Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOne
Silver · EPO · Oscar Insurance Company · Iowa
At age 40 it costs between $453.90 and $522.46 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 | $6,200 | $9,600 | No Charge | $3 |
| up to 150% of the federal poverty level | $0 | $1,450 | No Charge | $3 |
| 150% to 200% | $900 | $2,900 | No Charge | $3 |
| 200% to 250% | $5,200 | $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 | 45819IA0010076 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $6,200 |
| Deductible (family) | $12,400 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,600 |
| Family maximum | $19,200 |
| Primary care visit | No Charge |
| Specialist visit | $35 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% 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 | $355.18 | $403.11 | $453.90 | $634.33 | $963.92 |
| Woodbury County | $355.18 | $403.11 | $453.90 | $634.33 | $963.92 |
| Dallas County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Jasper County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Madison County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Marion County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Polk County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Warren County | $360.10 | $408.71 | $460.20 | $643.13 | $977.29 |
| Hamilton County | $362.52 | $411.45 | $463.29 | $647.44 | $983.86 |
| Hardin County | $362.52 | $411.45 | $463.29 | $647.44 | $983.86 |
| Tama County | $362.52 | $411.45 | $463.29 | $647.44 | $983.86 |
| Black Hawk County | $374.53 | $425.08 | $478.64 | $668.90 | $1,016.45 |
| Clinton County | $374.53 | $425.08 | $478.64 | $668.90 | $1,016.45 |
| Dubuque County | $374.53 | $425.08 | $478.64 | $668.90 | $1,016.45 |
| Jackson County | $374.53 | $425.08 | $478.64 | $668.90 | $1,016.45 |
| Scott County | $374.53 | $425.08 | $478.64 | $668.90 | $1,016.45 |
| Butler County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Cerro Gordo County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Fayette County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Franklin County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Hancock County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Kossuth County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Mitchell County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Winnebago County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Worth County | $380.35 | $431.68 | $486.07 | $679.28 | $1,032.23 |
| Adair County | $394.03 | $447.21 | $503.56 | $703.72 | $1,069.37 |
| Monroe County | $408.82 | $464 | $522.46 | $730.13 | $1,109.50 |
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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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.