TAK
TakeCare Insurance Company, Inc. — Standard Option
PSHB Offered in 2027|TakeCare Insurance Company, Inc.|Traditional|HMO/POS
Premium
biweekly · employee paysSelf Only
$39.35biweekly · employee pays
vs 2026−$7.50 -16.0%
Lowest$39.35 (2027)
Highest$47.46 (2025)
Since 2025-17.1%
Self Plus One
$78.93biweekly · employee pays
vs 2026−$15.04 -16.0%
Lowest$78.93 (2027)
Highest$95.09 (2025)
Since 2025-17.0%
Self & Family
$130.02biweekly · employee pays
vs 2026−$24.77 -16.0%
Lowest$130.02 (2027)
Highest$156.63 (2025)
Since 2025-17.0%
Premium history
SharePeriodRate type
Year by year
follows the chart's share, period and rate-type selection| Year | Self Only | Δ | Self Plus One | Δ | Self & Family | Δ | Listed as |
|---|
Changelog
- 2025First appears in OPM rate tablesNew plan option for 2025.
- 2026Largest increase: -1.3%Self Only employee share went from $47.46 to $46.85.
- 2027Largest decrease: -16.0%Self Only employee share went from $46.85 to $39.35.
Full rate schedule
Plan yearIn-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | $3,000 | $6,000 | $6,000 |
| Prescription out-of-pocket maximum | $3,000 | $6,000 | $6,000 |
- Type of accountNot Applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket Maximum per enrollee$2,400
- Tier 0$0 Copayment
- Tier 1$15 Copayment
- Tier 2$40 Copayment
- Tier 3$100 Copayment
- Tier 4$100 Copayment
- Tier 5$250 Copayment
- Mail Order PharmacyYes
- Deductible waiver (with Medicare Part A as Primary)No
- Deductible waiver (with Medicare Part B as Primary)No
- Deductible Waiver with Parts A & BNo
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & B20% Coinsurance
- Outpatient Hospital Services with Part AMember Pays Nothing
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNo
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays All Charges
- Specialty Physician Office Visit with Part CMember Pays All Charges
- Inpatient Hospital Services with Part CMember Pays All Charges
- Outpatient Hospital Services with Part CMember Pays All Charges
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Part B Premium Reimbursement with Part CNot applicable
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$25 Copayment
- Specialist Office Visit$40 Copayment
- Emergency Care$100 Copayment
- Urgent Care$15 Copayment
- Doctor Costs for Inpatient SurgeryMember Pays Nothing
- Hospital Inpatient Cost Per Admission$150 Copayment
- Hospital Room CostsMember Pays Nothing
- Other Inpatient Hospital CostsMember Pays Nothing
- Doctor Costs for Outpatient Surgery$150 Copayment
- Other Outpatient Surgery CostsMember Pays Nothing
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)Member Pays Nothing
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)$40 Copayment
- Enhanced Lab NetworkMember Pays Nothing
- Applied Behavioral Analysis (ABA)$40 Copayment
- ChiropracticMember Pays All Charges
- Occupational Therapy$15 Copayment
- Physical Therapy$15 Copayment
- Speech Therapy$15 Copayment
- Professional Services (Mental Health and Substance Use Disorder)$40 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)$150 Copayment
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)$150 Copayment
- Diagnosis and Treatment (Infertility Services)50% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)$40 Copayment
- Artificial Insemination Services (e.g. ICI, IVI, IUI)50% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures$150 Copayment
- Reconstructive Surgery$150 Copayment
- Hearing Services$40 Copayment
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays Nothing
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)$150 Copayment
- Hospice CareMember Pays Nothing
- Home Health Services (Skilled Nursing Care)Member Pays Nothing
- Durable Medical Equipment15% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)Member Pays Nothing
- Diabetes EducationMember Pays Nothing
- Nutritional CounselingMember Pays Nothing
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsCovered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesCovered
- Contact LensesCovered
- AcupunctureMember Pays All Charges
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Out-of-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | $3,000 | $6,000 | $6,000 |
- Type of accountNot Applicable
- Tier 0100% Coinsurance
- Tier 1100% Coinsurance
- Tier 2100% Coinsurance
- Tier 3100% Coinsurance
- Tier 4100% Coinsurance
- Tier 5100% Coinsurance
- Mail Order PharmacyYes
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible Waiver with Parts A & BNot applicable
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & B30%
- Outpatient Hospital Services with Part AMember Pays Nothing
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNo
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays All Charges
- Specialty Physician Office Visit with Part CMember Pays All Charges
- Inpatient Hospital Services with Part CMember Pays All Charges
- Outpatient Hospital Services with Part CMember Pays All Charges
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Part B Premium Reimbursement with Part CNot applicable
- Preventive Care30% Coinsurance
- Primary Care Office Visit30% Coinsurance
- Specialist Office Visit30% Coinsurance
- Emergency Care$100 Copayment
- Urgent Care30% Coinsurance
- Doctor Costs for Inpatient Surgery30% Coinsurance
- Hospital Inpatient Cost Per Admission30% Coinsurance
- Hospital Room Costs30% Coinsurance
- Other Inpatient Hospital Costs30% Coinsurance
- Doctor Costs for Outpatient Surgery30% Coinsurance
- Other Outpatient Surgery Costs30% Coinsurance
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)30% Coinsurance
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)30% Coinsurance
- Enhanced Lab Network30% Coinsurance
- Applied Behavioral Analysis (ABA)30% Coinsurance
- ChiropracticMember Pays All Charges
- Occupational Therapy30% Coinsurance
- Physical Therapy30% Coinsurance
- Speech Therapy30% Coinsurance
- Professional Services (Mental Health and Substance Use Disorder)30% Coinsurance
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)30% Coinsurance
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)30% Coinsurance
- Diagnosis and Treatment (Infertility Services)30% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)Member Pays All Charges
- Artificial Insemination Services (e.g. ICI, IVI, IUI)30% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures30% Coinsurance
- Reconstructive Surgery30% Coinsurance
- Hearing Services30% Coinsurance
- Hearing Aids (external)Not Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)30% Coinsurance
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)30% Coinsurance
- Hospice CareMember Pays All Charges
- Home Health Services (Skilled Nursing Care)30% Coinsurance
- Durable Medical EquipmentMember Pays All Charges
- Outpatient Rehabilitation (Skilled Nursing Care Facility)30% Coinsurance
- Diabetes EducationMember Pays All Charges
- Nutritional CounselingMember Pays All Charges
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsCovered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- AcupunctureMember Pays All Charges
- Chronic Disease Management: Heart DiseaseNot Covered
- Chronic Disease Management: ObesityNot Covered
- Chronic Disease Management: HypertensionNot Covered
- Chronic Disease Management: AsthmaNot Covered
States
3GuamNorthern Mariana IslandsPW
Counties covered
| State | Area |
|---|---|
| Guam | Entire state |
| Northern Mariana Islands | Entire state |
| PW | Entire state |
Service area over time
| Year | States / areas listed |
|---|---|
| 2027 | Guam, Northern Mariana Islands, PW |
| 2026 | Guam, Northern Mariana Islands, PW |
| 2025 | Guam, Northern Mariana Islands, PW |