Gold Elite | MercyOne
Gold · EPO · Oscar Insurance Company · Iowa
At age 40 it costs between $461.48 and $531.17 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 | 45819IA0010036 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Gold |
| Plan type | EPO |
| Deductible (individual) | $550 |
| Deductible (family) | $1,100 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $6,000 |
| Family maximum | $12,000 |
| Primary care visit | $25 |
| Specialist visit | $50 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $75 |
| 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
27 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 |
|---|---|---|---|---|---|
| Plymouth County | $361.10 | $409.84 | $461.48 | $644.91 | $980 |
| Woodbury County | $361.10 | $409.84 | $461.48 | $644.91 | $980 |
| Dallas County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Jasper County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Madison County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Marion County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Polk County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Warren County | $366.11 | $415.52 | $467.88 | $653.86 | $993.60 |
| Hamilton County | $368.57 | $418.31 | $471.02 | $658.25 | $1,000.27 |
| Hardin County | $368.57 | $418.31 | $471.02 | $658.25 | $1,000.27 |
| Tama County | $368.57 | $418.31 | $471.02 | $658.25 | $1,000.27 |
| Black Hawk County | $380.78 | $432.17 | $486.62 | $680.05 | $1,033.41 |
| Clinton County | $380.78 | $432.17 | $486.62 | $680.05 | $1,033.41 |
| Dubuque County | $380.78 | $432.17 | $486.62 | $680.05 | $1,033.41 |
| Jackson County | $380.78 | $432.17 | $486.62 | $680.05 | $1,033.41 |
| Scott County | $380.78 | $432.17 | $486.62 | $680.05 | $1,033.41 |
| Butler County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Cerro Gordo County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Fayette County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Franklin County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Hancock County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Kossuth County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Mitchell County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Winnebago County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Worth County | $386.69 | $438.88 | $494.18 | $690.61 | $1,049.45 |
| Adair County | $400.60 | $454.67 | $511.96 | $715.46 | $1,087.21 |
| Monroe County | $415.64 | $471.74 | $531.17 | $742.31 | $1,128.01 |
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.