QHP Index

UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)

Gold · HMO · UnitedHealthcare · Wisconsin

At age 40 it costs between $720.80 and $746.96 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 ID80180WI0100012
InsurerUnitedHealthcare
Metal levelGold
Plan typeHMO
Deductible (individual)$0
Deductible (family)$0
Drug deductible$500
Most you could pay in a year$8,500
Family maximum$17,000
Primary care visit$20
Specialist visit$60
Emergency room$650
Inpatient stay$2,000 Copay per Day
Generic drugs$5
Preferred brand drugs$50
Specialty drugs50% Coinsurance after deductible
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 $564$640.14 $720.80$1,007.31 $1,530.71
Kenosha County $572.34$649.60 $731.45$1,022.19 $1,553.32
Racine County $572.34$649.60 $731.45$1,022.19 $1,553.32
Brown County $572.84$650.17 $732.09$1,023.09 $1,554.69
Door County $572.84$650.17 $732.09$1,023.09 $1,554.69
Kewaunee County $572.84$650.17 $732.09$1,023.09 $1,554.69
Manitowoc County $572.84$650.17 $732.09$1,023.09 $1,554.69
Marinette County $572.84$650.17 $732.09$1,023.09 $1,554.69
Ozaukee County $574.60$652.17 $734.34$1,026.24 $1,559.46
Washington County $574.60$652.17 $734.34$1,026.24 $1,559.46
Waukesha County $574.60$652.17 $734.34$1,026.24 $1,559.46
Sheboygan County $583.20$661.93 $745.33$1,041.60 $1,582.81
Milwaukee County $584.47$663.38 $746.96$1,043.87 $1,586.26

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.