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 ID | 80180WI0100010 |
|---|---|
| Insurer | UnitedHealthcare |
| 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 | Yes |
| 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 | 1-866-569-3468 · 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.
| County | At 21 | At 30 | At 40 | At 50 | At 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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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.