# The Cheapest Plan
Bronze 60 PPO
The Most Popular Plan
Silver 1950 PPO
The Most Value Added Plan
Gold 80 PPO
The Most Expensive Plan
Platinum 90 PPO
Best for Young & Healthy Applicants who are age 30 and below Frequent doctor visits and taking prescription drugs Frequent doctor visits and taking prescription drugs Major illness, Pregnant, Newborn Children
Annual Deductible $6,300 Single
$12,600 Family
$1,950 Single
$3,900 Family
$0 Single
$0 Family
$0 Single
$0 Family
Annual Out of Pocket Maximum $7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$4,500 Single
$9,000 Family
Doctor Visit Copay
(Family\ Internal)
$65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Doctor Visit Copay
(Specialist)
$95 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $75 per visit $65 per visit $30 per visit
Urgent Care Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $40 per visit 35% after the annual deductible $30 per visit $15 per visit
Inpatient Fee 40% after the annual deductible 35% after the annual deductible 20% 10%
Outpatient Fee 40% after the annual deductible 35% after the annual deductible 20% 10%
Prescription Drug Fee $18/40% after the $500 drug deductible $15/$75 after $300 drug deductible $15/$80 $5/$25
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Acupuncture Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Emergency Room Visit Copay 40% after the annual deductible 35% after the annual deductible $350 per visit $150 per visit
Ambulance 40% after the annual deductible 35% after the annual deductible $250 per trip $150 per trip
Maternity Benefit
(Inpatient)
40% after the annual deductible 35% after the annual deductible 20% 10%
Maternity Benefit
(Maternity Benefit)
40% after the annual deductible 35% after the annual deductible 20% 10%
X Ray/Ultrasound 40% after the annual deductible 35% after the annual deductible $75 per visit $30 per visit
CT Scan/MRI Imaging 40% after the annual deductible 35% after the annual deductible 20% 10%
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF PDF
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〈Blue Shield〉
# The Cheapest Plan
Minimum Coverage EnhancedCare PPO
The Most Popular Plan
Bronze 60 EnhancedCare PPO
The Most Value Added Plan
Silver Value EnhancedCare PPO
The Most Expensive Plan
Platinum 90 EnhancedCare PPO
Best for Young & Healthy Applicants who are age 30 and below Limited Budget, favorable to hospital benefits Frequent doctor visits and taking prescription drugs Major illness, Pregnant, Newborn Children
Annual Deductible $8,150 Single
$16,300 Family
$6,300 Single
$12,600 Family
$5,000 Single
$10,000 Family
$0 Single
$0 Family
Annual Out of Pocket Maximum $8,150 Single
$16,300 Family
$7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$4,500 Single
$9,000 Family
Doctor Visit Copay
(Family\ Internal)
$0 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $15 per visit
Doctor Visit Copay
(Specialist)
$0 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $95 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $60 per visit $30 per visit
Urgent Care Visit Copay $0 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $15 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $0 after the annual deductible $40 per visit $35 per visit $15 per visit
Inpatient Fee 0% after the annual deductible 40% after the annual deductible 30% after the annual deductible 10%
Outpatient Fee 0% after the annual deductible 40% after the annual deductible 30% after the annual deductible 10%
Prescription Drug Fee 0% after the annual deductible 30% after the annual deductible $15(deductible waived)/$85 after $500 drug deductible $5/$25
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Acupuncture Visit Copay $0 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $15 per visit
Emergency Room Visit Copay 0% after the annual deductible 40% after the annual deductible $400 per visit after the annual deductible $150 per visit
Ambulance 0% after the annual deductible 40% after the annual deductible $250 per trip after the annual deductible $150 per trip
Maternity Benefit
(Inpatient)
0% after the annual deductible 40% after the annual deductible 30% after the annual deductible 10%
Maternity Benefit
(Maternity Benefit)
0% after the annual deductible 40% after the annual deductible 30% after the annual deductible 10%
X Ray/Ultrasound 0% after the annual deductible 40% after the annual deductible $70 per visit $30 per visit
