Pediatric dental benefits are required by the ACA. Although our medical plans don’t include pediatric dental benefits, you may choose an HMSA dental plan to get covered.
| Plan | Deductible | Max out– of–pocket | Coinsurance | Doctor visit copayment | Specialist visit copayment |
Premiums based on age: |
|
|---|---|---|---|---|---|---|---|
| Platinum PPO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$0 | $7,150 | 10% | $20 | $20 | $333.08 / month $362.70 / month $374.01 / month $385.33 / month $397.53 / month $409.72 / month $422.35 / month $435.41 / month $435.41 / month $435.41 / month $435.41 / month $437.15 / month $445.86 / month $456.30 / month $473.29 / month $487.22 / month $494.19 / month $504.64 / month $515.09 / month $521.62 / month $528.59 / month $532.07 / month $535.55 / month $539.03 / month $542.52 / month $549.48 / month $556.45 / month $566.90 / month $576.91 / month $590.85 / month $608.27 / month $628.73 / month $653.12 / month $680.54 / month $711.89 / month $742.81 / month $777.64 / month $812.03 / month $849.92 / month $888.24 / month $929.60 / month $970.96 / month $1,015.81 / month $1,061.09 / month $1,109.42 / month $1,133.37 / month $1,181.69 / month $1,223.49 / month $1,250.93 / month $1,285.33 / month $1,306.22 / month |
| Platinum HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$0 | $7,150 | 10% | $10 | $20 | $336.96 / month $366.91 / month $378.36 / month $389.81 / month $402.15 / month $414.47 / month $427.25 / month $440.46 / month $440.46 / month $440.46 / month $440.46 / month $442.22 / month $451.03 / month $461.61 / month $478.78 / month $492.88 / month $499.92 / month $510.50 / month $521.07 / month $527.67 / month $534.72 / month $538.25 / month $541.77 / month $545.29 / month $548.82 / month $555.87 / month $562.91 / month $573.49 / month $583.62 / month $597.71 / month $615.33 / month $636.03 / month $660.70 / month $688.44 / month $720.16 / month $751.43 / month $786.67 / month $821.47 / month $859.78 / month $898.55 / month $940.39 / month $982.24 / month $1,027.61 / month $1,073.41 / month $1,122.30 / month $1,146.53 / month $1,195.42 / month $1,237.71 / month $1,265.46 / month $1,300.25 / month $1,321.38 / month |
| Gold PPO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$0 | $7,900 | 30% | $30 | $30 | $298.84 / month $325.40 / month $335.56 / month $345.72 / month $356.65 / month $367.59 / month $378.92 / month $390.64 / month $390.64 / month $390.64 / month $390.64 / month $392.20 / month $400.01 / month $409.39 / month $424.62 / month $437.13 / month $443.37 / month $452.75 / month $462.12 / month $467.98 / month $474.23 / month $477.36 / month $480.49 / month $483.61 / month $486.73 / month $492.98 / month $499.24 / month $508.61 / month $517.59 / month $530.10 / month $545.72 / month $564.08 / month $585.96 / month $610.56 / month $638.69 / month $666.43 / month $697.68 / month $728.54 / month $762.52 / month $796.90 / month $834.01 / month $871.12 / month $911.36 / month $951.99 / month $995.34 / month $1,016.83 / month $1,060.19 / month $1,097.69 / month $1,122.30 / month $1,153.16 / month $1,171.91 / month |
