Silver Simple Diabetes
Silver · HMO · Oscar Health Insurance · Ohio
At age 40 it costs between $483.54 and $548.55 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 | $3 |
| 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 | $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 | 29341OH0100062 |
|---|---|
| Insurer | Oscar Health Insurance |
| 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 | $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 | 1-855-672-2755 |
Where it is sold, and what it costs there
31 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 |
|---|---|---|---|---|---|
| Butler County | $378.37 | $429.43 | $483.54 | $675.74 | $1,026.86 |
| Hamilton County | $378.37 | $429.43 | $483.54 | $675.74 | $1,026.86 |
| Warren County | $378.37 | $429.43 | $483.54 | $675.74 | $1,026.86 |
| Brown County | $388.74 | $441.21 | $496.79 | $694.27 | $1,055.01 |
| Clermont County | $388.74 | $441.21 | $496.79 | $694.27 | $1,055.01 |
| Clinton County | $388.74 | $441.21 | $496.79 | $694.27 | $1,055.01 |
| Highland County | $388.74 | $441.21 | $496.79 | $694.27 | $1,055.01 |
| Coshocton County | $407.66 | $462.68 | $520.97 | $728.06 | $1,106.35 |
| Morgan County | $407.66 | $462.68 | $520.97 | $728.06 | $1,106.35 |
| Perry County | $407.66 | $462.68 | $520.97 | $728.06 | $1,106.35 |
| Champaign County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Clark County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Darke County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Greene County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Miami County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Montgomery County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Preble County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Shelby County | $420.48 | $477.24 | $537.36 | $750.97 | $1,141.16 |
| Vinton County | $421.16 | $478 | $538.23 | $752.17 | $1,142.99 |
| Hocking County | $421.25 | $478.10 | $538.34 | $752.33 | $1,143.23 |
| Delaware County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Fairfield County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Fayette County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Franklin County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Licking County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Logan County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Madison County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Pickaway County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Union County | $422.42 | $479.44 | $539.84 | $754.43 | $1,146.42 |
| Lorain County | $425.02 | $482.39 | $543.16 | $759.07 | $1,153.48 |
| Morrow County | $429.23 | $487.17 | $548.55 | $766.59 | $1,164.91 |
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.