Back to main intersection

    You have indicated (Family) coverage.
There are many plan options. Our experience has shown these designs have the best value:

Apply Now!

250 deductible options 500 deductible options 1000 deductible options 2500 deductible options
Select-Value=800 Physicians
Select-Med=1,900 Physicians
Select-Care=2,800 Physicians 

Plan description for 80%
Plan description for 70%

  1. 80%

  2. 70%

  1. 80%
  2. 70%
  1. 80%
  2. 70%
  1. 80%
  2. 70%

    


 

80/20 - 250 Deductible                    

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $250 with 80/20 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
Age 32 Single
Female w/ Two Children

Select Med 
   Base-level
     -$381
   Mid-level
     - $427
   High-level
     - $477

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level 
Clarification>
Office & Rx copays apply AFTER the deductible is met.



 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 

 

High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.


 

AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
216
232
288
350
400
468
529
559
610
711

SelectMed
235
252
313
381
435
509
574
607
663
773

SelectCare
258
277
344
419
479
559
632
668
729
850

SelectValue
245
263
327
397
454
531
600
634
692
807

SelectMed
263
283
351
427
488
570
644
680
743
866

SelectCare
292
314
389
473
541
632
714
755
824
961

SelectValue
274
294
365
444
508
593
670
708
773
902

SelectMed
294
316
392
477
545
637
719
760
830
968

SelectCare
326
350
435
529
605
707
798
844
921
1074

 


 

70/30 - 250 Deductible

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $250 with 70/30 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
Age 32 Single
Female w/ Two Children

Select Med 
   Base-level
     -$364
   Mid-level
     - $403
   High-level
     - $451

 

 
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.


 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
206
222
275
335
383
447
505
534
583
680

SelectMed
224
241
299
364
416
486
549
580
633
739

SelectCare
247
265
329
400
457
535
604
638
697
813

SelectValue
232
249
309
376
430
502
567
599
654
763

SelectMed
249
267
332
403
461
539
609
643
702
819

SelectCare
276
296
368
447
512
598
675
714
779
909

SelectValue
259
278
345
420
480
561
634
670
731
853

SelectMed
278
299
371
451
515
602
680
719
785
915

SelectCare
308
331
411
500
572
668
755
798
871
1016

 


 

80/20 - 500 Deductible                  

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $500 with 80/20 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
 Age
29 Male w/ age 27 Spouse & one child

Select Med 
  Base-level
     - $277
  Mid-level
     - $323
  High-level
     - $362

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.



 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.

 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
191
205
255
310
354
414
468
494
540
629

SelectMed
208
223
277
337
385
450
508
537
587
684

SelectCare
228
245
305
370
424
495
559
591
645
753

SelectValue
222
239
296
360
412
482
544
575
628
732

SelectMed
242
260
323
393
449
525
593
627
684
798

SelectCare
264
284
352
428
489
572
646
683
745
869

SelectValue
248
267
332
403
461
539
608
643
702
819

SelectMed
271
291
362
440
503
587
663
701
766
893

SelectCare
295
317
394
479
547
640
723
764
834
972

 


 

70/30 - 500 Deductible                

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $500 with 70/30 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
 Age
29 Male w/ age 27 Spouse & one child

Select Med 
  Base-level
     - $268
  Mid-level
     - $306
  High-level
     - $342
 

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.


 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
185
199
247
300
343
401
453
478
522
609

SelectMed
201
216
268
326
373
435
492
520
568
662

SelectCare
221
237
295
358
410
479
541
572
624
728

SelectValue
210
226
280
341
390
455
514
544
593
692

SelectMed
229
246
306
372
425
497
561
593
647
755

SelectCare
249
268
333
405
463
541
611
646
705
822

SelectValue
235
252
314
381
436
509
575
608
664
774

SelectMed
256
275
342
416
475
555
627
663
724
844

SelectCare
279
300
372
453
518
605
683
722
789
920

 


 

80/20 - 1000 Deductible              

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $1000 with 80/20 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
Age 32
Male w/ age 29
Female & Three Children

    Select Med 
   Base-level
     -$304
   Mid-level
     - $n/a
   High-level
     - $404

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.



 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.

 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
173
186
230
280
320
374
423
447
488
569

SelectMed
188
202
251
304
348
407
460
486
530
618

SelectCare
206
222
276
335
383
448
506
534
583
680

Not
Available

SelectValue
233
250
311
378
432
505
571
603
659
768

SelectMed
249
268
332
404
462
540
610
645
704
821

SelectCare
274
295
366
445
508
594
671
709
774
903

 


 

70/30 - 1000 Deductible             

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $1000 with 70/30 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
Age 32
Male w/ age 29
Female & Three Children

    Select Med 
   Base-level
     -$296
   Mid-level
     - $n/a
   High-level
     - $382

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.


 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
168
180
224
272
311
364
411
434
474
553

SelectMed
182
196
243
296
338
395
447
472
515
601

SelectCare
201
216
268
326
372
435
491
519
567
661

Not
Available

SelectValue
220
237
294
358
409
478
540
570
523
726

SelectMed
236
253
314
382
437
511
577
610
666
776

SelectCare
259
278
346
420
481
562
634
671
732
854

 


 

80/20 - 2500 Deductible       

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $2500 with 80/20 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
 Age
29 Male w/ age 28 Female & Three Children.

Select Med 
  Base-level
     - $221
  Mid-level
     - $n/a
  High-level
     - $n/a
 

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.


 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
152
164
203
247
282
330
373
394
430
501

SelectMed
165
178
221
268
307
359
405
428
467
545

SelectCare
182
196
243
295
337
394
446
471
514
600

Not
Available
Not
Available

 


 

70/30 - 2500 Deductible       

Office Copays-> $15 for Level 1 Doctors
$25 for Level 2 Doctors
Hospital Deductible $2500 with 70/30 coverage
Rx Copays $10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx

Rate Example
 Age
29 Male w/ age 28 Female & Three Children.

Select Med 
  Base-level
     - $216
  Mid-level
     - $n/a
  High-level
     - $n/a
 

 

   
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price.
Base-Level
Clarification>
Office & Rx copays apply AFTER the deductible is met.


 
Mid-Level
Clarification>
Office copays apply
immediately. Rx copays
apply after deductible
is met.
 
High-Level
Clarification>
Office & Rx copays apply
immediately. Deductible
applies to hospital billed
charges.
 
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 ->

SelectValue
149
160
199
242
277
323
365
386
422
492

SelectMed
162
174
216
263
301
352
397
420
458
534

SelectCare
178
192
238
289
331
387
437
462
504
588

Not
Available
Not
Available

 


 

Disclaimer   

A. These are only estimated monthly premiums and are subject to change based on underwriting review

B. Premium rates are based on the age of the oldest family member. The enrollment application must be written with the oldest family member as the applicant.

C. Premiums under these plans are subject to adjustment each January 1, if your original effective date is January 1 through June 30, or each July 1, if your original effective date is July 1 through December 31.

D. Premiums will increase on the first of the month following the birthday on which the subscriber (policyholder) moves from one age category to another.

E.  Approval of your application is subject to IHC Health Plans underwriting requirements and is not guaranteed.