Engage by Medica Gold $0 Copay PCP Visits
Gold · EPO · Medica · Wisconsin
At age 40 it costs between $622.35 and $818.11 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 | 57845WI0050074 |
|---|---|
| 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
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 | $486.97 | $552.71 | $622.35 | $869.73 | $1,321.64 |
| Saint Croix County | $486.97 | $552.71 | $622.35 | $869.73 | $1,321.64 |
| Buffalo County | $533.74 | $605.80 | $682.12 | $953.26 | $1,448.57 |
| Jackson County | $533.74 | $605.80 | $682.12 | $953.26 | $1,448.57 |
| La Crosse County | $533.74 | $605.80 | $682.12 | $953.26 | $1,448.57 |
| Monroe County | $533.74 | $605.80 | $682.12 | $953.26 | $1,448.57 |
| Trempealeau County | $533.74 | $605.80 | $682.12 | $953.26 | $1,448.57 |
| Chippewa County | $623.67 | $707.86 | $797.05 | $1,113.87 | $1,692.64 |
| Dunn County | $623.67 | $707.86 | $797.05 | $1,113.87 | $1,692.64 |
| Eau Claire County | $623.67 | $707.86 | $797.05 | $1,113.87 | $1,692.64 |
| Pepin County | $623.67 | $707.86 | $797.05 | $1,113.87 | $1,692.64 |
| Crawford County | $624.37 | $708.66 | $797.94 | $1,115.12 | $1,694.53 |
| Vernon County | $624.37 | $708.66 | $797.94 | $1,115.12 | $1,694.53 |
| Barron County | $640.15 | $726.57 | $818.11 | $1,143.31 | $1,737.37 |
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.