Gold Classic Standard | with Atrium Health
Gold · HMO · Oscar Health Plan of North Carolina, Inc · North Carolina
At age 40 it costs between $627.54 and $797.53 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 | 69803NC0010057 |
|---|---|
| Insurer | Oscar Health Plan of North Carolina, Inc |
| Metal level | Gold |
| Plan type | HMO |
| 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 | 1-855-672-2755 · TTY 1-855-672-2755 |
Where it is sold, and what it costs there
12 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 |
|---|---|---|---|---|---|
| Anson County | $491.04 | $557.32 | $627.54 | $876.98 | $1,332.65 |
| Cabarrus County | $491.04 | $557.32 | $627.54 | $876.98 | $1,332.65 |
| Mecklenburg County | $491.04 | $557.32 | $627.54 | $876.98 | $1,332.65 |
| Stanly County | $491.04 | $557.32 | $627.54 | $876.98 | $1,332.65 |
| Union County | $491.04 | $557.32 | $627.54 | $876.98 | $1,332.65 |
| Cleveland County | $530.04 | $601.58 | $677.37 | $946.63 | $1,438.49 |
| Lincoln County | $530.04 | $601.58 | $677.37 | $946.63 | $1,438.49 |
| Davidson County | $536.89 | $609.35 | $686.13 | $958.86 | $1,457.08 |
| Davie County | $536.89 | $609.35 | $686.13 | $958.86 | $1,457.08 |
| Forsyth County | $536.89 | $609.35 | $686.13 | $958.86 | $1,457.08 |
| Yadkin County | $536.89 | $609.35 | $686.13 | $958.86 | $1,457.08 |
| Wilkes County | $624.06 | $708.29 | $797.53 | $1,114.55 | $1,693.67 |
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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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.