Silver Simple Women's Health with Menopause Benefits
Silver · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $657.03 and $929.79 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 | $6,000 | $10,150 | No Charge | $3 |
| up to 150% of the federal poverty level | $0 | $1,550 | No Charge | No Charge |
| 150% to 200% | $870 | $3,350 | No Charge | $3 |
| 200% to 250% | $5,500 | $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 | 21525FL0020013 |
|---|---|
| Insurer | Oscar Health Maintenance Organization of Florida |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $6,000 |
| Deductible (family) | $12,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,150 |
| Family maximum | $20,300 |
| 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 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 | $514.12 | $583.51 | $657.03 | $918.20 | $1,395.29 |
| Palm Beach County | $534.82 | $607.01 | $683.49 | $955.17 | $1,451.48 |
| Broward County | $540.55 | $613.52 | $690.82 | $965.41 | $1,467.04 |
| Bay County | $540.65 | $613.62 | $690.93 | $965.58 | $1,467.29 |
| Duval County | $540.65 | $613.62 | $690.93 | $965.58 | $1,467.29 |
| Escambia County | $540.65 | $613.62 | $690.93 | $965.58 | $1,467.29 |
| Miami-Dade County | $541.13 | $614.18 | $691.56 | $966.45 | $1,468.61 |
| Clay County | $556.87 | $632.03 | $711.66 | $994.54 | $1,511.30 |
| Brevard County | $575.87 | $653.61 | $735.96 | $1,028.49 | $1,562.90 |
| Walton County | $579.17 | $657.35 | $740.17 | $1,034.38 | $1,571.85 |
| Saint Johns County | $587.02 | $666.26 | $750.20 | $1,048.41 | $1,593.16 |
| Martin County | $591.76 | $671.64 | $756.26 | $1,056.87 | $1,606.01 |
| Manatee County | $592.95 | $672.98 | $757.77 | $1,058.98 | $1,609.23 |
| Citrus County | $606.58 | $688.45 | $775.19 | $1,083.33 | $1,646.23 |
| Leon County | $622.70 | $706.75 | $795.80 | $1,112.12 | $1,689.98 |
| Okaloosa County | $628.95 | $713.85 | $803.78 | $1,123.29 | $1,706.94 |
| Alachua County | $638.63 | $724.83 | $816.15 | $1,140.57 | $1,733.20 |
| Sarasota County | $644.29 | $731.26 | $823.39 | $1,150.69 | $1,748.58 |
| Saint Lucie County | $649.89 | $737.62 | $830.55 | $1,160.69 | $1,763.78 |
| Santa Rosa County | $727.54 | $825.75 | $929.79 | $1,299.38 | $1,974.53 |
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.