Individual & Family Plans

New special enrollment period

As of February 15 and continuing through May 15, 2021, you may be eligible to enroll for new healthcare coverage. If you live in Idaho, the state’s enrollment period begins March 1 and ends April 30. For questions about the timing and eligibility differences across Idaho, Montana, Oregon, and Washington, please contact us.

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 $5,500
Family $11,000

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 $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Bronze HSA 6900

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 $6,900
Family $13,800

Out-of-pocket max
Individual $6,900
Family $13,800

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 $1,500
Family $3,000

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 $3,650
Family $7,300

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Standard Bronze

Office Visits

Primary care
No deductible, $50

Urgent care
No deductible, $100

Specialist
No deductible, $100

Tier 1 prescription
Drug coverage No deductible, $20

In-network Costs

Deductible
Individual $8,550
Family $17,100

Out-of-pocket max
Individual $8,550
Family $17,100

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 $8,550
Family $17,100

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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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

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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)

Learn more about our plans and networks

Individual &
family plans