Bronze Simple Diabetes | with Atrium Health
Expanded Bronze · HMO · Oscar Health Plan of North Carolina, Inc · North Carolina
At age 40 it costs between $458.19 and $582.31 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 | 69803NC0010067 |
|---|---|
| Insurer | Oscar Health Plan of North Carolina, Inc |
| Metal level | Expanded Bronze |
| Plan type | HMO |
| Deductible (individual) | $5,500 |
| Deductible (family) | $11,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,150 |
| Family maximum | $20,300 |
| Primary care visit | $50 |
| Specialist visit | $150 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $75 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 · 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 | $358.53 | $406.92 | $458.19 | $640.31 | $973.02 |
| Cabarrus County | $358.53 | $406.92 | $458.19 | $640.31 | $973.02 |
| Mecklenburg County | $358.53 | $406.92 | $458.19 | $640.31 | $973.02 |
| Stanly County | $358.53 | $406.92 | $458.19 | $640.31 | $973.02 |
| Union County | $358.53 | $406.92 | $458.19 | $640.31 | $973.02 |
| Cleveland County | $387 | $439.24 | $494.58 | $691.17 | $1,050.30 |
| Lincoln County | $387 | $439.24 | $494.58 | $691.17 | $1,050.30 |
| Davidson County | $392 | $444.91 | $500.97 | $700.10 | $1,063.87 |
| Davie County | $392 | $444.91 | $500.97 | $700.10 | $1,063.87 |
| Forsyth County | $392 | $444.91 | $500.97 | $700.10 | $1,063.87 |
| Yadkin County | $392 | $444.91 | $500.97 | $700.10 | $1,063.87 |
| Wilkes County | $455.65 | $517.15 | $582.31 | $813.77 | $1,236.61 |
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.