Obamacare Providers, Plans and 2017 Rates for Sullivan County
The health insurance rates listed below are for calendar year 2017.
2017 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Sullivan County, New Hampshire.
Currently, there are 34 plans offered in Sullivan County.
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:
- 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 Claremont, NH area accept this insurance coverage as within the plan's "network".
‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Sullivan County here.
ADVERTISEMENT
|
||||||||||
Harvard Pilgrim Health Care of NELocal: 1-877-907-4742 | Toll Free: 1-877-907-4742 TTY: 1-800-637-8257 |
||||||||||
Plan: (HMO) ElevateHealth Silver 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
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 |
$281.90 $319.95 $360.26 $503.47 $765.07 |
$563.80 $639.90 $720.52 $1006.94 $1530.14 |
$742.80 $818.90 $899.52 $1185.94 |
$921.80 $997.90 $1078.52 $1364.94 |
$1100.80 $1176.90 $1257.52 $1543.94 |
$460.90 $498.95 $539.26 $682.47 |
$639.90 $677.95 $718.26 $861.47 |
$818.90 $856.95 $897.26 $1040.47 |
$179.00 |
Plan: (HMO) ElevateHealth Gold HSA 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
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 |
$330.74 $375.39 $422.69 $590.71 $897.64 |
$661.48 $750.78 $845.38 $1181.42 $1795.28 |
$871.50 $960.80 $1055.40 $1391.44 |
$1081.52 $1170.82 $1265.42 $1601.46 |
$1291.54 $1380.84 $1475.44 $1811.48 |
$540.76 $585.41 $632.71 $800.73 |
$750.78 $795.43 $842.73 $1010.75 |
$960.80 $1005.45 $1052.75 $1220.77 |
$210.02 |
Plan: (HMO) ElevateHealth Bronze 5750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
Deductible: Individual:
$5,750
: Family:
$11,500 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 |
Bronze | 21 30 40 50 60 |
$209.51 $237.79 $267.75 $374.19 $568.61 |
$419.02 $475.58 $535.50 $748.38 $1137.22 |
$552.06 $608.62 $668.54 $881.42 |
$685.10 $741.66 $801.58 $1014.46 |
$818.14 $874.70 $934.62 $1147.50 |
$342.55 $370.83 $400.79 $507.23 |
$475.59 $503.87 $533.83 $640.27 |
$608.63 $636.91 $666.87 $773.31 |
$133.04 |
Plan: (HMO) New Hampshire Network Bronze HSA 5100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
Deductible: Individual:
$5,100
: Family:
$10,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$236.58 $268.52 $302.35 $422.54 $642.08 |
$473.16 $537.04 $604.70 $845.08 $1284.16 |
$623.39 $687.27 $754.93 $995.31 |
$773.62 $837.50 $905.16 $1145.54 |
$923.85 $987.73 $1055.39 $1295.77 |
$386.81 $418.75 $452.58 $572.77 |
$537.04 $568.98 $602.81 $723.00 |
$687.27 $719.21 $753.04 $873.23 |
$150.23 |
Plan: (HMO) ElevateHealth Silver HSA 3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$253.65 $287.89 $324.16 $453.02 $688.40 |
$507.30 $575.78 $648.32 $906.04 $1376.80 |
$668.37 $736.85 $809.39 $1067.11 |
$829.44 $897.92 $970.46 $1228.18 |
$990.51 $1058.99 $1131.53 $1389.25 |
$414.72 $448.96 $485.23 $614.09 |
$575.79 $610.03 $646.30 $775.16 |
$736.86 $771.10 $807.37 $936.23 |
$161.07 |
Plan: (HMO) ElevateHealth Bronze HSA 6300Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
Deductible: Individual:
$6,300
: Family:
$12,600 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 |
$220.69 $250.49 $282.04 $394.16 $598.96 |
$441.38 $500.98 $564.08 $788.32 $1197.92 |
$581.52 $641.12 $704.22 $928.46 |
$721.66 $781.26 $844.36 $1068.60 |
