SoloCare
Summary of Benefits and Coverage Plans
SoloCare
Summary of Benefits & Coverage
Select Plan Year:
Formulary List & Lookup
Formulary List:
Look-Up Tool:
SoloCare Rate Tables
2024
2025
2024 Georgia SoloCare
Summary of Benefits and Coverage Plans
Individual/Family
SoloCare Plans are available to residents of Atkinson, Baker, Baldwin, Banks, Barrow, Ben Hill, Berrien, Bibb, Bleckley, Brooks, Burke, Calhoun, Carroll, Catoosa, Chattooga, Clarke, Clay, Clinch, Coffee, Colquitt, Columbia, Cook, Crawford, Crisp, Dade, Dawson, Decatur, Dodge, Dooly, Dougherty, Early, Echols, Elbert, Emanuel, Fannin, Floyd, Franklin, Gilmer, Glascock, Gordon, Grady, Greene, Habersham, Hall, Hancock, Haralson, Hart, Heard, Houston, Irwin, Jackson, Jeff Davis, Jefferson, Jenkins, Jones, Lamar, Lanier, Lee, Lincoln, Lowndes, Lumpkin, Madison, McDuffie, Miller, Mitchell, Monroe, Morgan, Murray, Oconee, Oglethorpe, Peach, Pickens, Pike, Polk, Pulaski, Putnam, Rabun, Randolph, Richmond, Schley, Seminole, Stephens, Sumter, Taliaferro, Telfair, Terrell, Thomas, Tift, Towns, Turner, Twiggs, Union, Walker, Walton, Warren, Washington, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, and Worth counties.
ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans
Please note that 02 – 06 Levels are cost-sharing subsidy.
Alliant Health Plans Network
All SoloCare Plans listed below are ICHRA eligible
2024 Solocare Health Plans
| Plan Name | Plan Number | Plan Type | Metal Type | Off Marketplace | On Marketplace |
|---|---|---|---|---|---|
| SoloCare Gold PPO 2300 - 3 Free PCP Visits, $5 Generic Rx 40002 | 40002 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver PPO 7000 - 3 Free PCP Visits, $5 Generic Rx 40017 | 40017 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Gold PPO 1500 - 3 Free PCP Visits 40330 | 40330 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver PPO 6000/60 - 3 Free PCP Visits 40331 | 40331 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Gold PPO Chiro 2300 - 3 Free PCP Visits, $5 Generic Rx 40355 | 40355 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Gold PPO Chiro 1500 - 3 Free PCP Visits 40358 | 40358 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare SoloCare Silver PPO Chiro 7000 - 3 Free PCP Visits, $5 Generic Rx 40369 | 40369 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver PPO Chiro 6000/60 - 3 Free PCP Visits 40373 | 40373 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare PPO Standard Platinum 40377 | 40377 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare PPO Standard Gold 40378 | 40378 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare PPO Standard Silver 40379 | 40379 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Platinum PPO - $0 PCP, $0 Generic Rx 40380 | 40380 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Exp Bronze PPO 9450 - $0 Generic Rx 40381 | 40381 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Bronze PPO HDHP 7050 40382 | 40382 | PPO HDHP | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Catastrophic PPO 40383 | 40383 | PPO | Catastrophic | 00 | 01 |
| SoloCare Exp Bronze PPO Chiro 9450 - $0 Generic Rx 40385 | 40385 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Bronze PPO HDHP Chiro 7050 40386 | 40386 | PPO HDHP | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Gold PPO HDHP Chiro 1600 40387 | 40387 | PPO HDHP | Gold | 00 | 01 | 02 | 03 |
| SoloCare Gold PPO HDHP Chiro 3000 40388 | 40388 | PPO HDHP | Gold | 00 | 01 | 02 | 03 |
| SoloCare Catastrophic PPO Chiro 40392 | 40392 | PPO | Silver | 00 | 01 |
