Balance by Medica Bronze $0 Copay PCP Visits
Expanded Bronze · EPO · Medica · Missouri
At age 40 it costs between $482.38 and $657.56 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 | 53461MO0080041 |
|---|---|
| Insurer | Medica |
| Metal level | Expanded Bronze |
| Plan type | EPO |
| Deductible (individual) | $7,500 |
| Deductible (family) | $15,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,600 |
| Family maximum | $21,200 |
| Primary care visit | No Charge |
| Specialist visit | $150 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $30 |
| Preferred brand drugs | $200 |
| 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
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 |
|---|---|---|---|---|---|
| Franklin County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Jefferson County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Lincoln County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Saint Charles County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Saint Louis County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Saint Louis City | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Warren County | $377.45 | $428.41 | $482.38 | $674.13 | $1,024.40 |
| Barry County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Cedar County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Christian County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Dade County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Dallas County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Douglas County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Greene County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Hickory County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Laclede County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Lawrence County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Ozark County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Polk County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Stone County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Taney County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Webster County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Wright County | $389.76 | $442.37 | $498.11 | $696.10 | $1,057.80 |
| Barton County | $422.59 | $479.64 | $540.07 | $754.74 | $1,146.90 |
| Jasper County | $422.59 | $479.64 | $540.07 | $754.74 | $1,146.90 |
| McDonald County | $422.59 | $479.64 | $540.07 | $754.74 | $1,146.90 |
| Newton County | $422.59 | $479.64 | $540.07 | $754.74 | $1,146.90 |
| Howell County | $430.47 | $488.58 | $550.13 | $768.81 | $1,168.28 |
| Texas County | $430.47 | $488.58 | $550.13 | $768.81 | $1,168.28 |
| Saint Clair County | $514.52 | $583.98 | $657.56 | $918.94 | $1,396.41 |
| Vernon County | $514.52 | $583.98 | $657.56 | $918.94 | $1,396.41 |
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.