Medica Individual Choice Silver Share
Silver · EPO · Medica · Wisconsin
At age 40 it costs between $644.22 and $942.25 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 | $3,525 | $8,850 | $30 | $20 |
| up to 150% of the federal poverty level | $0 | $1,650 | $5 | $5 |
| 150% to 200% | $500 | $3,500 | $5 | $10 |
| 200% to 250% | $1,875 | $8,450 | $30 | $20 |
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 | 57845WI0040027 |
|---|---|
| Insurer | Medica |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $3,525 |
| Deductible (family) | $7,050 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,850 |
| Family maximum | $17,700 |
| Primary care visit | $30 |
| Specialist visit | $110 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $20 |
| Preferred brand drugs | $125 |
| 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 1-800-947-3529 |
Where it is sold, and what it costs there
7 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 |
|---|---|---|---|---|---|
| Polk County | $504.08 | $572.14 | $644.22 | $900.29 | $1,368.08 |
| Ashland County | $621.77 | $705.71 | $794.62 | $1,110.48 | $1,687.48 |
| Burnett County | $621.77 | $705.71 | $794.62 | $1,110.48 | $1,687.48 |
| Sawyer County | $621.77 | $705.71 | $794.62 | $1,110.48 | $1,687.48 |
| Clark County | $662.65 | $752.10 | $846.86 | $1,183.49 | $1,798.42 |
| Rusk County | $662.65 | $752.10 | $846.86 | $1,183.49 | $1,798.42 |
| Marathon County | $737.29 | $836.82 | $942.25 | $1,316.79 | $2,000.99 |
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.