CT Scan/MRI Imaging 0% after the annual deductible 40% after the annual deductible $300 after the annual deductible 10%
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF PDF
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〈Health Net〉
,
# The Cheapest Plan
Bronze 60 HMO
The Most Popular Plan
Silver 70 HMO 2500/45
The Most Value Added Plan
Gold 80 HMO
The Most Expensive Plan
Platinum 90 PPO
Best for Limited Budget, favorable to hospital benefits Frequent doctor visits and taking prescription drugs Frequent doctor visits and taking prescription drugs Major illness, Pregnant, Newborn Children
Annual Deductible $6,300 Single
$12,600 Family
$2,500 Single
$5,000 Family
$0 Single
$0 Family
$0 Single
$0 Family
Annual Out of Pocket Maximum $7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$4,500 Single
$9,000 Family
Doctor Visit Copay
(Family\ Internal)
$65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Doctor Visit Copay
(Specialist)
$95 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $75 per visit $65 per visit $30 per visit
Urgent Care Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $40 per visit $25 per visit after the annual deductible $40 per visit $15 per visit
Inpatient Fee 40% after the annual deductible 35% after the annual deductible $600 Copay per day up to 5 days $250 Copay per day up to 5 days
Outpatient Fee 40% after the annual deductible 35% after the annual deductible $340/surgery $125/surgery
Prescription Drug Fee $18/40% after $500 drug deductible $20(deductible waived)/$65 after $350 drug deductible $15/$55 $5/$25
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Acupuncture Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $45 per visit $30 per visit $15 per visit
Emergency Room Visit Copay 40% after the annual deductible $350 per visit after the annual deductible $350 per visit $150 per visit
Ambulance 40% after the annual deductible $250 per trip after the annual deductible $250 per trip $150 per trip
Maternity Benefit
(Inpatient)
40% after the annual deductible 35% after the annual deductible $600 Copay per day up to 5 days $250 Copay per day up to 5 days
Maternity Benefit
(Maternity Benefit)
40% after the annual deductible 35% after the annual deductible $340/surgery $125/surgery
X Ray/Ultrasound 40% after the annual deductible $70 per visit after the annual deductible $75 per visit $30 per visit
CT Scan/MRI Imaging 40% after the annual deductible $350 after the annual deductible $275 per visit $75 per visit
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF PDF
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〈Kaiser〉
# The Cheapest Plan
Bronze 60 EPO
The Most Popular Plan
Silver 70 EPO Off Exchange
The Most Value Added Plan
Gold 80 EPO
The Most Expensive Plan
Platinum 90 EPO
Best for Limited Budget, favorable to hospital benefits Frequent doctor visits and taking prescription drugs Frequent doctor visits and taking prescription drugs Major illness, Pregnant, Newborn Children
Annual Deductible $6,300 Single
$12,600 Family
$4,000 Single
$8,000 Family
$0 Single
$0 Family
$0 Single
$0 Family
Annual Out of Pocket Maximum $7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$4,500 Single
$9,000 Family
Doctor Visit Copay
(Family\ Internal)
$65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Doctor Visit Copay
(Specialist)
$95 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $80 per visit $65 per visit $30 per visit
Urgent Care Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $40 per visit $40 per visit $40 per visit $15 per visit
Inpatient Fee 40% after the annual deductible 20% after the annual deductible 20% 10%
Outpatient Fee 40% after the annual deductible 20% 20% 10%
Prescription Drug Fee $18/40% after $500 drug deductible $16/$90 after $300 drug deductible $15/$80 $5/$25
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Acupuncture Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Emergency Room Visit Copay 40% after the annual deductible $400 per visit $350 per visit $150 per visit
Ambulance 40% after the annual deductible $255 per trip $250 per trip $150 per trip
Maternity Benefit
(Inpatient)
40% after the annual deductible 20% after the annual deductible 20% 10%
Maternity Benefit
(Maternity Benefit)
40% after the annual deductible 20% 20% 10%
X Ray/Ultrasound 40% after the annual deductible $85 per visit $75 per visit $30 per visit
CT Scan/MRI Imaging 40% after the annual deductible $325 per visit $275 per visit 10%
