SilverEPO

Medica with CHI Health Silver Standard

Medica

Starting at

$908

/month before subsidy

Key facts

Medica with CHI Health Silver Standard is a 2026 Silver EPO health insurance plan from Medica, sold on the ACA Marketplace in Nebraska under plan ID 20305NE0050057. The monthly premium starts at $908 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $6,000 ($12,000 for a family), and the individual out-of-pocket maximum is $8,900 ($17,800 for a family). After the deductible, coinsurance is 40% for covered in-network care. The plan is not HSA-eligible.

Plan ID
20305NE0050057
Plan year
2026
State
Nebraska
Metal level
Silver
Plan type
EPO
HSA-eligible
No

Individual Deductible

$6,000

Family: $12,000

Out-of-Pocket Max

$8,900

Family: $17,800

Coinsurance

40%

You pay after deductible

Network Type

EPO

NEN003

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

Medical Services

Primary Care Visit$40.00
Specialist Visit$80.00
Urgent Care$60.00
Emergency Room40.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$20.00
Brand Name Drugs$80.00 Copay after deductible
Specialty Drugs$350.00 Copay after deductible
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
3.0overall
Medical care

How well doctors manage and coordinate care

Member experience
Not rated

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

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

$8,170

your estimated cost

Deductible
$6,000
Copays
$10
Coinsurance
$2,100

Managing type 2 diabetes

A year of routine care

$2,000

your estimated cost

Deductible
$1,100
Copays
$900
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.
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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

$1,650/month

Annual Premium

$10,896

OOP Maximum

$8,900

💡 What this means:

With a $6,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 40% (coinsurance) until you hit $8,900 total. Then insurance covers everything else for the year.

More plans from Medica in Nebraska

View all Marketplace plans in Nebraska

Frequently asked questions about Medica with CHI Health Silver Standard

How much does Medica with CHI Health Silver Standard cost per month?

Medica with CHI Health Silver Standard from Medica starts at $908 per month before any subsidy in Nebraska. 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 Medica with CHI Health Silver Standard?

The individual medical deductible is $6,000, and the family deductible is $12,000. 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 Medica with CHI Health Silver Standard?

The most you would pay in a year for covered in-network care is $8,900 for an individual and $17,800 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Medica with CHI Health Silver Standard HSA-eligible?

No. Medica with CHI Health Silver Standard 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 Medica with CHI Health Silver Standard use?

Medica with CHI Health Silver Standard 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.