Medica Insure Gold Standard
Gold · EPO · Medica · Nebraska
At age 40 it costs between $1,189.59 and $1,441.81 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 20305NE0040055 |
|---|---|
| Insurer | Medica |
| Metal level | Gold |
| Plan type | EPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $2,000 |
| Deductible (family) | $4,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,200 |
| Family maximum | $16,400 |
| Primary care visit | $30 |
| Specialist visit | $60 |
| Emergency room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-888-592-8211 · TTY 1-800-833-7352 |
Where it is sold, and what it costs there
93 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Burt County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Dodge County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Douglas County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Sarpy County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Saunders County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Thurston County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Washington County | $930.83 | $1,056.49 | $1,189.59 | $1,662.45 | $2,526.26 |
| Cass County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Fillmore County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Gage County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Jefferson County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Johnson County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Lancaster County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Nemaha County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Otoe County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Pawnee County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Richardson County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Saline County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Seward County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Thayer County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| York County | $1,028.41 | $1,167.25 | $1,314.31 | $1,836.74 | $2,791.11 |
| Adams County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Antelope County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Blaine County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Boone County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Boyd County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Buffalo County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Butler County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Cedar County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Clay County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Colfax County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Cuming County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Custer County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Dakota County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Dawson County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Dixon County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Franklin County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Furnas County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Garfield County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Gosper County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Greeley County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Hall County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Hamilton County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Harlan County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Holt County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Howard County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Kearney County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Keya Paha County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Knox County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Loup County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Madison County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Merrick County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Nance County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Nuckolls County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Phelps County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Pierce County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Platte County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Polk County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Rock County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Sherman County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Stanton County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Valley County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Wayne County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Webster County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Wheeler County | $1,063.22 | $1,206.75 | $1,358.79 | $1,898.91 | $2,885.58 |
| Arthur County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Banner County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Box Butte County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Brown County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Chase County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Cherry County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Cheyenne County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Dawes County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Deuel County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Dundy County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Frontier County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Garden County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Grant County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Hayes County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Hitchcock County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Hooker County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Keith County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Kimball County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Lincoln County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Logan County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| McPherson County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Morrill County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Perkins County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Red Willow County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Scotts Bluff County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Sheridan County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Sioux County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
| Thomas County | $1,128.18 | $1,280.48 | $1,441.81 | $2,014.92 | $3,061.87 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.