Individual & Family Plans

Health Plans for Individuals & Families

Gold 1500

Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs

Deductible
Individual $1,500
Family $3,000

Out-of-pocket max
Individual $5,000
Family $10,000

Preventive services
No deductible, covered in full

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Silver 3000

Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs

Deductible
Individual $3,000
Family $6,000

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

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Silver 4000

Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage After deductible, 30%

In-network Costs

Deductible
Individual $4,000
Family $8,000

Out-of-pocket max
Individual $7,900
Family $15,800

Preventive services
No deductible, covered in full

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Bronze 7000

Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage After deductible, 40%

In-network Costs

Deductible
Individual $7,000
Family $14,000

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

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Bronze HSA 6750

Office Visits

Primary care
After deductible, covered in full

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs

Deductible
Individual $6,750
Family $13,500

Out-of-pocket max
Individual $6,750
Family $13,500

Preventive services
No deductible, covered in full

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Standard Gold

Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $60

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $10

In-network Costs

Deductible
Individual $1,000
Family $2,000

Out-of-pocket max
Individual $7,300
Family $14,600

Preventive services
No deductible, covered in full

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Standard Silver

Office Visits

Primary care
No deductible, $40

Urgent care
No deductible, $70

Specialist
No deductible, $80

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs

Deductible
Individual $3,550
Family $7,100

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

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Standard Bronze

Office Visits

Primary care
No deductible, $45

Urgent care
After deductible, covered in full

Specialist
No deductible, $90

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs

Deductible
Individual $7,900
Family $15,800

Out-of-pocket max
Individual $7,900
Family $15,800

Preventive services
No deductible, covered in full

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Catastrophic+

Office Visits

Primary care
Telemedicine and office combined visits 1-3 no deductible, After deductible, covered in full. Visits 4+ After deductible, covered in full after deductible.

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs

Deductible
Individual $8,150
Family $16,300

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

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Dental Advantage 0-20-50 1000

Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

$1,000 per person, age 19 and older

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Dental Advantage 0-20-50 1500

Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

$1,500 per person, age 19 and older

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Kids Dental Advantage 0-20-50

Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

N/A

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‡‡‡Deductible and out-of-pocket maximum amounts shown above are the costs for individuals. Amounts for families are twice the individual amounts.

**This is a cost-sharing plan. Cost-sharing plans are only available to those who qualify financially and enroll through HealthCare.gov.

***The Affordable Care Act (ACA) has special provisions for members of federally recognized American Indian tribes that purchase healthcare coverage through the Marketplace, including zero-cost health services for those whose income is at or below 300 percent of the Federal Poverty Level. Please note that even with a zero cost-sharing plan, out-of-network providers can bill for the amount over the network rate.

+Only available for people under 30, or people of any age with a hardship exemption or affordability exemption.

Individual &
family plans

Health Plans for Individuals & Families

Office Visits

In-network Costs

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Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Members Pay

Annual Max. Benefit

Members Pay

Annual Max. Benefit

Members Pay

Annual Max. Benefit

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Individual &family plans

Health Plans for Individuals & Families

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Office Visits

In-network Costs

Plan Downloads (PDFs)

Members Pay

Annual Max. Benefit

Members Pay

Annual Max. Benefit

Members Pay

Annual Max. Benefit

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Individual &
family plans