| Gold PPO 1000 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$1,000 | $7,900 | 20% 1 | $20 | $20 | $281.03 / month $306.01 / month $315.56 / month $325.11 / month $335.40 / month $345.69 / month $356.33 / month $367.36 / month $367.36 / month $367.36 / month $367.36 / month $368.83 / month $376.18 / month $384.99 / month $399.32 / month $411.08 / month $416.96 / month $425.76 / month $434.58 / month $440.10 / month $445.98 / month $448.92 / month $451.84 / month $454.78 / month $457.72 / month $463.60 / month $469.48 / month $478.30 / month $486.74 / month $498.50 / month $513.20 / month $530.46 / month $551.04 / month $574.18 / month $600.63 / month $626.71 / month $656.10 / month $685.12 / month $717.09 / month $749.41 / month $784.31 / month $819.20 / month $857.04 / month $895.25 / month $936.03 / month $956.23 / month $997.01 / month $1,032.27 / month $1,055.41 / month $1,084.44 / month $1,102.07 / month |
| Gold HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$1,000 | $7,900 | 20% 1 | $15 | $30 | $281.88 / month $306.93 / month $316.52 / month $326.09 / month $336.41 / month $346.73 / month $357.42 / month $368.47 / month $368.47 / month $368.47 / month $368.47 / month $369.94 / month $377.31 / month $386.16 / month $400.53 / month $412.32 / month $418.22 / month $427.06 / month $435.89 / month $441.43 / month $447.33 / month $450.27 / month $453.22 / month $456.17 / month $459.11 / month $465.00 / month $470.90 / month $479.75 / month $488.22 / month $500.01 / month $514.75 / month $532.07 / month $552.71 / month $575.92 / month $602.45 / month $628.61 / month $658.08 / month $687.19 / month $719.25 / month $751.68 / month $786.69 / month $821.69 / month $859.64 / month $897.96 / month $938.86 / month $959.13 / month $1,000.03 / month $1,035.40 / month $1,058.61 / month $1,087.72 / month $1,105.41 / month |
| Silver PPO 2500 Direct |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$2,500 | $7,900 | 30% 1 | $45 | $45 | $247.93 / month $269.97 / month $278.40 / month $286.82 / month $295.90 / month $304.98 / month $314.37 / month $324.10 / month $324.10 / month $324.10 / month $324.10 / month $325.40 / month $331.87 / month $339.65 / month $352.29 / month $362.66 / month $367.84 / month $375.63 / month $383.41 / month $388.26 / month $393.45 / month $396.05 / month $398.64 / month $401.23 / month $403.83 / month $409.01 / month $414.19 / month $421.97 / month $429.43 / month $439.80 / month $452.76 / month $467.99 / month $486.15 / month $506.56 / month $529.90 / month $552.91 / month $578.84 / month $604.44 / month $632.64 / month $661.15 / month $691.94 / month $722.74 / month $756.12 / month $789.82 / month $825.80 / month $843.62 / month $879.60 / month $910.71 / month $931.13 / month $956.73 / month $972.29 / month |
| Silver PPO 2500 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$2,500 | $7,900 | 30% 1 | $45 | $45 | $317.09 / month $345.28 / month $356.06 / month $366.83 / month $378.44 / month $390.05 / month $402.07 / month $414.50 / month $414.50 / month $414.50 / month $414.50 / month $416.16 / month $424.45 / month $434.40 / month $450.56 / month $463.83 / month $470.46 / month $480.41 / month $490.36 / month $496.58 / month $503.21 / month $506.52 / month $509.84 / month $513.15 / month $516.47 / month $523.10 / month $529.74 / month $539.68 / month $549.21 / month $562.48 / month $579.06 / month $598.54 / month $621.75 / month $647.86 / month $677.71 / month $707.14 / month $740.30 / month $773.05 / month $809.11 / month $845.58 / month $884.96 / month $924.34 / month $967.03 / month $1,010.15 / month $1,056.15 / month $1,078.95 / month $1,124.96 / month $1,164.75 / month $1,190.87 / month $1,223.61 / month $1,243.50 / month |
| Silver PPO 3500 |
Prescription drugs (30-day supply)
Additional benefitsUrgent Care visit: $55
Fitness membership |