| SoloCare PPO Standard Expanded Bronze 40393 | 40393 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare PPO Standard Platinum Chiro 40394 | 40394 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare PPO Standard Gold Chiro 40395 | 40395 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare PPO Standard Silver Chiro 40396 | 40396 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare PPO Standard Expanded Bronze Chiro 40397 | 40397 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Platinum PPO Chiro - $0 PCP, $0 Generic Rx 40398 | 40398 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO 2300 - 3 Free PCP Visits, $5 Generic Rx 11003 | 110003 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO 1500 - 3 Free PCP Visits 110004 | 110004 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver HMO 7000 - 3 Free PCP Visits, $5 Generic Rx 110008 | 110008 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver No Referral HMO 6000/60 - 3 Free PCP Visits 110009 | 110009 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Bronze No Referral HMO HDHP 110019 | 110019 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Catastrophic HMO 110023 | 110023 | HMO | Catastrophic | 00 | 01 |
| SoloCare No Referral HMO Standard Gold 110024 | 110024 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare No Referral HMO Standard Silver110025 | 110025 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare No Referral HMO Standard Expanded Bronze 110027 | 110027 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Platinum HMO - $0 PCP, $0 Generic Rx 110028 | 110028 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Exp Bronze HMO 9450 - $0 Generic Rx 110030 | 110030 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Platinum HMO Chiro - $0 PCP, $0 Generic Rx 110034 | 110034 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO Chiro 2300 - 3 Free PCP Visits, $5 Generic Rx 110035 | 110035 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO Chiro 1500 - 3 Free PCP Visits 110036 | 110036 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare SoloCare Silver HMO Chiro 7000 - 3 Free PCP Visits, $5 Generic Rx 110038 | 110038 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver HMO Chiro 6000 - 3 Free PCP Visits 110039 | 110039 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Exp Bronze No Referral HMO Chiro 9450 - $0 Generic Rx 110040 | 110040 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Bronze No Referral HMO Chiro HDHP 7050 110042 | 110042 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Catastrophic PPO Chiro 110046 | 110046 | PPO | Catastrophic | 00 | 01 |
| SoloCare No Referral HMO Standard Platinum 110047 | 110047 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare No Referral HMO Standard Platinum Chiro 110048 | 110048 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare No Referral HMO Standard Gold Chiro 110049 | 110049 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare No Referral HMO Standard Silver Chiro 110050 | 110050 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare No Referral HMO Standard Expanded Bronze Chiro 110051 | 110051 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Silver PPO 6000/70 - 3 Free PCP Visits 40007 | 40007 | PPO | Silver | 00 | |
| SoloCare Silver PPO Chiro 6000/70 - 3 Free PCP Visits 40384 | 40384 | PPO | Silver | 00 | |
| SoloCare Gold PPO HDHP 1600 40324 | 40324 | PPO HDHP | Gold | 00 | |
| SoloCare Gold PPO HDHP 3000 HDHP 40344 | 40344 | PPO HDHP | Gold | 00 | |
| SoloCare Silver PPO HDHP 6000 40345 | 40345 | PPO | Silver | 00 | |
| SoloCare Silver PPO HDHP Chiro 6000 40391 | 40391 | PPO HDHP | Silver | 00 | |
| SoloCare Silver No Referral HMO 6000/70 - 3 Free PCP Visits 110029 | 110029 | HMO | Silver | 00 | |
| SoloCare Gold HMO HDHP 1600 110031 | 110031 | HMO HDHP | Gold | 00 | |
| SoloCare Gold HMO HDHP Chiro 1600 110043 | 110043 | HMO HDHP | Gold | 00 | |
| SoloCare Gold HMO HDHP 3000 HDHP 110032 | 110032 | HMO HDHP | Gold | 00 | |
| SoloCare Gold HMO HDHP Chiro 3000 110044 | 110044 | HMO HDHP | Gold | 00 | |
| SoloCare Silver HMO HDHP 6000 110033 | 110033 | HMO HDHP | Silver | 00 | |
| SoloCare Silver HMO HDHP Chiro 6000 110045 | 110045 | HMO HDHP | Silver | 00 | |
| SoloCare Silver No Referral HMO Chiro 6000/70 - 3 Free PCP Visits | 110037 | HMO | Silver | 00 |
2025 Tennessee SoloCare
Summary of Benefits and Coverage Plans
Individual/Family
SoloCare Plans are now available to Southeast Tennessee residents of Bledsoe, Bradley, Franklin, Grundy, Hamilton, Marion, McMinn, Meigs, Polk, Rhea and Sequatchie counties.
ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans
Please note that 02 – 06 Levels are cost-sharing subsidy.
