SilverEPO

Silver Simple

Oscar Insurance Company

Starting at

$708

/month before subsidy

Key facts

Silver Simple is a 2026 Silver EPO health insurance plan from Oscar Insurance Company, sold on the ACA Marketplace in Alabama under plan ID 17091AL0010006. The monthly premium starts at $708 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $6,300 ($12,600 for a family), and the individual out-of-pocket maximum is $9,300 ($18,600 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.

Plan ID
17091AL0010006
Plan year
2026
State
Alabama
Metal level
Silver
Plan type
EPO
HSA-eligible
No

Individual Deductible

$6,300

Family: $12,600

Out-of-Pocket Max

$9,300

Family: $18,600

Coinsurance

50%

You pay after deductible

Network Type

EPO

ALN001

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

Medical Services

Primary Care Visit$10.00
Specialist Visit$70.00
Urgent Care$100.00
Emergency Room50.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible
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

$9,600

your estimated cost

Deductible
$8,000
Copays
$0
Coinsurance
$1,600

Managing type 2 diabetes

A year of routine care

$4,700

your estimated cost

Deductible
$4,300
Copays
$400
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,800

your estimated cost

Deductible
$2,600
Copays
$200
Coinsurance
$0
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.
Check a medication
Check a doctor

Enter your ZIP code first to search nearby doctors.

Official Plan Documents
Published by Oscar Insurance Company. These are the authoritative source for coverage details.
Who This Plan Is Best For

This Silver EPO 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

$1,483/month

Annual Premium

$8,496

OOP Maximum

$9,300

💡 What this means:

With a $6,300 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $9,300 total. Then insurance covers everything else for the year.

More plans from Oscar Insurance Company in Alabama

View all Marketplace plans in Alabama

Frequently asked questions about Silver Simple

How much does Silver Simple cost per month?

Silver Simple from Oscar Insurance Company starts at $708 per month before any subsidy in Alabama. 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 Silver Simple?

The individual medical deductible is $6,300, and the family deductible is $12,600. 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 Silver Simple?

The most you would pay in a year for covered in-network care is $9,300 for an individual and $18,600 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Silver Simple HSA-eligible?

No. Silver Simple 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 Silver Simple use?

Silver Simple is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.

Understand what you'd actually pay

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.