$3,500 | $7,900 | 20% 1 | $35 | $35 | $312.84 / month $340.65 / month $351.28 / month $361.91 / month $373.37 / month $384.82 / month $396.68 / month $408.94 / month $408.94 / month $408.94 / month $408.94 / month $410.58 / month $418.75 / month $428.57 / month $444.52 / month $457.61 / month $464.15 / month $473.96 / month $483.77 / month $489.91 / month $496.46 / month $499.72 / month $502.99 / month $506.27 / month $509.54 / month $516.08 / month $522.63 / month $532.44 / month $541.84 / month $554.93 / month $571.29 / month $590.51 / month $613.41 / month $639.17 / month $668.62 / month $697.65 / month $730.36 / month $762.67 / month $798.26 / month $834.24 / month $873.09 / month $911.93 / month $954.06 / month $996.59 / month $1,041.98 / month $1,064.47 / month $1,109.87 / month $1,149.13 / month $1,174.89 / month $1,207.20 / month $1,226.82 / month |
| Silver HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$2,500 | $7,900 | 30% 1 | $40 | $60 | $319.46 / month $347.85 / month $358.71 / month $369.57 / month $381.26 / month $392.95 / month $405.07 / month $417.59 / month $417.59 / month $417.59 / month $417.59 / month $419.26 / month $427.61 / month $437.63 / month $453.92 / month $467.29 / month $473.96 / month $483.98 / month $494.01 / month $500.27 / month $506.95 / month $510.29 / month $513.64 / month $516.98 / month $520.32 / month $527.00 / month $533.68 / month $543.70 / month $553.31 / month $566.67 / month $583.38 / month $603.00 / month $626.39 / month $652.69 / month $682.76 / month $712.41 / month $745.82 / month $778.81 / month $815.14 / month $851.89 / month $891.55 / month $931.23 / month $974.24 / month $1,017.67 / month $1,064.02 / month $1,086.99 / month $1,133.35 / month $1,173.43 / month $1,199.74 / month $1,232.73 / month $1,252.77 / month |
| Bronze PPO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$7,900 | $7,900 | 0% 1 | $50 2 | $0 1 | $218.04 / month $237.41 / month $244.83 / month $252.24 / month $260.22 / month $268.20 / month $276.46 / month $285.02 / month $285.02 / month $285.02 / month $285.02 / month $286.16 / month $291.86 / month $298.70 / month $309.81 / month $318.93 / month $323.49 / month $330.33 / month $337.18 / month $341.45 / month $346.00 / month $348.29 / month $350.57 / month $352.85 / month $355.13 / month $359.69 / month $364.25 / month $371.09 / month $377.65 / month $386.76 / month $398.16 / month $411.56 / month $427.52 / month $445.48 / month $466.00 / month $486.24 / month $509.04 / month $531.56 / month $556.34 / month $581.43 / month $608.50 / month $635.59 / month $664.94 / month $694.58 / month $726.22 / month $741.90 / month $773.53 / month $800.89 / month $818.84 / month $841.36 / month $855.05 / month |
| Bronze PPO HSA |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$6,750 | $6,750 | 0% 1 | $0 1 | $0 1 | $217.51 / month $236.85 / month $244.24 / month $251.64 / month $259.59 / month $267.56 / month $275.80 / month $284.33 / month $284.33 / month $284.33 / month $284.33 / month $285.47 / month $291.15 / month $297.98 / month $309.07 / month $318.17 / month $322.72 / month $329.54 / month $336.36 / month $340.63 / month $345.18 / month $347.45 / month $349.73 / month $352.00 / month $354.28 / month $358.83 / month $363.37 / month $370.20 / month $376.73 / month $385.84 / month $397.21 / month $410.57 / month $426.50 / month $444.41 / month $464.88 / month $485.07 / month $507.81 / month $530.27 / month $555.01 / month $580.03 / month $607.04 / month $634.06 / month $663.34 / month $692.91 / month $724.48 / month $740.11 / month $771.67 / month $798.96 / month $816.88 / month $839.34 / month $852.99 / month |
| Bronze HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership |
