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WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice

WellSense Health Plan

Starting at

$390

/month before subsidy

Key facts

WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice is a 2026 Silver HMO health insurance plan from WellSense Health Plan, sold on the ACA Marketplace in New Hampshire under plan ID 13219NH0010004. The monthly premium starts at $390 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $0, and the individual out-of-pocket maximum is $10,250 ($20,500 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.

Plan ID: 13219NH0010004
Plan year: 2026
State: New Hampshire
Metal level: Silver
Plan type: HMO
HSA-eligible: No

Individual Deductible

Family: $0

Out-of-Pocket Max

$10,250

Family: $20,500

Coinsurance

50%

You pay after deductible

Network Type

HMO

NHN001

Cost Sharing

What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$50.00

Specialist Visit$100.00

Urgent Care$60.00

Emergency Room$2,000.00

Prescription Drugs

Generic Drugs$25.00

Brand Name Drugs45.00%

Specialty Drugs50.00%

What you'd typically pay

Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$6,060

your estimated cost

Deductible: $0
Copays: $6,000
Coinsurance: $0

Managing type 2 diabetes

A year of routine care

$1,620

your estimated cost

Deductible: $0
Copays: $1,200
Coinsurance: $400

A simple fracture

ER visit + follow-up

$2,500

your estimated cost

Deductible: $0
Copays: $2,400
Coinsurance: $100

Is your medication or doctor covered?

Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.

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Official Plan Documents

Published by WellSense Health Plan. These are the authoritative source for coverage details.

Summary of Benefits & Coverage (SBC)Standardized cost & coverage summary Plan BrochureFull plan details from the insurer Drug FormularyCovered prescriptions & drug tiers

Who This Plan Is Best For

This Silver HMO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.

Consider this plan if you:

Visit the doctor a few times per year
Take regular prescription medications
Want moderate protection against high medical bills
May qualify for Cost-Sharing Reductions (CSR) to lower deductibles

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost

What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,244/month

Annual Premium

$4,680

OOP Maximum

$10,250

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $10,250 total. Then insurance covers everything else for the year.

More plans from WellSense Health Plan in New Hampshire

View all Marketplace plans in New Hampshire

Frequently asked questions about WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice

How much does WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice cost per month?

WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice from WellSense Health Plan starts at $390 per month before any subsidy in New Hampshire. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice?

The individual medical deductible is $0. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice?

The most you would pay in a year for covered in-network care is $10,250 for an individual and $20,500 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice HSA-eligible?

No. WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice use?

WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.

Understand what you'd actually pay

2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
How ACA subsidies work
Premium tax credits and who qualifies
The 2026 subsidy cliff
Why income near 400% FPL matters again this year

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Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.