Family Size

Coverage Groups

Under
Age 1

Ages
1 to 5

Ages
6 to 18

Ages
19 & 20 and Parents and Caretakers 

Pregnant Women

1

$2,754

$1,893

$1,801

$355

$2,588

2

$3,720

$2,558

$2,434

$476

$3,456

3

$4,688

$3,222

$3,066

$598

$4,355

4

$5,654

$3,886

$3,698

$719

$5,252

5

$6,621

$4,550

$4,330

$841

$6,151

6

$7,588

$5,215

$4,963

$963

$7,049

7

$8,556

$5,880

$5,596

$1,085

$7,948

8

$9,522

$6,544

$6,228

$1,207

$8,846

9

$10,490

$7,209

$6,861

$1,328

$9,745

10

$11,457

$7,874

$7,493

$1,451

$10,642

11

$12,424

$8,539

$8,126

$1,574

$11,541

12

$13,391

$9,203

$8,758

$1,697

$12,439

13

$14,359

$9,868

$9,391

$1,820

$13,338

14

$15,325

$10,169

$10,533

$1,943

$14,236

15

$16,293

$11,197

$10,656

$2,066

$15,135

16

$17,259

$11,861

$11,288

$2,188

$16,032

17

$18,226

$12,525

$11,920

$2,311

$16,931

18

$19,193

$13,190

$12,553

$2,434

$17,829

19

$20,161

$13,855

$13,186

$2,557

$18,728

20

$21,127

$14,519

$13,818

$2,680

$19,626

21

$22,095

$15,184

$14,451

$2,803

$20,525

22

$23,062

$15,849

$15,083

$2,926

$21,422

23

$24,029

$15,944

$15,716

$3,049

$22,321

24

$24,996

$17,178

$16,348

$3,172

$23,219