$6,000 | $7,900 | 40% 1 | $40 2 | $60 1 | $216.11 / month $235.33 / month $242.67 / month $250.02 / month $257.92 / month $265.84 / month $274.03 / month $282.50 / month $282.50 / month $282.50 / month $282.50 / month $283.63 / month $289.29 / month $296.06 / month $307.08 / month $316.12 / month $320.64 / month $327.42 / month $334.20 / month $338.44 / month $342.96 / month $345.22 / month $347.47 / month $349.74 / month $351.99 / month $356.52 / month $361.04 / month $367.81 / month $374.32 / month $383.36 / month $394.66 / month $407.94 / month $423.76 / month $441.56 / month $461.90 / month $481.95 / month $504.55 / month $526.87 / month $551.45 / month $576.31 / month $603.14 / month $629.98 / month $659.08 / month $688.45 / month $719.82 / month $735.35 / month $766.71 / month $793.83 / month $811.62 / month $833.95 / month $847.50 / month |
| Catastrophic Plan |
This is single coverage for individuals under 30 years of age OR who have a hardship exemption from healthcare.gov. Prescription drugs (30-day supply)
Additional benefits |
$7,900 | $7,900 | 0% 1 | $50 2 | $0 1 | $117.09 / month $127.50 / month $131.48 / month $135.47 / month $139.75 / month $144.04 / month $148.48 / month $153.06 / month $153.06 / month $153.06 / month $153.06 / month $153.68 / month $156.74 / month $160.41 / month $166.38 / month $171.28 / month $173.73 / month $177.41 / month $181.07 / month $183.38 / month $185.82 / month $187.04 / month $188.27 / month $189.49 / month $190.72 / month $193.17 / month $195.62 / month $199.29 / month $202.81 / month $207.71 / month $213.84 / month $221.03 / month $229.60 / month $239.24 / month $250.26 / month $261.13 / month $273.38 / month $285.46 / month $298.78 / month $312.25 / month $326.80 / month $341.34 / month $357.10 / month $373.02 / month $390.01 / month $398.42 / month $415.42 / month $430.11 / month $439.76 / month $451.84 / month $459.18 / month |
Health benefits
These benefits are included in all HMSA individual plans and others are available when you enroll:
- HMSA’s Online Care.
- An annual preventive exam with no copayment.
- Generic drug coverage*.
- Adult vision coverage.
*All plans except the Bronze PPO HSA plan and the Catastrophic plan cover generic drugs before you meet the deductible.
Pediatric dental benefits are required by the ACA. Although our medical plans don’t include pediatric dental benefits, you may choose an HMSA dental plan to get covered.
| Plan | Deductible | Max out– of–pocket | Coinsurance | Doctor visit copayment | Specialist visit copayment |
Premiums based on age: |
|
|---|---|---|---|---|---|---|---|
| Platinum PPO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$0 | $7,150 | 10% - 20% 5 | $20 | $20 | $336.95 / month $366.91 / month $378.36 / month $389.81 / month $402.15 / month $414.47 / month $427.25 / month $440.46 / month $440.46 / month $440.46 / month $440.46 / month $442.22 / month $451.03 / month $461.60 / month $478.78 / month $492.88 / month $499.92 / month $510.50 / month $521.06 / month $527.67 / month $534.72 / month $538.25 / month $541.77 / month $545.29 / month $548.81 / month $555.86 / month $562.91 / month $573.48 / month $583.61 / month $597.71 / month $615.32 / month $636.02 / month $660.69 / month $688.44 / month $720.15 / month $751.42 / month $786.66 / month $821.46 / month $859.78 / month $898.54 / month $940.38 / month $982.23 / month $1,027.60 / month $1,073.40 / month $1,122.30 / month $1,146.52 / month $1,195.41 / month $1,237.70 / month $1,265.45 / month $1,300.24 / month $1,321.38 / month |
