Silver Simple PCP Saver
Silver · EPO · Oscar Insurance Company · Michigan
At age 40 it costs $471.47 a month before any subsidy.
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 | $5,500 | $9,800 | $20 | $3 |
| up to 150% of the federal poverty level | $0 | $1,850 | $5 | No Charge |
| 150% to 200% | $600 | $3,350 | $10 | $3 |
| 200% to 250% | $4,750 | $7,800 | $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 | 77739MI0070025 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $5,500 |
| Deductible (family) | $11,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,800 |
| Family maximum | $19,600 |
| Primary care visit | $20 |
| Specialist visit | $70 |
| 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
4 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 |
|---|---|---|---|---|---|
| Kent County | $368.92 | $418.71 | $471.47 | $658.87 | $1,001.22 |
| Muskegon County | $368.92 | $418.71 | $471.47 | $658.87 | $1,001.22 |
| Oceana County | $368.92 | $418.71 | $471.47 | $658.87 | $1,001.22 |
| Ottawa County | $368.92 | $418.71 | $471.47 | $658.87 | $1,001.22 |
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.