QHP Index

UHC Gold Standard (No Referrals)

Gold · HMO · UnitedHealthcare · Wisconsin

At age 40 it costs between $700.73 and $726.16 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 ID80180WI0100010
InsurerUnitedHealthcare
Metal levelGold
Plan typeHMO
Standardised designDesign 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 deductibleIncluded 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 room25% Coinsurance after deductible
Inpatient stay25% Coinsurance after deductible
Generic drugs$15
Preferred brand drugs$30
Specialty drugs$250
Adult dental includedNo
Child dental includedYes
Share of premium buying essential health benefits100.00%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-866-569-3468 · TTY 1-866-569-3468

Where it is sold, and what it costs there

13 counties. The premium is the price before any tax credit; what you pay depends on your income.

CountyAt 21At 30At 40At 50At 60
Walworth County $548.30$622.32 $700.73$979.27 $1,488.10
Kenosha County $556.40$631.52 $711.08$993.74 $1,510.08
Racine County $556.40$631.52 $711.08$993.74 $1,510.08
Brown County $556.89$632.07 $711.71$994.61 $1,511.41
Door County $556.89$632.07 $711.71$994.61 $1,511.41
Kewaunee County $556.89$632.07 $711.71$994.61 $1,511.41
Manitowoc County $556.89$632.07 $711.71$994.61 $1,511.41
Marinette County $556.89$632.07 $711.71$994.61 $1,511.41
Ozaukee County $558.60$634.02 $713.90$997.67 $1,516.05
Washington County $558.60$634.02 $713.90$997.67 $1,516.05
Waukesha County $558.60$634.02 $713.90$997.67 $1,516.05
Sheboygan County $566.96$643.51 $724.58$1,012.60 $1,538.74
Milwaukee County $568.20$644.91 $726.16$1,014.81 $1,542.10

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.