Gold Simple | with AdventHealth
Gold · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $588.32 and $697.43 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 | 21525FL0010023 |
|---|---|
| Insurer | Oscar Health Maintenance Organization of Florida |
| Metal level | Gold |
| Plan type | HMO |
| Deductible (individual) | $3,000 |
| Deductible (family) | $6,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,950 |
| Family maximum | $19,900 |
| Primary care visit | $5 |
| Specialist visit | $10 |
| Emergency room | 20% Coinsurance after deductible |
| Inpatient stay | 20% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $65 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 | $460.35 | $522.49 | $588.32 | $822.17 | $1,249.37 |
| Hillsborough County | $465.59 | $528.43 | $595.01 | $831.53 | $1,263.59 |
| Pasco County | $470.49 | $534 | $601.28 | $840.29 | $1,276.89 |
| Osceola County | $481.02 | $545.95 | $614.73 | $859.09 | $1,305.47 |
| Volusia County | $485.91 | $551.50 | $620.98 | $867.82 | $1,318.73 |
| Orange County | $488.08 | $553.95 | $623.75 | $871.68 | $1,324.61 |
| Lake County | $493.27 | $559.85 | $630.39 | $880.96 | $1,338.71 |
| Seminole County | $494.40 | $561.14 | $631.83 | $882.99 | $1,341.78 |
| Flagler County | $494.84 | $561.63 | $632.39 | $883.77 | $1,342.97 |
| Marion County | $500.68 | $568.26 | $639.85 | $894.19 | $1,358.81 |
| Charlotte County | $537.28 | $609.80 | $686.63 | $959.56 | $1,458.14 |
| Polk County | $545.73 | $619.40 | $697.43 | $974.66 | $1,481.09 |
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.
Double opt-in, one click to unsubscribe. We never sell or share the list, and we are not an insurance agent or broker: this is a notification about published data, not a sales call. Privacy.
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.