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF PDF
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〈Oscar〉
# The Cheapest Plan
Bronze 60 HMO
The Most Popular Plan
Silver 70 Off-Exchange HMO
The Most Value Added Plan
Gold 80 HMO
The Most Expensive Plan
Platinum 90 HMO
Best for Limited Budget, favorable to hospital benefits Frequent doctor visits and taking prescription drugs Frequent doctor visits and taking prescription drugs Major illness, Pregnant, Newborn Children
Annual Deductible $6,300 Single
$12,600 Family
$4,000 Single
$8,000 Family
$0 Single
$0 Family
$0 Single
$0 Family
Annual Out of Pocket Maximum $7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$7,800 Single
$15,600 Family
$4,500 Single
$9,000 Family
Doctor Visit Copay
(Family\ Internal)
$65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Doctor Visit Copay
(Specialist)
$95 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $80 per visit $65 per visit $30 per visit
Urgent Care Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $40 per visit $40 per visit $40 per visit $15 per visit
Inpatient Fee 40% after the annual deductible 20% after the annual deductible $600 Copay per day up to 5 days $250 Copay per day up to 5 days
Outpatient Fee 40% after the annual deductible 20% after the annual deductible $300/surgery $100/surgery
Prescription Drug Fee $18/40% after $500 drug deductible $16/$90 after the $300 drug deductible $15/$80 $5/$25
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Acupuncture Visit Copay $65 per visit (1st 3 visits not subject to annual deductible,then subject to the deductible after that) $40 per visit $30 per visit $15 per visit
Emergency Room Visit Copay 40% after the annual deductible $400 per visit $350 per visit $150 per visit
Ambulance 40% after the annual deductible $255 per trip $250 per trip $150 per trip
Maternity Benefit
(Inpatient)
40% after the annual deductible 20% after the annual deductible $600 Copay per day up to 5 days $250 Copay per day up to 5 days
Maternity Benefit
(Maternity Benefit)
40% after the annual deductible 20% after the annual deductible $300/surgery $100/surgery
X Ray/Ultrasound 40% after the annual deductible $85 per visit $75 per visit $30 per visit
CT Scan/MRI Imaging 40% after the annual deductible $325 per visit $275 per visit $75 per visit
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF PDF
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〈Blue Cross〉
# Premium Assistance Plan
Silver 73 HMO
Premium Assistance Plan
Silver 87 HMO
Premium Assistance Plan
Silver 94 HMO
Best for Must qualify the income guidelines Must qualify the income guidelines Must qualify the income guidelines
Annual Deductible $3,700 Single
$7,400 Family
$1,400 Single
$2,800 Family
$75 Single
$150 Family
Annual Out of Pocket Maximum $6,500 Single
$13,000 Family
$2,700 Single
$5,400 Family
$1,000 Single
$2,000 Family
Doctor Visit Copay
(Family\ Internal)
$35 per visit $15 per visit $5 per visit
Doctor Visit Copay
(Specialist)
$75 per visit $25 per visit $8 per visit
Urgent Care Visit Copay $35 per visit $15 per visit $5 per visit
Preventive Care $0 (Once Per Year) $0 (Once Per Year) $0 (Once Per Year)
Laboratory fee Copay $40 per visit $20 per visit $8 per visit
Inpatient Fee 20% after the annual deductible 15% after the annual deductible 10% after the annual deductible
Outpatient Fee 20% 15% 10%
Prescription Drug Fee $16/$85 after $275 drug deductible $5(deductible waived)/$45 after $100 drug deductible $3/$15
Lifetime Maximum Unlimited Unlimited Unlimited
Acupuncture Visit Copay $35 per visit $15 per visit $5 per visit
Emergency Room Visit Copay $400 per visit $100 per visit $50 per visit
Ambulance $250 per trip $75 per trip $30 per trip
Maternity Benefit
(Inpatient)
20% after the annual deductible 15% after the annual deductible 10% after the annual deductible
Maternity Benefit
(Outpatient)
20% 15% 10%
X Ray/Ultrasound $85 per visit $40 per visit $8 per visit
CT Scan/MRI Imaging $325 per visit $100 per visit $50 per visit
Dental Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding dental Plan
Vision Insurance Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan Available free to applicants who are age 18 and below; Applicants who are age 19 and above may pay additional fee for adding vision Plan
Summary of Benefits(SBC) PDF PDF PDF
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〈Covered CA〉
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