Silver Simple Breathe Easy with Enhanced COPD Benefits
Silver · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $683.68 and $810.49 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 | $6,200 | $9,600 | No Charge | $3 |
| up to 150% of the federal poverty level | $0 | $1,450 | No Charge | $3 |
| 150% to 200% | $900 | $2,900 | No Charge | $3 |
| 200% to 250% | $5,200 | $8,100 | No Charge | $3 |
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 | 21525FL0010013 |
|---|---|
| Insurer | Oscar Health Maintenance Organization of Florida |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $6,200 |
| Deductible (family) | $12,400 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,600 |
| Family maximum | $19,200 |
| Primary care visit | No Charge |
| Specialist visit | $40 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $75 |
| Specialty drugs | 50% 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 |
Where it is sold, and what it costs there
12 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 |
|---|---|---|---|---|---|
| Pinellas County | $534.97 | $607.18 | $683.68 | $955.45 | $1,451.89 |
| Hillsborough County | $541.06 | $614.10 | $691.47 | $966.32 | $1,468.42 |
| Pasco County | $546.76 | $620.56 | $698.75 | $976.50 | $1,483.88 |
| Osceola County | $559 | $634.45 | $714.38 | $998.35 | $1,517.09 |
| Volusia County | $564.68 | $640.89 | $721.64 | $1,008.49 | $1,532.50 |
| Orange County | $567.19 | $643.75 | $724.86 | $1,012.99 | $1,539.33 |
| Lake County | $573.23 | $650.61 | $732.58 | $1,023.77 | $1,555.72 |
| Seminole County | $574.55 | $652.10 | $734.26 | $1,026.12 | $1,559.29 |
| Flagler County | $575.05 | $652.68 | $734.91 | $1,027.03 | $1,560.67 |
| Marion County | $581.84 | $660.37 | $743.58 | $1,039.14 | $1,579.08 |
| Charlotte County | $624.37 | $708.65 | $797.93 | $1,115.11 | $1,694.51 |
| Polk County | $634.20 | $719.80 | $810.49 | $1,132.66 | $1,721.18 |
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.