Wellmark Silver Traditional HMO
Silver · HMO · Wellmark Health Plan of Iowa, Inc. · Iowa
At age 40 it costs between $525 and $611.94 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 | $7,500 | $45 | $30 |
| up to 150% of the federal poverty level | $0 | $2,200 | No Charge | No Charge |
| 150% to 200% | $400 | $3,450 | $20 | $10 |
| 200% to 250% | $5,000 | $6,800 | $45 | $10 |
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 | 25896IA0370003 |
|---|---|
| Insurer | Wellmark Health Plan of Iowa, Inc. |
| 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 | $7,500 |
| Family maximum | $15,000 |
| Primary care visit | $45 |
| Specialist visit | $75 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $30 |
| Preferred brand drugs | $60 |
| Specialty drugs | $300 |
| 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 | 1-800-819-0893 · TTY 1-888-781-4262 |
Where it is sold, and what it costs there
99 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 |
|---|---|---|---|---|---|
| Boone County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Calhoun County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Carroll County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Dallas County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Greene County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Grundy County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Hamilton County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Hardin County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Jasper County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Madison County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Marion County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Marshall County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Polk County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Poweshiek County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Story County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Tama County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Warren County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Webster County | $410.80 | $466.26 | $525 | $733.68 | $1,114.90 |
| Appanoose County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Benton County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Black Hawk County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Buchanan County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Cedar County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Clayton County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Clinton County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Davis County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Delaware County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Des Moines County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Dubuque County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Henry County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Iowa County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Jackson County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Jefferson County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Johnson County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Jones County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Keokuk County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Lee County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Linn County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Louisa County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Lucas County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Mahaska County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Monroe County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Muscatine County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Scott County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Van Buren County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Wapello County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Washington County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Wayne County | $413.59 | $469.42 | $528.57 | $738.67 | $1,122.48 |
| Allamakee County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Bremer County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Butler County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Cerro Gordo County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Chickasaw County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Emmet County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Fayette County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Floyd County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Franklin County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Hancock County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Howard County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Humboldt County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Kossuth County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Mitchell County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Winnebago County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Winneshiek County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Worth County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Wright County | $454.26 | $515.59 | $580.55 | $811.31 | $1,232.86 |
| Adair County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Adams County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Audubon County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Buena Vista County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Cass County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Cherokee County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Clarke County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Clay County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Crawford County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Decatur County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Dickinson County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Fremont County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Guthrie County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Harrison County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Ida County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Lyon County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Mills County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Monona County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Montgomery County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| O'Brien County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Osceola County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Page County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Palo Alto County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Plymouth County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Pocahontas County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Pottawattamie County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Ringgold County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Sac County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Shelby County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Sioux County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Taylor County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Union County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
| Woodbury County | $478.83 | $543.47 | $611.94 | $855.19 | $1,299.54 |
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.