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.
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.