| Platinum HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$0 | $7,150 | 10% | $10 | $20 | $341.07 / month $371.39 / month $382.98 / month $394.57 / month $407.05 / month $419.54 / month $432.47 / month $445.84 / month $445.84 / month $445.84 / month $445.84 / month $447.63 / month $456.54 / month $467.25 / month $484.64 / month $498.90 / month $506.03 / month $516.73 / month $527.43 / month $534.12 / month $541.26 / month $544.82 / month $548.39 / month $551.95 / month $555.52 / month $562.66 / month $569.79 / month $580.48 / month $590.74 / month $605.01 / month $622.84 / month $643.80 / month $668.77 / month $696.85 / month $728.95 / month $760.61 / month $796.28 / month $831.50 / month $870.28 / month $909.52 / month $951.87 / month $994.23 / month $1,040.15 / month $1,086.52 / month $1,136.01 / month $1,160.53 / month $1,210.02 / month $1,252.82 / month $1,280.91 / month $1,316.13 / month $1,337.52 / month |
| Gold PPO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$0 | $7,350 | 30% | $30 | $30 | $303.18 / month $330.13 / month $340.43 / month $350.74 / month $361.83 / month $372.94 / month $384.43 / month $396.32 / month $396.32 / month $396.32 / month $396.32 / month $397.90 / month $405.83 / month $415.33 / month $430.80 / month $443.48 / month $449.82 / month $459.33 / month $468.84 / month $474.78 / month $481.13 / month $484.30 / month $487.47 / month $490.63 / month $493.81 / month $500.15 / month $506.49 / month $516.00 / month $525.12 / month $537.80 / month $553.65 / month $572.28 / month $594.48 / month $619.45 / month $647.98 / month $676.11 / month $707.82 / month $739.13 / month $773.61 / month $808.48 / month $846.13 / month $883.78 / month $924.60 / month $965.82 / month $1,009.81 / month $1,031.61 / month $1,075.60 / month $1,113.65 / month $1,138.61 / month $1,169.93 / month $1,188.96 / month |
| Gold PPO 1000 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$1,000 | $7,350 | 20% 1 | $20 | $20 | $284.53 / month $309.82 / month $319.50 / month $329.16 / month $339.58 / month $349.98 / month $360.78 / month $371.93 / month $371.93 / month $371.93 / month $371.93 / month $373.42 / month $380.86 / month $389.79 / month $404.29 / month $416.20 / month $422.15 / month $431.08 / month $439.99 / month $445.58 / month $451.52 / month $454.50 / month $457.48 / month $460.45 / month $463.43 / month $469.38 / month $475.33 / month $484.26 / month $492.81 / month $504.72 / month $519.59 / month $537.07 / month $557.90 / month $581.33 / month $608.11 / month $634.52 / month $664.28 / month $693.65 / month $726.01 / month $758.74 / month $794.08 / month $829.42 / month $867.72 / month $906.41 / month $947.69 / month $968.14 / month $1,009.42 / month $1,045.14 / month $1,068.57 / month $1,097.94 / month $1,115.79 / month |
| Gold HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$1,000 | $7,350 | 20% 1 | $15 | $30 | $287.91 / month $313.51 / month $323.29 / month $333.07 / month $343.61 / month $354.15 / month $365.06 / month $376.35 / month $376.35 / month $376.35 / month $376.35 / month $377.86 / month $385.38 / month $394.42 / month $409.10 / month $421.14 / month $427.16 / month $436.19 / month $445.23 / month $450.87 / month $456.90 / month $459.91 / month $462.92 / month $465.92 / month $468.93 / month $474.95 / month $480.98 / month $490.01 / month $498.67 / month $510.72 / month $525.76 / month $543.45 / month $564.53 / month $588.24 / month $615.33 / month $642.06 / month $672.16 / month $701.90 / month $734.64 / month $767.76 / month $803.52 / month $839.27 / month $878.03 / month $917.17 / month $958.94 / month $979.65 / month $1,021.42 / month $1,057.55 / month $1,081.26 / month $1,110.99 / month $1,129.05 / month |
