2026 Schedules of Benefits and SBCs: New Hampshire
Individual Market effective 1/1/26
Some plans pending regulatory approval. If a document doesn't display, please check back soon.
Some plans pending regulatory approval. If a document doesn't display, please check back soon.
HMO - OFF EXCHANGE without dental | SOB | SBC |
---|---|---|
NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201585 | ||
NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201586 | ||
NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201591 | ||
NH Local Choice HMO HSA Silver 3500 MD0000201589 | ||
NH Local Choice HMO HSA Bronze 6000 MD0000201590 | ||
NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care MD0000201597 | ||
NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care MD0000201609 | ||
NH Local Choice HMO Silver 2500 + $0 Rx list + $0 Virtual Urgent Care MD0000201593 | ||
NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care MD0000201595 | ||
NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care MD0000201600 | ||
NH Local Choice HMO Bronze 6500 + $0 Rx list + $0 Virtual Urgent Care MD0000201606 | ||
NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care MD0000201605 |
HMO - ON EXCHANGE without dental | SOB | SBC |
---|---|---|
NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201585 | ||
NH Local HMO Silver 6000 Standard+ $0 Rx list + $0 Virtual Urgent Care MD0000201586 | ||
NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201591 | ||
NH Local Choice HMO HSA Bronze 6000 MD0000201590 | ||
NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care MD0000201597 | ||
NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care MD0000201609 | ||
NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care MD0000201595 | ||
NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care MD0000201600 | ||
NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care MD0000201605 |
HMO - ON EXCHANGE without dental - AI/AN - Limited | SOB | SBC |
---|---|---|
NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201585 | ||
NH Local HMO Silver 6000 Standard+ $0 Rx list + $0 Virtual Urgent Care MD0000201586 | ||
NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care MD0000201591 | ||
NH Local Choice HMO Bronze 6000 MD0000201616 | ||
NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care MD0000201597 | ||
NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care MD0000201609 | ||
NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care MD0000201595 | ||
NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care MD0000201600 | ||
NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care MD0000201605 |
HMO - ON EXCHANGE without dental - AI/AN - $0 | SOB | SBC |
---|---|---|
NH Local HMO CSR100 MD0000201607 | ||
NH Local HMO CSR100 MD0000201607 | ||
NH Local HMO CSR100 MD0000201607 | ||
NH Local Choice HMO CSR100 MD0000201608 | ||
NH Local Choice HMO CSR100 MD0000201608 | ||
NH Local Choice HMO CSR100 MD0000201608 | ||
NH Local Choice HMO CSR100 MD0000201608 | ||
NH Local Choice HMO CSR100 MD0000201608 | ||
NH Local Choice HMO CSR100 MD0000201608 |
HMO - ON EXCHANGE without dental - CSR - 73% | SOB | SBC |
---|---|---|
NH Local HMO Silver 3000 Standard CSR73 + $0 Rx list + $0 Virtual Urgent Care MD0000201587 | ||
NH Local Choice HMO Silver 2500 CSR73 + $0 Rx list + $0 Virtual Urgent Care MD0000201596 | ||
NH Local Choice HMO Silver 3500 CSR73 + $0 Rx list + $0 Virtual Urgent Care MD0000201604 |
HMO - ON EXCHANGE without dental - CSR - 87% | SOB | SBC |
---|---|---|
NH Local HMO Silver 700 Standard CSR87 + $0 Rx list + $0 Virtual Urgent Care MD0000201588 | ||
NH Local Choice HMO Silver 1400 CSR87 + $0 Rx list + $0 Virtual Urgent Care MD0000201598 | ||
NH Local Choice HMO Silver 1600 CSR87 + $0 Rx list + $0 Virtual Urgent Care MD0000201602 |
HMO - ON EXCHANGE without dental - CSR - 94% | SOB | SBC |
---|---|---|
NH Local HMO Silver Standard CSR94 + $0 Rx list + $0 Virtual Urgent Care MD0000201592 | ||
NH Local Choice HMO Silver 400 CSR94 + $0 Rx list + $0 Virtual Urgent Care MD0000201599 | ||
NH Local Choice HMO Silver 500 CSR94 + $0 Rx list + $0 Virtual Urgent Care MD0000201603 |
HMO - OFF EXCHANGE with dental | SOB | SBC |
---|---|---|
NH Local Choice HMO HSA Silver 3500 MD0000201589 | ||
NH Local Choice HMO HSA Bronze 6000 MD0000201590 | ||
NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care MD0000201597 | ||
NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care MD0000201609 | ||
NH Local Choice HMO Silver 2500 + $0 Rx list + $0 Virtual Urgent Care MD0000201593 | ||
NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care MD0000201594 | ||
NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care MD0000201601 | ||
NH Local Choice HMO Bronze 6500 + $0 Rx list + $0 Virtual Urgent Care MD0000201606 | ||
NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care MD0000201605 |