Medica with CHI Health Gold Standard + Adult Eye Exam
Gold · EPO · Medica · Nebraska
At age 40 it costs between $901.53 and $1,029.76 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 | 20305NE0100007 |
|---|---|
| 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 | 99.40% |
| 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
13 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 |
|---|---|---|---|---|---|
| Dodge County | $705.43 | $800.66 | $901.53 | $1,259.89 | $1,914.52 |
| Douglas County | $705.43 | $800.66 | $901.53 | $1,259.89 | $1,914.52 |
| Sarpy County | $705.43 | $800.66 | $901.53 | $1,259.89 | $1,914.52 |
| Saunders County | $705.43 | $800.66 | $901.53 | $1,259.89 | $1,914.52 |
| Washington County | $705.43 | $800.66 | $901.53 | $1,259.89 | $1,914.52 |
| Fillmore County | $779.38 | $884.60 | $996.05 | $1,391.97 | $2,115.24 |
| Lancaster County | $779.38 | $884.60 | $996.05 | $1,391.97 | $2,115.24 |
| Saline County | $779.38 | $884.60 | $996.05 | $1,391.97 | $2,115.24 |
| Seward County | $779.38 | $884.60 | $996.05 | $1,391.97 | $2,115.24 |
| Buffalo County | $805.76 | $914.54 | $1,029.76 | $1,439.09 | $2,186.83 |
| Hall County | $805.76 | $914.54 | $1,029.76 | $1,439.09 | $2,186.83 |
| Hamilton County | $805.76 | $914.54 | $1,029.76 | $1,439.09 | $2,186.83 |
| Kearney County | $805.76 | $914.54 | $1,029.76 | $1,439.09 | $2,186.83 |
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.
Get told when this changes
When this plan’s price or benefits change.
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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.