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The amounts shown are what the member pays
Scroll down to view the rates

Plan Type – All HMO Ambetter Essential Care 1 Ambetter Essential Care 2 HSA BlueCross Pathway X Guided 37TC BlueCross Pathway X Guided HSA 37TO Kaiser HSA  6,200/40%
Plan Name Ambetter Essential Care 1 Ambetter Essential Care 2 HSA BlueCross 37TC BlueCross HSA 37TO Kaiser 6,200/40%
Metal Level Bronze Bronze HSA Bronze Bronze HSA Bronze HSA
Preventive Care
government list
100% Coverage – Member pays Nothing; List of Covered Services
Deductible
Individual / Family
$7,900 / $15,800 $6550/$13100 $6,750 / $13,500 $6,700 / $13,400 $6,200 / $12,40000
Coinsurance Deductibe then 0% Deductibe then 0% Deductibe then 40% Deductible then 0% Deductible then 40%
Maximum Out of Pocket
Individual / Family
$7,900 / $15,800 $6,550 / $13,100 $7,900 / $15,800 $6,700 / $13,400 $6,550 / $13,100
Dr Office Copay               PCP/Specialist/UrgentCare Deductible then 0% Deductible then 0% Deductible then 40% Deductible then 0% Deductible then 40%
All Lab / X-rays & Imaging Deductible then 0% Deductible then 0% Deductible then $500 / 40% Deductible then 0% Deductible then 40%
Emergency Room Deductible then 0% Deductible then 0% Deductible then $500 / 40% Deductible then 0% Deductible then 40%
Inpatient / Outpatient
Hospital & Surgery
Deductible then 0% Deductible then 0% Deductible then $500 / 40% Deductible then 0% Deductible then 40%
Rx Deductible Tier 1 No Ded; Tier 2,3, 4 Med Ded Medical Deductible Medical Deductible Medical Deductible Medical Deductible
Rx Copays $20 / Med Deductible then 0% Medical Deductible then 0% Med Deductible then 25%/35%/45%/45% Medical Deductible then 0% Medical Deductible then 50%
Benefits shown are for services at In-Network Providers. There is No Coverage for Out of Network Providers, except for Emergencies
Rates shown for Ambetter & BlueCross residents of counties:  Cherokee, Cobb, Dekalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, & Henry
Rates shown for Kaiser residents of counties: Clayton, Cobb, DeKalb, Fulton, Gwinnett and Henry – Other Kaiser counties are 10% higher
For rates in other counties please use the “Online Quotes” link on the 2019 Recommended Plans page
Rates shown are for non-tobacco users, within + / – $5; regular tobacco user rates will be approx. 15% higher. Regular use = 4 or more times per week on average in the last 6 week on average in the last 6 months.
Please see plan brochure for a complete listing of benefit details, plan limitations and exclusions.

Add the rate for the age of each family member to be insured. There is no family discount.

Ambetter Essential Care 1 Ambetter Essential Care 2 HSA BlueCross 37TC BlueCross HSA 37TO Kaiser HSA  6,200/40%
Per Child Age 0-14 $237 $245 $188 $194 $252
Age 15 $259 $268 $206 $212 $275
Age 16 $267 $276 $212 $218 $284
Age 17 $275 $284 $218 $225 $292
Age 18 $283 $293 $225 $232 $301
Age 19 $292 $302 $232 $239 $310
Age 20 $301 $311 $239 $246 $320
Age 21-24 $310 $321 $246 $254 $330
Age 25 $311 $322 $247 $254 $330
Age 26 $317 $328 $252 $260 $337
Age 27 $325 $337 $259 $266 $346
Age 28 $337 $349 $268 $276 $358
Age 29 $347 $359 $276 $284 $369
Age 30 $353 $365 $280 $289 $375
Age 31 $359 $372 $286 $294 $382
Age 32 $367 $379 $292 $300 $390
Age 33 $371 $384 $295 $304 $395
Ambetter Essential Care 1 Ambetter Essential Care 2 HSA BlueCross 37TC BlueCross HSA 37TO Kaiser HSA  6,200/40%
Age 34 $377 $390 $299 $308 $400
Age 35 $379 $393 $302 $310 $403
Age 36 $381 $394 $303 $312 $405
Age 37 $384 $397 $305 $314 $408
Age 38 $387 $400 $307 $316 $411
Age 39 $391 $405 $311 $320 $416
Age 40 $396 $410 $315 $324 $421
Age 41 $404 $418 $321 $330 $429
Age 42 $411 $425 $327 $336 $437
Age 43 $421 $435 $335 $344 $447
Age 44 $433 $448 $345 $355 $461
Age 45 $448 $463 $356 $366 $476
Age 46 $465 $481 $370 $380 $494
Age 47 $485 $502 $385 $397 $515
Age 48 $507 $525 $403 $415 $539
Age 49 $529 $547 $420 $433 $562
Age 50 $554 $573 $441 $453 $589
Age 51 $578 $599 $460 $473 $615
Age 52 $605 $627 $481 $495 $644
Age 53 $632 $655 $503 $518 $672
Ambetter Essential Care 1 Ambetter Essential Care 2 HSA BlueCross 37TC BlueCross HSA 37TO Kaiser HSA  6,200/40%
Age 54 $662 $685 $527 $542 $704
Age 55 $691 $715 $549 $566 $735
Age 56 $723 $749 $575 $592 $769
Age 57 $756 $782 $601 $619 $804
Age 58 $790 $818 $628 $647 $840
Age 59 $807 $835 $642 $661 $858
Age 60 $841 $871 $669 $689 $895
Age 61 $871 $902 $693 $713 $926
Age 62 $891 $922 $708 $729 $947
Age 63 $915 $947 $728 $749 $973
Age 64 $930 $962 $739 $761 $989
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