
$660.62 $749.80 $844.26 $1179.86 $1792.92 |
$870.37 $959.55 $1054.01 $1389.61 |
$1080.12 $1169.30 $1263.76 $1599.36 |
$1289.87 $1379.05 $1473.51 $1809.11 |
$540.06 $584.65 $631.88 $799.68 |
$749.81 $794.40 $841.63 $1009.43 |
$959.56 $1004.15 $1051.38 $1219.18 |
$209.75 |
Plan: (HMO) Gym Access IND Platinum HMO 91Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$250
: Family:
$750 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 |
$334.70 $379.88 $427.74 $597.77 $908.36 |
$669.40 $759.76 $855.48 $1195.54 $1816.72 |
$881.93 $972.29 $1068.01 $1408.07 |
$1094.46 $1184.82 $1280.54 $1620.60 |
$1306.99 $1397.35 $1493.07 $1833.13 |
$547.23 $592.41 $640.27 $810.30 |
$759.76 $804.94 $852.80 $1022.83 |
$972.29 $1017.47 $1065.33 $1235.36 |
$212.53 |
Plan: (HMO) IND Platinum HMO 92Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$325.75 $369.73 $416.31 $581.79 $884.09 |
$651.50 $739.46 $832.62 $1163.58 $1768.18 |
$858.35 $946.31 $1039.47 $1370.43 |
$1065.20 $1153.16 $1246.32 $1577.28 |
$1272.05 $1360.01 $1453.17 $1784.13 |
$532.60 $576.58 $623.16 $788.64 |
$739.45 $783.43 $830.01 $995.49 |
$946.30 $990.28 $1036.86 $1202.34 |
$206.85 |
Plan: (HMO) Gym Acccess IND Platinum HMO 92Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care 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 |
Platinum | 21 30 40 50 60 |
$330.08 $374.64 $421.84 $589.52 $895.83 |
$660.16 $749.28 $843.68 $1179.04 $1791.66 |
$869.76 $958.88 $1053.28 $1388.64 |
$1079.36 $1168.48 $1262.88 $1598.24 |
$1288.96 $1378.08 $1472.48 $1807.84 |
$539.68 $584.24 $631.44 $799.12 |
$749.28 $793.84 $841.04 $1008.72 |
$958.88 $1003.44 $1050.64 $1218.32 |
$209.60 |
ADVERTISEMENT
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||||||||||
UnitedHealthcare of Florida, Inc.Local: 1-877-887-0441 | Toll Free: 1-877-887-0441 |
||||||||||
Plan: (HMO) Gold Compass 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
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 |
$323.37 $367.02 $413.26 $577.53 $877.61 |
$646.74 $734.04 $826.52 $1155.06 $1755.22 |
$852.08 $939.38 $1031.86 $1360.40 |
$1057.42 $1144.72 $1237.20 $1565.74 |
$1262.76 $1350.06 $1442.54 $1771.08 |
$528.71 $572.36 $618.60 $782.87 |
$734.05 $777.70 $823.94 $988.21 |
$939.39 $983.04 $1029.28 $1193.55 |
$205.34 |
Plan: (HMO) Gold Compass HSA 1600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
Deductible: Individual:
$1,600
: Family:
$3,200 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 |
Gold | 21 30 40 50 60 |
$297.14 $337.25 $379.74 $530.68 $806.42 |
$594.28 $674.50 $759.48 $1061.36 $1612.84 |
$782.96 $863.18 $948.16 $1250.04 |
$971.64 $1051.86 $1136.84 $1438.72 |
$1160.32 $1240.54 $1325.52 $1627.40 |
$485.82 $525.93 $568.42 $719.36 |
$674.50 $714.61 $757.10 $908.04 |
$863.18 $903.29 $945.78 $1096.72 |
$188.68 |
Plan: (HMO) Silver Compass 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
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 |
$272.09 $308.81 $347.72 $485.93 $738.42 |
$544.18 $617.62 $695.44 $971.86 $1476.84 |
$716.95 $790.39 $868.21 $1144.63 |
$889.72 $963.16 $1040.98 $1317.40 |
$1062.49 $1135.93 $1213.75 $1490.17 |
$444.86 $481.58 $520.49 $658.70 |
$617.63 $654.35 $693.26 $831.47 |
$790.40 $827.12 $866.03 $1004.24 |
$172.77 |
Plan: (HMO) Silver Compass HSA 3600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
Deductible: Individual:
$3,600
: Family:
$7,200 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 |
$274.05 $311.03 $350.22 $489.43 $743.73 |
$548.10 $622.06 $700.44 $978.86 $1487.46 |
$722.11 $796.07 $874.45 $1152.87 |
$896.12 $970.08 $1048.46 $1326.88 |
$1070.13 $1144.09 $1222.47 $1500.89 |
$448.06 $485.04 $524.23 $663.44 |
$622.07 $659.05 $698.24 $837.45 |
$796.08 $833.06 $872.25 $1011.46 |
$174.01 |
Plan: (HMO) Bronze Compass 4200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
Deductible: Individual:
$4,200
: Family:
$8,400 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 |
$232.16 $263.49 $296.68 $414.62 $630.05 |
$464.32 $526.98 $593.36 $829.24 $1260.10 |
$611.73 $674.39 $740.77 $976.65 |
$759.14 $821.80 $888.18 $1124.06 |
$906.55 $969.21 $1035.59 $1271.47 |
$379.57 $410.90 $444.09 $562.03 |
$526.98 $558.31 $591.50 $709.44 |
$674.39 $705.72 $738.91 $856.85 |
$147.41 |
Plan: (HMO) Bronze Compass 6400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)
Deductible: Individual:
$6,400
: Family:
$12,800 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 |
Bronze | 21 30 40 50 60 |
$238.42 $270.60 $304.69 $425.80 $647.05 |
$476.84 $541.20 $609.38 $851.60 $1294.10 |
$628.23 $692.59 $760.77 $1002.99 |
$779.62 $843.98 $912.16 $1154.38 |
$931.01 $995.37 $1063.55 $1305.77 |
$389.81 $421.99 $456.08 $577.19 |
$541.20 $573.38 $607.47 $728.58 |
$692.59 $724.77 $758.86 $879.97 |
$151.39 |
Plan: (HMO) Catastrophic Compass 6850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, 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 |
$191.84 $217.72 $245.15 $342.60 $520.61 |
$383.68 $435.44 $490.30 $685.20 $1041.22 |
$505.49 $557.25 $612.11 $807.01 |
$627.30 $679.06 $733.92 $928.82 |
$749.11 $800.87 $855.73 $1050.63 |
$313.65 $339.53 $366.96 $464.41 |
$435.46 $461.34 $488.77 $586.22 |
$557.27 $583.15 $610.58 $708.03 |
$121.81 |
†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 Brevard County here.