Gold Simple
Gold · HMO · Oscar Health Maintenance Organization of Florida · Florida
At age 40 it costs between $592.94 and $839.09 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 | 21525FL0020016 |
|---|---|
| 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
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 | $463.97 | $526.59 | $592.94 | $828.63 | $1,259.19 |
| Palm Beach County | $482.65 | $547.80 | $616.82 | $862 | $1,309.89 |
| Broward County | $487.83 | $553.67 | $623.43 | $871.24 | $1,323.94 |
| Bay County | $487.91 | $553.77 | $623.54 | $871.39 | $1,324.16 |
| Duval County | $487.91 | $553.77 | $623.54 | $871.39 | $1,324.16 |
| Escambia County | $487.91 | $553.77 | $623.54 | $871.39 | $1,324.16 |
| Miami-Dade County | $488.35 | $554.27 | $624.10 | $872.18 | $1,325.35 |
| Clay County | $502.55 | $570.38 | $642.24 | $897.53 | $1,363.88 |
| Brevard County | $519.70 | $589.85 | $664.17 | $928.17 | $1,410.44 |
| Walton County | $522.68 | $593.23 | $667.97 | $933.49 | $1,418.52 |
| Saint Johns County | $529.76 | $601.27 | $677.03 | $946.14 | $1,437.75 |
| Martin County | $534.04 | $606.12 | $682.49 | $953.78 | $1,449.36 |
| Manatee County | $535.11 | $607.34 | $683.85 | $955.68 | $1,452.25 |
| Citrus County | $547.41 | $621.30 | $699.58 | $977.66 | $1,485.65 |
| Leon County | $561.96 | $637.81 | $718.17 | $1,003.64 | $1,525.13 |
| Okaloosa County | $567.60 | $644.21 | $725.38 | $1,013.72 | $1,540.44 |
| Alachua County | $576.33 | $654.13 | $736.54 | $1,029.31 | $1,564.14 |
| Sarasota County | $581.45 | $659.93 | $743.08 | $1,038.45 | $1,578.02 |
| Saint Lucie County | $586.50 | $665.67 | $749.53 | $1,047.47 | $1,591.74 |
| Santa Rosa County | $656.58 | $745.20 | $839.09 | $1,172.63 | $1,781.92 |
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.