Gold Simple
Gold · EPO · Oscar Insurance Company · Missouri
At age 40 it costs between $509.77 and $625.42 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 | 69512MO0010064 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Gold |
| Plan type | EPO |
| Deductible (individual) | $3,300 |
| Deductible (family) | $6,600 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,950 |
| Family maximum | $19,900 |
| Primary care visit | $5 |
| Specialist visit | $10 |
| Emergency room | 20% Coinsurance after deductible |
| Inpatient stay | 20% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $65 Copay after deductible |
| 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 | $398.89 | $452.73 | $509.77 | $712.40 | $1,082.57 |
| Saint Charles County | $398.89 | $452.73 | $509.77 | $712.40 | $1,082.57 |
| Saint Louis County | $398.89 | $452.73 | $509.77 | $712.40 | $1,082.57 |
| Saint Louis City | $398.89 | $452.73 | $509.77 | $712.40 | $1,082.57 |
| Warren County | $398.89 | $452.73 | $509.77 | $712.40 | $1,082.57 |
| Cass County | $419.12 | $475.69 | $535.62 | $748.53 | $1,137.46 |
| Clay County | $419.12 | $475.69 | $535.62 | $748.53 | $1,137.46 |
| Jackson County | $419.12 | $475.69 | $535.62 | $748.53 | $1,137.46 |
| Platte County | $419.12 | $475.69 | $535.62 | $748.53 | $1,137.46 |
| Clinton County | $460.15 | $522.25 | $588.05 | $821.80 | $1,248.81 |
| Ray County | $460.15 | $522.25 | $588.05 | $821.80 | $1,248.81 |
| Bates County | $489.38 | $555.44 | $625.42 | $874.02 | $1,328.15 |
| Henry County | $489.38 | $555.44 | $625.42 | $874.02 | $1,328.15 |
| Johnson County | $489.38 | $555.44 | $625.42 | $874.02 | $1,328.15 |
| Lafayette County | $489.38 | $555.44 | $625.42 | $874.02 | $1,328.15 |
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.