HMO Gold 2000
Gold · HMO · Aspirus Health Plan · Wisconsin
At age 40 it costs between $626.69 and $780.35 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 | 86584WI0010015 |
|---|---|
| Insurer | Aspirus Health Plan |
| 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 | 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 | 1-866-631-4611 · TTY 1-866-631-5404 |
Where it is sold, and what it costs there
20 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 |
|---|---|---|---|---|---|
| Adams County | $490.37 | $556.57 | $626.69 | $875.80 | $1,330.87 |
| Juneau County | $490.37 | $556.57 | $626.69 | $875.80 | $1,330.87 |
| Marquette County | $490.37 | $556.57 | $626.69 | $875.80 | $1,330.87 |
| Sauk County | $490.37 | $556.57 | $626.69 | $875.80 | $1,330.87 |
| Columbia County | $490.93 | $557.20 | $627.40 | $876.80 | $1,332.38 |
| Waushara County | $490.93 | $557.20 | $627.40 | $876.80 | $1,332.38 |
| Lincoln County | $528.34 | $599.66 | $675.21 | $943.61 | $1,433.90 |
| Marathon County | $528.34 | $599.66 | $675.21 | $943.61 | $1,433.90 |
| Portage County | $528.34 | $599.66 | $675.21 | $943.61 | $1,433.90 |
| Wood County | $528.34 | $599.66 | $675.21 | $943.61 | $1,433.90 |
| Shawano County | $539.51 | $612.34 | $689.49 | $963.56 | $1,464.22 |
| Florence County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Forest County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Iron County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Langlade County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Oneida County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Vilas County | $599.82 | $680.79 | $766.57 | $1,071.27 | $1,627.91 |
| Clark County | $610.60 | $693.03 | $780.35 | $1,090.53 | $1,657.17 |
| Price County | $610.60 | $693.03 | $780.35 | $1,090.53 | $1,657.17 |
| Taylor County | $610.60 | $693.03 | $780.35 | $1,090.53 | $1,657.17 |
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.