$861.80 $921.40 $984.50 $1208.74 |
$360.83 $390.63 $422.18 $534.30 |
$500.97 $530.77 $562.32 $674.44 |
$641.11 $670.91 $702.46 $814.58 |
$140.14 |
Plan: (HMO) New Hampshire Network Gold 1000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
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 |
$371.94 $422.15 $475.34 $664.28 $1009.44 |
$743.88 $844.30 $950.68 $1328.56 $2018.88 |
$980.06 $1080.48 $1186.86 $1564.74 |
$1216.24 $1316.66 $1423.04 $1800.92 |
$1452.42 $1552.84 $1659.22 $2037.10 |
$608.12 $658.33 $711.52 $900.46 |
$844.30 $894.51 $947.70 $1136.64 |
$1080.48 $1130.69 $1183.88 $1372.82 |
$236.18 |
Plan: (HMO) New Hampshire Network Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care of NE)
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 |
$316.62 $359.36 $404.64 $565.48 $859.31 |
$633.24 $718.72 $809.28 $1130.96 $1718.62 |
$834.29 $919.77 $1010.33 $1332.01 |
$1035.34 $1120.82 $1211.38 $1533.06 |
$1236.39 $1321.87 $1412.43 $1734.11 |
$517.67 $560.41 $605.69 $766.53 |
$718.72 $761.46 $806.74 $967.58 |
$919.77 $962.51 $1007.79 $1168.63 |
$201.05 |
ADVERTISEMENT
|
||||||||||
Minuteman Health, IncLocal: 1-857-265-3201 | Toll Free: 1-855-644-1776 |
||||||||||
Plan: (HMO) MyDoc HMO PlatinumSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$303.95 $344.98 $388.44 $542.85 $824.91 |
$607.90 $689.96 $776.88 $1085.70 $1649.82 |
$800.91 $882.97 $969.89 $1278.71 |
$993.92 $1075.98 $1162.90 $1471.72 |
$1186.93 $1268.99 $1355.91 $1664.73 |
$496.96 $537.99 $581.45 $735.86 |
$689.97 $731.00 $774.46 $928.87 |
$882.98 $924.01 $967.47 $1121.88 |
$193.01 |
Plan: (HMO) MyDoc HMO Gold Basic 1000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$270.33 $306.83 $345.48 $482.81 $733.68 |
$540.66 $613.66 $690.96 $965.62 $1467.36 |
$712.32 $785.32 $862.62 $1137.28 |
$883.98 $956.98 $1034.28 $1308.94 |
$1055.64 $1128.64 $1205.94 $1480.60 |
$441.99 $478.49 $517.14 $654.47 |
$613.65 $650.15 $688.80 $826.13 |
$785.31 $821.81 $860.46 $997.79 |
$171.66 |
Plan: (HMO) MyDoc HMO Bronze ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, Inc)
Deductible: Individual:
$4,750
: Family:
$9,500 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 |
Bronze | 21 30 40 50 60 |
$178.26 $202.32 $227.81 $318.36 $483.79 |
$356.52 $404.64 $455.62 $636.72 $967.58 |
$469.71 $517.83 $568.81 $749.91 |
$582.90 $631.02 $682.00 $863.10 |
$696.09 $744.21 $795.19 $976.29 |
$291.45 $315.51 $341.00 $431.55 |
$404.64 $428.70 $454.19 $544.74 |
$517.83 $541.89 $567.38 $657.93 |
$113.19 |
Plan: (HMO) MyDoc HMO Silver BasicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$207.00 $234.95 $264.55 $369.71 $561.80 |
$414.00 $469.90 $529.10 $739.42 $1123.60 |
$545.45 $601.35 $660.55 $870.87 |
$676.90 $732.80 $792.00 $1002.32 |
$808.35 $864.25 $923.45 $1133.77 |
$338.45 $366.40 $396.00 $501.16 |
$469.90 $497.85 $527.45 $632.61 |
$601.35 $629.30 $658.90 $764.06 |
$131.45 |
Plan: (HMO) MyDoc HMO Silver CareSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, Inc)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$209.75 $238.06 $268.06 $374.61 $569.25 |
$419.50 $476.12 $536.12 $749.22 $1138.50 |
$552.69 $609.31 $669.31 $882.41 |
$685.88 $742.50 $802.50 $1015.60 |
$819.07 $875.69 $935.69 $1148.79 |
$342.94 $371.25 $401.25 $507.80 |
$476.13 $504.44 $534.44 $640.99 |
$609.32 $637.63 $667.63 $774.18 |
$133.19 |