| Silver PPO 2000 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$2,000 | $7,350 | 30% - 50% 1,5 | $45 | $45 | $320.85 / month $349.37 / month $360.27 / month $371.18 / month $382.92 / month $394.66 / month $406.82 / month $419.41 / month $419.41 / month $419.41 / month $419.41 / month $421.08 / month $429.48 / month $439.54 / month $455.89 / month $469.31 / month $476.03 / month $486.10 / month $496.16 / month $502.45 / month $509.16 / month $512.51 / month $515.87 / month $519.23 / month $522.58 / month $529.29 / month $536.00 / month $546.06 / month $555.72 / month $569.13 / month $585.91 / month $605.62 / month $629.11 / month $655.53 / month $685.73 / month $715.50 / month $749.06 / month $782.19 / month $818.68 / month $855.59 / month $895.43 / month $935.28 / month $978.48 / month $1,022.10 / month $1,068.65 / month $1,091.72 / month $1,138.27 / month $1,178.53 / month $1,204.96 / month $1,238.09 / month $1,258.23 / month |
| Silver PPO 2500 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$2,500 | $7,350 | 25% - 30% 1,5 | $35 | $35 | $249.64 / month $271.82 / month $280.31 / month $288.79 / month $297.92 / month $307.06 / month $316.53 / month $326.32 / month $326.32 / month $326.32 / month $326.32 / month $327.62 / month $334.15 / month $341.98 / month $354.71 / month $365.15 / month $370.37 / month $378.20 / month $386.04 / month $390.93 / month $396.15 / month $398.76 / month $401.37 / month $403.98 / month $406.59 / month $411.82 / month $417.03 / month $424.87 / month $432.38 / month $442.81 / month $455.86 / month $471.21 / month $489.48 / month $510.03 / month $533.53 / month $556.70 / month $582.81 / month $608.58 / month $636.97 / month $665.69 / month $696.69 / month $727.69 / month $761.30 / month $795.24 / month $831.46 / month $849.41 / month $885.63 / month $916.95 / month $937.51 / month $963.29 / month $978.96 / month |
| Silver PPO 3500 |
Prescription drugs (30-day supply)
Additional benefitsUrgent Care visit: $55
Fitness membership Plan resources
Summary of Benefits Coverage |
$3,500 6 | $7,350 | 20% 1 | $30 | $65 | $316.00 / month $344.09 / month $354.83 / month $365.57 / month $377.13 / month $388.70 / month $400.68 / month $413.07 / month $413.07 / month $413.07 / month $413.07 / month $414.72 / month $422.98 / month $432.89 / month $449.01 / month $462.22 / month $468.83 / month $478.75 / month $488.66 / month $494.86 / month $501.47 / month $504.77 / month $508.07 / month $511.38 / month $514.69 / month $521.29 / month $527.91 / month $537.82 / month $547.31 / month $560.53 / month $577.06 / month $596.47 / month $619.60 / month $645.62 / month $675.37 / month $704.70 / month $737.74 / month $770.37 / month $806.32 / month $842.67 / month $881.90 / month $921.14 / month $963.69 / month $1,006.65 / month $1,052.50 / month $1,075.22 / month $1,121.07 / month $1,160.73 / month $1,186.75 / month $1,219.39 / month $1,239.21 / month |
| Silver HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$2,500 | $7,350 | 30% 1 | $30 | $50 | $318.59 / month $346.91 / month $357.73 / month $368.57 / month $380.23 / month $391.89 / month $403.96 / month $416.46 / month $416.46 / month $416.46 / month $416.46 / month $418.12 / month $426.45 / month $436.45 / month $452.69 / month $466.01 / month $472.68 / month $482.67 / month $492.67 / month $498.92 / month $505.58 / month $508.91 / month $512.25 / month $515.57 / month $518.91 / month $525.56 / month $532.23 / month $542.23 / month $551.80 / month $565.13 / month $581.79 / month $601.36 / month $624.69 / month $650.92 / month $680.90 / month $710.48 / month $743.79 / month $776.69 / month $812.92 / month $849.57 / month $889.13 / month $928.70 / month $971.60 / month $1,014.91 / month $1,061.13 / month $1,084.04 / month $1,130.26 / month $1,170.24 / month $1,196.48 / month $1,229.38 / month $1,249.38 / month |
