Home Individuals & Families Plans

We can help you choose the right plan

Determining which health insurance plan is best for you is as simple as understanding the amount of flexibility you want, whether you want to pay more up front for coverage, if you qualify for financial assistance, if your provider is in our network, the costs of your prescription drugs, and whether you have a chronic illness.

Breaking down the costs

Premium

The amount that must be paid for your health insurance plan. You and/or your employer usually pay it monthly, quarterly, or yearly.

Deductible

The amount you owe for health care services your health insurance plan covers before your plan begins to pay.

Out-of-Pocket Max

The maximum amount that you have to pay each year before the plan pays for all covered services.

HMO vs. PPO

We offer both HMO and PPO plans. Both plans require you to select a Primary Care Provider from our network. HMO plans generally come with lower premiums but are more restrictive. PPO plans offer you greater flexibility but the premiums are higher.

HMO

HEALTH MAINTENANCE ORGANIZATION

  • Less coverage choice
  • Lower premium
  • PCP coordinates in-network care
  • No out-of-network coverage

PPO

PREFERRED PROVIDER ORGANIZATION

  • More coverage choice
  • Higher premium
  • You coordinate care, no referrals needed
  • Out-of-network coverage at additional cost

Understanding the metal levels

All of our plans cover the same set of essential health benefits. The metal levels are based on how you and the plan will share the costs for health care services.

There are different metal levels

Catastrophic
For people under 30 or with certain exemptions.
Bronze
Bronze level of coverage pays 60% of health care costs.
Silver
Silver level of coverage pays 70% of health care costs.
Gold
Gold level of coverage pays 80% of health care costs.

Find out if you qualify for financial assistance

If your household falls within the income ranges shown in this chart, you may be eligible for Advance Premium Tax Credits, and other cost sharing reductions to lower your out-of-pocket costs for healthcare services. Financial assistance is determined by the Federal Government through Healthcare.gov, not by Community Health Options.

You may qualify for financial assistance for 2018 when:

You may qualify for financial assistance for 2019 when:

In or out-of-network?

Understanding whether your doctor is in-network is important as it will impact the cost of your visit. Our tool helps you look up a provider to see whether they’re covered by your plan.

Prescription medications

Find out if your medication is covered and to what extent. We'll also show you alternatives and whether there are requirements or limits on coverage.

There are five tiers of medications going from Tier 1 (least expensive) to Tier 5 (most expensive)

Chronic Illness Support Program (CISP)

Our CISP Program reduces financial barriers (copays, deductibles, coinsurance) for select services for Members with certain chronic conditions. You will pay less for out-of-pocket medical and pharmacy services for these conditions.

Receive reduced out-of-pocket medical and pharmacy services for select chronic conditions:

  • Diabetes
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Hypertension
  • Coronary Artery Disease

Get free local help choosing a plan

Do you still need help choosing a plan? People and groups in the community can help you with the application process and with selecting and enrolling in a plan.

Assisters

  • Trained and certified individuals
  • Help you apply for and enroll in a health plan or apply for Medicaid/Children’s Health Insurance Program (CHIP)
  • Required to provide fair, impartial, and accurate information
Find an assister

Brokers

  • Trained and registered by the Marketplace;
    licensed in their states
  • Provide services at no cost to you
  • Required to act in a consumer's best interest
  • Can refer customers for Medicaid/CHIP help

Get an instant healthcare quote

Our online comparison tool will help you choose health insurance coverage, determine if you are eligible for an Advanced Tax Credits, and find a plan that is best for you and your family. To choose and enroll, click the button below.