Silver Simple Diabetes
Silver · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $656.38 and $928.87 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 | 21525FL0020011 |
|---|---|
| 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
20 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 |
|---|---|---|---|---|---|
| Hernando County | $513.61 | $582.94 | $656.38 | $917.29 | $1,393.91 |
| Palm Beach County | $534.29 | $606.41 | $682.81 | $954.23 | $1,450.04 |
| Broward County | $540.02 | $612.91 | $690.13 | $964.46 | $1,465.58 |
| Bay County | $540.11 | $613.01 | $690.25 | $964.62 | $1,465.83 |
| Duval County | $540.11 | $613.01 | $690.25 | $964.62 | $1,465.83 |
| Escambia County | $540.11 | $613.01 | $690.25 | $964.62 | $1,465.83 |
| Miami-Dade County | $540.60 | $613.57 | $690.87 | $965.49 | $1,467.15 |
| Clay County | $556.31 | $631.40 | $710.96 | $993.56 | $1,509.81 |
| Brevard County | $575.30 | $652.96 | $735.23 | $1,027.47 | $1,561.35 |
| Walton County | $578.60 | $656.70 | $739.44 | $1,033.36 | $1,570.29 |
| Saint Johns County | $586.44 | $665.60 | $749.46 | $1,047.37 | $1,591.58 |
| Martin County | $591.17 | $670.97 | $755.51 | $1,055.82 | $1,604.42 |
| Manatee County | $592.36 | $672.31 | $757.02 | $1,057.93 | $1,607.63 |
| Citrus County | $605.98 | $687.77 | $774.43 | $1,082.26 | $1,644.59 |
| Leon County | $622.08 | $706.05 | $795.01 | $1,111.02 | $1,688.30 |
| Okaloosa County | $628.33 | $713.14 | $802.99 | $1,122.17 | $1,705.25 |
| Alachua County | $637.99 | $724.11 | $815.34 | $1,139.44 | $1,731.49 |
| Sarasota County | $643.65 | $730.54 | $822.58 | $1,149.55 | $1,746.85 |
| Saint Lucie County | $649.25 | $736.89 | $829.73 | $1,159.54 | $1,762.03 |
| Santa Rosa County | $726.82 | $824.93 | $928.87 | $1,298.09 | $1,972.57 |
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.
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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.