Plan: (HMO) MyDoc HMO Bronze Basic 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$177.26 $201.19 $226.53 $316.58 $481.08 |
$354.52 $402.38 $453.06 $633.16 $962.16 |
$467.08 $514.94 $565.62 $745.72 |
$579.64 $627.50 $678.18 $858.28 |
$692.20 $740.06 $790.74 $970.84 |
$289.82 $313.75 $339.09 $429.14 |
$402.38 $426.31 $451.65 $541.70 |
$514.94 $538.87 $564.21 $654.26 |
$112.56 |
Plan: (HMO) MyDoc HMO Bronze 6300Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, Inc)
Deductible: Individual:
$6,300
: Family:
$12,600 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 |
$172.50 $195.78 $220.45 $308.08 $468.16 |
$345.00 $391.56 $440.90 $616.16 $936.32 |
$454.54 $501.10 $550.44 $725.70 |
$564.08 $610.64 $659.98 $835.24 |
$673.62 $720.18 $769.52 $944.78 |
$282.04 $305.32 $329.99 $417.62 |
$391.58 $414.86 $439.53 $527.16 |
$501.12 $524.40 $549.07 $636.70 |
$109.54 |
Plan: (HMO) MyDoc HMO Simple CareSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, Inc)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$114.96 $130.48 $146.92 $205.31 $311.99 |
$229.92 $260.96 $293.84 $410.62 $623.98 |
$302.92 $333.96 $366.84 $483.62 |
$375.92 $406.96 $439.84 $556.62 |
$448.92 $479.96 $512.84 $629.62 |
$187.96 $203.48 $219.92 $278.31 |
$260.96 $276.48 $292.92 $351.31 |
$333.96 $349.48 $365.92 $424.31 |
$73.00 |
Plan: (HMO) MyDoc HMO Platinum Extra ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$326.51 $370.58 $417.28 $583.14 $886.14 |
$653.02 $741.16 $834.56 $1166.28 $1772.28 |
$860.35 $948.49 $1041.89 $1373.61 |
$1067.68 $1155.82 $1249.22 $1580.94 |
$1275.01 $1363.15 $1456.55 $1788.27 |
$533.84 $577.91 $624.61 $790.47 |
$741.17 $785.24 $831.94 $997.80 |
$948.50 $992.57 $1039.27 $1205.13 |
$207.33 |
Plan: (HMO) MyDoc HMO Silver Assistance ASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, 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 |
$208.86 $237.06 $266.92 $373.03 $566.85 |
$417.72 $474.12 $533.84 $746.06 $1133.70 |
$550.35 $606.75 $666.47 $878.69 |
$682.98 $739.38 $799.10 $1011.32 |
$815.61 $872.01 $931.73 $1143.95 |
$341.49 $369.69 $399.55 $505.66 |
$474.12 $502.32 $532.18 $638.29 |
$606.75 $634.95 $664.81 $770.92 |
$132.63 |
Plan: (HMO) MyDoc HMO Bronze HSA 5800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-644-1776 - Provider Directory for This Plan: (Minuteman Health, Inc)
Deductible: Individual:
$5,800
: Family:
$11,600 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 |
$173.27 $196.66 $221.44 $309.47 $470.26 |
$346.54 $393.32 $442.88 $618.94 $940.52 |
$456.57 $503.35 $552.91 $728.97 |
$566.60 $613.38 $662.94 $839.00 |
$676.63 $723.41 $772.97 $949.03 |
$283.30 $306.69 $331.47 $419.50 |
$393.33 $416.72 $441.50 $529.53 |
$503.36 $526.75 $551.53 $639.56 |
$110.03 |
ADVERTISEMENT
|
||||||||||
Celtic Insurance CompanyLocal: 1-844-265-1278 | Toll Free: 1-844-265-1278 TTY: 1-855-742-0123 |
||||||||||
Plan: (EPO) Ambetter Secure Care 1 (2017) with 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-265-1278 - Provider Directory for This Plan: (Celtic Insurance Company)
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 |
$331.61 $376.37 $423.79 $592.24 $899.97 |
$663.22 $752.74 $847.58 $1184.48 $1799.94 |
$873.79 $963.31 $1058.15 $1395.05 |
$1084.36 $1173.88 $1268.72 $1605.62 |
$1294.93 $1384.45 $1479.29 $1816.19 |
$542.18 $586.94 $634.36 $802.81 |
$752.75 $797.51 $844.93 $1013.38 |
$963.32 $1008.08 $1055.50 $1223.95 |
$210.57 |
