Harmony by Medica Silver $0 Copay PCP Visits
Silver · PPO · Medica · Oklahoma
At age 40 it costs between $641.38 and $905.41 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $3,500 | $10,450 | No Charge | $25 |
| up to 150% of the federal poverty level | $0 | $2,050 | No Charge | $10 |
| 150% to 200% | $850 | $3,350 | No Charge | $10 |
| 200% to 250% | $2,400 | $8,450 | No Charge | $25 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 21333OK0010047 |
|---|---|
| Insurer | Medica |
| Metal level | Silver |
| Plan type | PPO |
| Deductible (individual) | $3,500 |
| Deductible (family) | $7,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,450 |
| Family maximum | $20,900 |
| Primary care visit | No Charge |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $25 |
| Preferred brand drugs | $125 |
| Specialty drugs | 60% Coinsurance after deductible |
| 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 1-800-676-3777 |
Where it is sold, and what it costs there
25 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 |
|---|---|---|---|---|---|
| Creek County | $501.86 | $569.61 | $641.38 | $896.32 | $1,362.05 |
| Osage County | $501.86 | $569.61 | $641.38 | $896.32 | $1,362.05 |
| Rogers County | $501.86 | $569.61 | $641.38 | $896.32 | $1,362.05 |
| Tulsa County | $501.86 | $569.61 | $641.38 | $896.32 | $1,362.05 |
| Wagoner County | $501.86 | $569.61 | $641.38 | $896.32 | $1,362.05 |
| Adair County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Atoka County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Beckham County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Cherokee County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Cotton County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Delaware County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Garfield County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Greer County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Jackson County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Jefferson County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Nowata County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Ottawa County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Pittsburg County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Pottawatomie County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Stephens County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Washington County | $550.97 | $625.35 | $704.13 | $984.02 | $1,495.32 |
| Comanche County | $569.59 | $646.48 | $727.94 | $1,017.29 | $1,545.87 |
| Cleveland County | $708.46 | $804.10 | $905.41 | $1,265.31 | $1,922.76 |
| Grady County | $708.46 | $804.10 | $905.41 | $1,265.31 | $1,922.76 |
| McClain County | $708.46 | $804.10 | $905.41 | $1,265.31 | $1,922.76 |
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.