Engage by Medica Gold Standard
Gold · EPO · Medica · Wisconsin
At age 40 it costs between $642.70 and $844.86 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 | 57845WI0050055 |
|---|---|
| Insurer | Medica |
| Metal level | Gold |
| Plan type | EPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $2,000 |
| Deductible (family) | $4,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,200 |
| Family maximum | $16,400 |
| Primary care visit | $30 |
| Specialist visit | $60 |
| Emergency room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| 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
14 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 |
|---|---|---|---|---|---|
| Pierce County | $502.89 | $570.78 | $642.70 | $898.16 | $1,364.85 |
| Saint Croix County | $502.89 | $570.78 | $642.70 | $898.16 | $1,364.85 |
| Buffalo County | $551.19 | $625.60 | $704.42 | $984.42 | $1,495.93 |
| Jackson County | $551.19 | $625.60 | $704.42 | $984.42 | $1,495.93 |
| La Crosse County | $551.19 | $625.60 | $704.42 | $984.42 | $1,495.93 |
| Monroe County | $551.19 | $625.60 | $704.42 | $984.42 | $1,495.93 |
| Trempealeau County | $551.19 | $625.60 | $704.42 | $984.42 | $1,495.93 |
| Chippewa County | $644.06 | $731 | $823.10 | $1,150.29 | $1,747.97 |
| Dunn County | $644.06 | $731 | $823.10 | $1,150.29 | $1,747.97 |
| Eau Claire County | $644.06 | $731 | $823.10 | $1,150.29 | $1,747.97 |
| Pepin County | $644.06 | $731 | $823.10 | $1,150.29 | $1,747.97 |
| Crawford County | $644.78 | $731.82 | $824.03 | $1,151.58 | $1,749.93 |
| Vernon County | $644.78 | $731.82 | $824.03 | $1,151.58 | $1,749.93 |
| Barron County | $661.08 | $750.32 | $844.86 | $1,180.69 | $1,794.17 |
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.