Plan: (EPO) Ambetter Balanced Care 8 (2017)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-265-1278 - Provider Directory for This Plan: (Celtic Insurance Company)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$320.71 $363.99 $409.85 $572.77 $870.38 |
$641.42 $727.98 $819.70 $1145.54 $1740.76 |
$845.06 $931.62 $1023.34 $1349.18 |
$1048.70 $1135.26 $1226.98 $1552.82 |
$1252.34 $1338.90 $1430.62 $1756.46 |
$524.35 $567.63 $613.49 $776.41 |
$727.99 $771.27 $817.13 $980.05 |
$931.63 $974.91 $1020.77 $1183.69 |
$203.64 |
ADVERTISEMENT
|
||||||||||
Matthew Thornton Hlth Plan(Anthem BCBS)Local: 1-855-748-1804 | Toll Free: 1-855-748-1804 |
||||||||||
Plan: (HMO) Anthem Bronze Pathway X Enhanced HMO 25 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$5,150
: Family:
$10,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$226.49 $257.07 $289.45 $404.51 $614.69 |
$452.98 $514.14 $578.90 $809.02 $1229.38 |
$596.80 $657.96 $722.72 $952.84 |
$740.62 $801.78 $866.54 $1096.66 |
$884.44 $945.60 $1010.36 $1240.48 |
$370.31 $400.89 $433.27 $548.33 |
$514.13 $544.71 $577.09 $692.15 |
$657.95 $688.53 $720.91 $835.97 |
$143.82 |
Plan: (HMO) Anthem Bronze Pathway X Enhanced HMO 0 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$6,050
: Family:
$12,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$220.11 $249.82 $281.30 $393.12 $597.38 |
$440.22 $499.64 $562.60 $786.24 $1194.76 |
$579.99 $639.41 $702.37 $926.01 |
$719.76 $779.18 $842.14 $1065.78 |
$859.53 $918.95 $981.91 $1205.55 |
$359.88 $389.59 $421.07 $532.89 |
$499.65 $529.36 $560.84 $672.66 |
$639.42 $669.13 $700.61 $812.43 |
$139.77 |
Plan: (HMO) Anthem Bronze Pathway X Enhanced HMO 5400 30Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$5,400
: Family:
$10,800 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 |
$220.58 $250.36 $281.90 $393.96 $598.65 |
$441.16 $500.72 $563.80 $787.92 $1197.30 |
$581.23 $640.79 $703.87 $927.99 |
$721.30 $780.86 $843.94 $1068.06 |
$861.37 $920.93 $984.01 $1208.13 |
$360.65 $390.43 $421.97 $534.03 |
$500.72 $530.50 $562.04 $674.10 |
$640.79 $670.57 $702.11 $814.17 |
$140.07 |
Plan: (HMO) Anthem Bronze Pathway X Enhanced HMO 5750 10Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$5,750
: Family:
$11,500 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 |
Bronze | 21 30 40 50 60 |
$222.87 $252.96 $284.83 $398.05 $604.87 |
$445.74 $505.92 $569.66 $796.10 $1209.74 |
$587.26 $647.44 $711.18 $937.62 |
$728.78 $788.96 $852.70 $1079.14 |
$870.30 $930.48 $994.22 $1220.66 |
$364.39 $394.48 $426.35 $539.57 |
$505.91 $536.00 $567.87 $681.09 |
$647.43 $677.52 $709.39 $822.61 |
$141.52 |
Plan: (HMO) Anthem Silver Pathway X Enhanced HMO 10 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$263.52 $299.10 $336.78 $470.65 $715.19 |
$527.04 $598.20 $673.56 $941.30 $1430.38 |
$694.38 $765.54 $840.90 $1108.64 |
$861.72 $932.88 $1008.24 $1275.98 |
$1029.06 $1100.22 $1175.58 $1443.32 |
$430.86 $466.44 $504.12 $637.99 |
$598.20 $633.78 $671.46 $805.33 |
$765.54 $801.12 $838.80 $972.67 |
$167.34 |
Plan: (HMO) Anthem Silver Pathway X Enhanced HMO 4000 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
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 |
$262.24 $297.64 $335.14 $468.36 $711.72 |
$524.48 $595.28 $670.28 $936.72 $1423.44 |
$691.00 $761.80 $836.80 $1103.24 |
$857.52 $928.32 $1003.32 $1269.76 |
$1024.04 $1094.84 $1169.84 $1436.28 |
