Gold Elite
Gold · EPO · Oscar Insurance Company · Iowa
At age 40 it costs between $560.82 and $645.53 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 | 45819IA0010063 |
|---|---|
| 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
48 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 |
|---|---|---|---|---|---|
| Buena Vista County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Cherokee County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Ida County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Monona County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Palo Alto County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Sac County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Sioux County | $438.84 | $498.07 | $560.82 | $783.75 | $1,190.98 |
| Boone County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Calhoun County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Carroll County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Greene County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Grundy County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Marshall County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Poweshiek County | $447.91 | $508.37 | $572.42 | $799.96 | $1,215.61 |
| Benton County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Buchanan County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Cedar County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Clayton County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Delaware County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Iowa County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Jones County | $462.75 | $525.21 | $591.39 | $826.46 | $1,255.89 |
| Bremer County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Chickasaw County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Floyd County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Howard County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Humboldt County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Wright County | $469.94 | $533.37 | $600.57 | $839.29 | $1,275.38 |
| Adams County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Audubon County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Cass County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Clarke County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Decatur County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Guthrie County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Harrison County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Mills County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Montgomery County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Pottawattamie County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Ringgold County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Shelby County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Union County | $486.84 | $552.56 | $622.18 | $869.49 | $1,321.27 |
| Appanoose County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Jefferson County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Keokuk County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Lucas County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Mahaska County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Van Buren County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Wapello County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
| Wayne County | $505.12 | $573.30 | $645.53 | $902.12 | $1,370.86 |
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.
Double opt-in, one click to unsubscribe. We never sell or share the list, and we are not an insurance agent or broker: this is a notification about published data, not a sales call. Privacy.
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.