Silver Simple Diabetes | with AdventHealth
Silver · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $651.26 and $772.05 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 | $6,500 | $10,000 | No Charge | No Charge |
| up to 150% of the federal poverty level | $0 | $1,550 | No Charge | No Charge |
| 150% to 200% | $800 | $3,350 | No Charge | No Charge |
| 200% to 250% | $4,600 | $8,100 | No Charge | No Charge |
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 | 21525FL0010015 |
|---|---|
| Insurer | Oscar Health Maintenance Organization of Florida |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $6,500 |
| Deductible (family) | $13,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,000 |
| Family maximum | $20,000 |
| Primary care visit | No Charge |
| Specialist visit | $40 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | No Charge |
| Preferred brand drugs | $75 Copay after deductible |
| 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 | $509.60 | $578.39 | $651.26 | $910.13 | $1,383.04 |
| Hillsborough County | $515.40 | $584.97 | $658.67 | $920.49 | $1,398.78 |
| Pasco County | $520.83 | $591.13 | $665.61 | $930.19 | $1,413.51 |
| Osceola County | $532.49 | $604.36 | $680.50 | $951 | $1,445.14 |
| Volusia County | $537.90 | $610.50 | $687.42 | $960.66 | $1,459.82 |
| Orange County | $540.29 | $613.22 | $690.48 | $964.95 | $1,466.33 |
| Lake County | $546.05 | $619.75 | $697.83 | $975.22 | $1,481.94 |
| Seminole County | $547.30 | $621.17 | $699.43 | $977.46 | $1,485.34 |
| Flagler County | $547.78 | $621.72 | $700.05 | $978.32 | $1,486.66 |
| Marion County | $554.24 | $629.06 | $708.31 | $989.86 | $1,504.19 |
| Charlotte County | $594.76 | $675.04 | $760.09 | $1,062.22 | $1,614.15 |
| Polk County | $604.12 | $685.66 | $772.05 | $1,078.94 | $1,639.55 |
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.