$428.76 $464.16 $501.66 $634.88 |
$595.28 $630.68 $668.18 $801.40 |
$761.80 $797.20 $834.70 $967.92 |
$166.52 |
Plan: (HMO) Anthem Gold Pathway X Enhanced HMO 1000 10Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$1,000
: 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 |
$339.45 $385.28 $433.82 $606.26 $921.27 |
$678.90 $770.56 $867.64 $1212.52 $1842.54 |
$894.45 $986.11 $1083.19 $1428.07 |
$1110.00 $1201.66 $1298.74 $1643.62 |
$1325.55 $1417.21 $1514.29 $1859.17 |
$555.00 $600.83 $649.37 $821.81 |
$770.55 $816.38 $864.92 $1037.36 |
$986.10 $1031.93 $1080.47 $1252.91 |
$215.55 |
Plan: (HMO) Anthem Catastrophic Pathway X Enhanced HMO 7150 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$174.11 $197.61 $222.51 $310.96 $472.53 |
$348.22 $395.22 $445.02 $621.92 $945.06 |
$458.78 $505.78 $555.58 $732.48 |
$569.34 $616.34 $666.14 $843.04 |
$679.90 $726.90 $776.70 $953.60 |
$284.67 $308.17 $333.07 $421.52 |
$395.23 $418.73 $443.63 $532.08 |
$505.79 $529.29 $554.19 $642.64 |
$110.56 |
Plan: (HMO) Anthem Silver Pathway X Enhanced HMO 4200 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
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 |
Silver | 21 30 40 50 60 |
$263.04 $298.55 $336.17 $469.79 $713.89 |
$526.08 $597.10 $672.34 $939.58 $1427.78 |
$693.11 $764.13 $839.37 $1106.61 |
$860.14 $931.16 $1006.40 $1273.64 |
$1027.17 $1098.19 $1173.43 $1440.67 |
$430.07 $465.58 $503.20 $636.82 |
$597.10 $632.61 $670.23 $803.85 |
$764.13 $799.64 $837.26 $970.88 |
$167.03 |
Plan: (HMO) Anthem Bronze Pathway X Enhanced HMO 6350 40Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$213.96 $242.84 $273.44 $382.13 $580.69 |
$427.92 $485.68 $546.88 $764.26 $1161.38 |
$563.78 $621.54 $682.74 $900.12 |
$699.64 $757.40 $818.60 $1035.98 |
$835.50 $893.26 $954.46 $1171.84 |
$349.82 $378.70 $409.30 $517.99 |
$485.68 $514.56 $545.16 $653.85 |
$621.54 $650.42 $681.02 $789.71 |
$135.86 |
Plan: (HMO) Anthem Silver Pathway X Enhanced HMO 5300 25Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
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 |
Silver | 21 30 40 50 60 |
$246.74 $280.05 $315.33 $440.68 $669.65 |
$493.48 $560.10 $630.66 $881.36 $1339.30 |
$650.16 $716.78 $787.34 $1038.04 |
$806.84 $873.46 $944.02 $1194.72 |
$963.52 $1030.14 $1100.70 $1351.40 |
$403.42 $436.73 $472.01 $597.36 |
$560.10 $593.41 $628.69 $754.04 |
$716.78 $750.09 $785.37 $910.72 |
$156.68 |
Plan: (HMO) Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
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 |
$266.92 $302.95 $341.12 $476.72 $724.42 |
$533.84 $605.90 $682.24 $953.44 $1448.84 |
$703.33 $775.39 $851.73 $1122.93 |
$872.82 $944.88 $1021.22 $1292.42 |
$1042.31 $1114.37 $1190.71 $1461.91 |
$436.41 $472.44 $510.61 $646.21 |
$605.90 $641.93 $680.10 $815.70 |
$775.39 $811.42 $849.59 $985.19 |
$169.49 |
Plan: (HMO) Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1804 - Provider Directory for This Plan: (Matthew Thornton Hlth Plan(Anthem BCBS))
Deductible: Individual:
$1,000
: 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 |
$343.60 $389.99 $439.12 $613.67 $932.53 |
$687.20 $779.98 $878.24 $1227.34 $1865.06 |
$905.39 $998.17 $1096.43 $1445.53 |
$1123.58 $1216.36 $1314.62 $1663.72 |
$1341.77 $1434.55 $1532.81 $1881.91 |
$561.79 $608.18 $657.31 $831.86 |
$779.98 $826.37 $875.50 $1050.05 |
$998.17 $1044.56 $1093.69 $1268.24 |
$218.19 |