Alliant Health Plans Network
All SoloCare Plans listed below are ICHRA eligible
2025 SoloCare Health Plans (TN)
| Plan Name | Plan Number | Plan Type | Metal Type | Off Marketplace | On Marketplace |
|---|---|---|---|---|---|
| SoloCare Gold EPO HDHP 1600 10001 | 10001 | EPO | Gold | 00 | |
| SoloCare Gold EPO HDHP 3000 10002 | 10002 | EPO | Gold | 00 | |
| SoloCare Silver EPO HDHP 3500 10003 | 10003 | EPO | Silver | 00 | |
| SoloCare Bronze EPO HDHP 8050 10004 | 10004 | EPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Standard Platinum EPO 10005 | 10005 | EPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Standard Gold EPO 10006 | 10006 | EPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Standard Silver EPO 10007 | 10007 | EPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Standard Exp Bronze EPO 10008 | 10008 | EPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 | 10010 | EPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver EPO 6000/70 - 3 Free PCP Visits 10012 | 10012 | EPO | Silver | 00 | |
| SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 | 10013 | EPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 | 10014 | EPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Exp Bronze EPO 7200 10015 | 10015 | EPO | Bronze | 00 | 01 | 02 | 03 |
2025 Georgia SoloCare
Summary of Benefits and Coverage Plans
Individual/Family
SoloCare Plans are available to Georgia residents of Atkinson, Baker, Baldwin, Banks, Barrow, Ben Hill, Berrien, Bibb, Bleckley, Brooks, Burke, Calhoun, Carroll, Catoosa, Chattooga, Clarke, Clay, Clinch, Coffee, Colquitt, Columbia, Cook, Crawford, Crisp, Dade, Dawson, Decatur, Dodge, Dooly, Dougherty, Early, Echols, Elbert, Emanuel, Fannin, Floyd, Franklin, Gilmer, Glascock, Gordon, Grady, Greene, Habersham, Hall, Hancock, Haralson, Hart, Heard, Houston, Irwin, Jackson, Jeff Davis, Jefferson, Jenkins, Jones, Lamar, Lanier, Lee, Lincoln, Lowndes, Lumpkin, Madison, McDuffie, Miller, Mitchell, Monroe, Morgan, Murray, Oconee, Oglethorpe, Peach, Pickens, Pike, Polk, Pulaski, Putnam, Rabun, Randolph, Richmond, Schley, Seminole, Stephens, Sumter, Taliaferro, Telfair, Terrell, Thomas, Tift, Towns, Turner, Twiggs, Union, Walker, Walton, Warren, Washington, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, and Worth counties.
ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans
Please note that 02 – 06 Levels are cost-sharing subsidy.
Alliant Health Plans Network
All SoloCare Plans listed below are ICHRA eligible
2025 SoloCare Health Plans (GA)
| Plan Name | Plan Number | Plan Type | Metal Type | Off Marketplace | On Marketplace |
|---|---|---|---|---|---|
| SoloCare Gold PPO HDHP Chiro 1600 40324 | 40324 | PPO HDHP | Gold | 00 | |
| SoloCare Gold PPO HDHP Chiro 3000 40344 | 40344 | PPO HDHP | Gold | 00 | |
| SoloCare Silver PPO HDHP Chiro 3500 40345 | 40345 | PPO HDHP | Silver | 00 | |
| SoloCare Bronze PPO Chiro HDHP 8050 40382 | 40382 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Standard Platinum PPO Chiro 40377 | 40377 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Standard Gold PPO Chiro 40378 | 40378 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Standard Silver PPO Chiro 40379 | 40379 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Standard Exp Bronze PPO Chiro 40393 | 40393 | PPO | Bronze | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Platinum PPO Chiro - $0 PCP, $0 Rx 40380 | 40380 | PPO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Gold PPO Chiro 2300 - 3 Free PCP Visits, $5 Generic Rx 40002 | 40002 | PPO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver PPO Chiro 6000/70 - 3 Free PCP Visits 40007 | 40007 | PPO | Silver | 00 | |
| SoloCare Silver PPO Chiro 7000 - 3 Free PCP Visits, $5 Generic Rx 40017 | 40017 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver PPO Chiro 6000/60 - 3 Free PCP Visits 40331 | 40331 | PPO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Exp Bronze PPO Chiro 7200 40381 | 40381 | PPO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO HDHP 1600 110031 | 110031 | HMO HDHP | Gold | 00 | |
| SoloCare Gold HMO HDHP 3000 110032 | 110032 | HMO HDHP | Gold | 00 | |
| SoloCare Silver HMO HDHP 3500 110033 | 110033 | HMO HDHP | Silver | 00 | |
| SoloCare Bronze HMO HDHP 8050 110019 | 110019 | HMO HDHP | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Standard Platinum HMO 110047 | 110047 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Standard Gold HMO 110024 | 110024 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Standard Silver HMO 110025 | 110025 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Standard Exp Bronze HMO 110027 | 110027 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Platinum HMO - $0 PCP, $0 Rx 110028 | 110028 | HMO | Platinum | 00 | 01 | 02 | 03 |
| SoloCare Gold HMO 2300 - 3 Free PCP Visits, $5 Generic Rx 110003 | 110003 | HMO | Gold | 00 | 01 | 02 | 03 |
| SoloCare Silver HMO 7000 - 3 Free PCP Visits, $5 Generic Rx 110008 | 110008 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Silver HMO 6000/60 - 3 Free PCP Visits 110009 | 110009 | HMO | Silver | 00 | 01 | 02 | 03 | 04 | 05 | 06 |
| SoloCare Exp Bronze HMO 7200 110030 | 110030 | HMO | Bronze | 00 | 01 | 02 | 03 |
| SoloCare Silver HMO 6000/70 - 3 Free PCP Visits 110029 | 110029 | HMO | Silver | 00 |
