Medica Individual Choice Gold $0 Copay PCP Visits
Gold · EPO · Medica · Wisconsin
At age 40 it costs between $629.10 and $920.14 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 | 57845WI0040074 |
|---|---|
| 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 1-800-947-3529 |
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 | $492.26 | $558.71 | $629.10 | $879.17 | $1,335.98 |
| Ashland County | $607.18 | $689.15 | $775.98 | $1,084.43 | $1,647.89 |
| Burnett County | $607.18 | $689.15 | $775.98 | $1,084.43 | $1,647.89 |
| Sawyer County | $607.18 | $689.15 | $775.98 | $1,084.43 | $1,647.89 |
| Clark County | $647.10 | $734.46 | $826.99 | $1,155.72 | $1,756.23 |
| Rusk County | $647.10 | $734.46 | $826.99 | $1,155.72 | $1,756.23 |
| Marathon County | $719.99 | $817.18 | $920.14 | $1,285.90 | $1,954.04 |
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.