Silver Simple PCP Saver
Silver · EPO · Oscar Insurance Company · Missouri
At age 40 it costs between $554.70 and $680.54 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 | $5,100 | $10,000 | $20 | $3 |
| up to 150% of the federal poverty level | $0 | $1,900 | $5 | No Charge |
| 150% to 200% | $800 | $3,200 | $10 | $3 |
| 200% to 250% | $4,900 | $8,000 | $20 | $3 |
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 | 69512MO0010025 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $5,100 |
| Deductible (family) | $10,200 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,000 |
| Family maximum | $20,000 |
| Primary care visit | $20 |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $100 |
| Specialty drugs | 50% 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 | 1-855-672-2755 |
Where it is sold, and what it costs there
15 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 |
|---|---|---|---|---|---|
| Lincoln County | $434.05 | $492.64 | $554.70 | $775.20 | $1,177.99 |
| Saint Charles County | $434.05 | $492.64 | $554.70 | $775.20 | $1,177.99 |
| Saint Louis County | $434.05 | $492.64 | $554.70 | $775.20 | $1,177.99 |
| Saint Louis City | $434.05 | $492.64 | $554.70 | $775.20 | $1,177.99 |
| Warren County | $434.05 | $492.64 | $554.70 | $775.20 | $1,177.99 |
| Cass County | $456.06 | $517.62 | $582.83 | $814.50 | $1,237.72 |
| Clay County | $456.06 | $517.62 | $582.83 | $814.50 | $1,237.72 |
| Jackson County | $456.06 | $517.62 | $582.83 | $814.50 | $1,237.72 |
| Platte County | $456.06 | $517.62 | $582.83 | $814.50 | $1,237.72 |
| Clinton County | $500.70 | $568.29 | $639.89 | $894.24 | $1,358.88 |
| Ray County | $500.70 | $568.29 | $639.89 | $894.24 | $1,358.88 |
| Bates County | $532.52 | $604.39 | $680.54 | $951.06 | $1,445.22 |
| Henry County | $532.52 | $604.39 | $680.54 | $951.06 | $1,445.22 |
| Johnson County | $532.52 | $604.39 | $680.54 | $951.06 | $1,445.22 |
| Lafayette County | $532.52 | $604.39 | $680.54 | $951.06 | $1,445.22 |
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.