Silver Simple PCP Saver
Silver · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $650.20 and $920.12 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 | $5,000 | $9,250 | $20 | $3 |
| up to 150% of the federal poverty level | $0 | $1,750 | $5 | No Charge |
| 150% to 200% | $850 | $3,100 | $10 | $3 |
| 200% to 250% | $4,800 | $7,900 | $10 | $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 | 21525FL0020012 |
|---|---|
| Insurer | Oscar Health Maintenance Organization of Florida |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $5,000 |
| Deductible (family) | $10,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,250 |
| Family maximum | $18,500 |
| Primary care visit | $20 |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $125 |
| 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 | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Palm Beach County | $529.26 | $600.70 | $676.38 | $945.24 | $1,436.39 |
| Broward County | $534.93 | $607.14 | $683.63 | $955.37 | $1,451.78 |
| Bay County | $535.03 | $607.24 | $683.75 | $955.54 | $1,452.03 |
| Duval County | $535.03 | $607.24 | $683.75 | $955.54 | $1,452.03 |
| Escambia County | $535.03 | $607.24 | $683.75 | $955.54 | $1,452.03 |
| Miami-Dade County | $535.51 | $607.79 | $684.37 | $956.40 | $1,453.34 |
| Clay County | $551.08 | $625.46 | $704.26 | $984.20 | $1,495.59 |
| Brevard County | $569.89 | $646.81 | $728.30 | $1,017.80 | $1,546.65 |
| Walton County | $573.15 | $650.52 | $732.47 | $1,023.63 | $1,555.50 |
| Saint Johns County | $580.92 | $659.33 | $742.40 | $1,037.51 | $1,576.59 |
| Martin County | $585.61 | $664.66 | $748.40 | $1,045.88 | $1,589.32 |
| Manatee County | $586.78 | $665.98 | $749.89 | $1,047.97 | $1,592.50 |
| Citrus County | $600.27 | $681.30 | $767.13 | $1,072.07 | $1,629.11 |
| Leon County | $616.22 | $699.40 | $787.52 | $1,100.56 | $1,672.41 |
| Okaloosa County | $622.41 | $706.42 | $795.43 | $1,111.61 | $1,689.20 |
| Alachua County | $631.99 | $717.29 | $807.67 | $1,128.71 | $1,715.18 |
| Sarasota County | $637.59 | $723.66 | $814.83 | $1,138.73 | $1,730.40 |
| Saint Lucie County | $643.14 | $729.95 | $821.92 | $1,148.62 | $1,745.45 |
| Santa Rosa County | $719.98 | $817.17 | $920.12 | $1,285.87 | $1,954 |
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.