Select by Medica Gold $0 Copay PCP Visits
Gold · EPO · Medica · Missouri
At age 40 it costs between $881.40 and $903.94 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 53461MO0010045 |
|---|---|
| Insurer | Medica |
| Metal level | Gold |
| Plan type | EPO |
| Deductible (individual) | $1,500 |
| Deductible (family) | $3,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,800 |
| Family maximum | $17,600 |
| Primary care visit | No Charge |
| Specialist visit | $75 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $75 |
| Specialty drugs | 60% 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 | 1-888-592-8211 · TTY 1-800-676-3777 |
Where it is sold, and what it costs there
13 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 |
|---|---|---|---|---|---|
| Henry County | $689.67 | $782.78 | $881.40 | $1,231.75 | $1,871.77 |
| Johnson County | $689.67 | $782.78 | $881.40 | $1,231.75 | $1,871.77 |
| Lafayette County | $689.67 | $782.78 | $881.40 | $1,231.75 | $1,871.77 |
| Cass County | $704.91 | $800.07 | $900.88 | $1,258.97 | $1,913.13 |
| Clay County | $704.91 | $800.07 | $900.88 | $1,258.97 | $1,913.13 |
| Jackson County | $704.91 | $800.07 | $900.88 | $1,258.97 | $1,913.13 |
| Platte County | $704.91 | $800.07 | $900.88 | $1,258.97 | $1,913.13 |
| Caldwell County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
| Clinton County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
| Daviess County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
| DeKalb County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
| Grundy County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
| Livingston County | $707.31 | $802.80 | $903.94 | $1,263.25 | $1,919.64 |
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.