Balance by Medica Bronze $0 Copay PCP Visits
Expanded Bronze · PPO · Medica · Oklahoma
At age 40 it costs between $402.90 and $518.07 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 | 21333OK0060074 |
|---|---|
| Insurer | Medica |
| Metal level | Expanded Bronze |
| Plan type | PPO |
| Deductible (individual) | $7,500 |
| Deductible (family) | $15,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,600 |
| Family maximum | $21,200 |
| Primary care visit | No Charge |
| Specialist visit | $150 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $30 |
| Preferred brand drugs | $200 |
| 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
9 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 |
|---|---|---|---|---|---|
| Blaine County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Carter County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Johnston County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Kingfisher County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Murray County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Pontotoc County | $315.26 | $357.82 | $402.90 | $563.05 | $855.61 |
| Canadian County | $405.38 | $460.10 | $518.07 | $724 | $1,100.19 |
| Logan County | $405.38 | $460.10 | $518.07 | $724 | $1,100.19 |
| Oklahoma County | $405.38 | $460.10 | $518.07 | $724 | $1,100.19 |
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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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.