| Bronze PPO 7350 |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$7,350 | $7,350 | 0% 1 | $50 2 | $0 1 | $212.99 / month $231.92 / month $239.16 / month $246.40 / month $254.20 / month $261.99 / month $270.07 / month $278.42 / month $278.42 / month $278.42 / month $278.42 / month $279.53 / month $285.10 / month $291.79 / month $302.64 / month $311.55 / month $316.01 / month $322.68 / month $329.37 / month $333.55 / month $338.00 / month $340.23 / month $342.46 / month $344.68 / month $346.91 / month $351.37 / month $355.81 / month $362.50 / month $368.90 / month $377.81 / month $388.95 / month $402.04 / month $417.63 / month $435.17 / month $455.22 / month $474.98 / month $497.26 / month $519.25 / month $543.47 / month $567.97 / month $594.43 / month $620.88 / month $649.55 / month $678.51 / month $709.41 / month $724.73 / month $755.63 / month $782.36 / month $799.90 / month $821.89 / month $835.26 / month |
| Bronze HMO |
Prescription drugs (30-day supply)
Additional benefits
Fitness membership Plan resources
Summary of Benefits Coverage |
$6,000 | $7,350 | 40% 1 | $40 2 | $60 1 | $207.95 / month $226.43 / month $233.50 / month $240.56 / month $248.18 / month $255.78 / month $263.67 / month $271.82 / month $271.82 / month $271.82 / month $271.82 / month $272.91 / month $278.35 / month $284.87 / month $295.47 / month $304.17 / month $308.52 / month $315.05 / month $321.57 / month $325.64 / month $329.99 / month $332.17 / month $334.34 / month $336.52 / month $338.69 / month $343.04 / month $347.39 / month $353.92 / month $360.16 / month $368.86 / month $379.74 / month $392.51 / month $407.74 / month $424.86 / month $444.43 / month $463.73 / month $485.48 / month $506.95 / month $530.60 / month $554.52 / month $580.35 / month $606.17 / month $634.16 / month $662.44 / month $692.61 / month $707.56 / month $737.73 / month $763.83 / month $780.95 / month $802.42 / month $815.46 / month |
| Catastrophic Plan |
This is single coverage for individuals under 30 years of age OR who have a hardship exemption from healthcare.gov. Prescription drugs (30-day supply)
Additional benefitsPlan resources
Summary of Benefits Coverage |
$7,350 | $7,350 | 0% 1 | $50 2 | $0 1 | $147.44 / month $160.54 / month $165.56 / month $170.56 / month $175.97 / month $181.36 / month $186.95 / month $192.73 / month $192.73 / month $192.73 / month $192.73 / month $193.50 / month $197.36 / month $201.98 / month $209.49 / month $215.66 / month $218.75 / month $223.38 / month $228.00 / month $230.89 / month $233.98 / month $235.51 / month $237.05 / month $238.60 / month $240.14 / month $243.22 / month $246.31 / month $250.94 / month $255.37 / month $261.54 / month $269.24 / month $278.30 / month $289.10 / month $301.24 / month $315.12 / month $328.80 / month $344.21 / month $359.44 / month $376.21 / month $393.17 / month $411.48 / month $429.78 / month $449.64 / month $469.68 / month $491.07 / month $501.68 / month $523.07 / month $541.57 / month $553.71 / month $568.94 / month $578.19 / month |
Health benefits
These benefits are included in all HMSA individual plans and others are available when you enroll:
- HMSA’s Online Care.
- An annual preventive exam with no copayment.
- Generic drug coverage*.
- Adult vision coverage.
*Generic drugs are covered before you meet the deductible.