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Expanded_bronzePPOHSA Eligible

Harmony by Medica Expanded Bronze Standard + Adult Eye Exam

Medica

Starting at

$659

/month before subsidy

Key facts

Harmony by Medica Expanded Bronze Standard + Adult Eye Exam is a 2026 Expanded_bronze PPO health insurance plan from Medica, sold on the ACA Marketplace in Oklahoma under plan ID 21333OK0070009. The monthly premium starts at $659 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $7,500 ($15,000 for a family), and the individual out-of-pocket maximum is $10,000 ($20,000 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is HSA-eligible, so it can be paired with a Health Savings Account.

Plan ID
21333OK0070009
Plan year
2026
State
Oklahoma
Metal level
Expanded_bronze
Plan type
PPO
HSA-eligible
Yes

Individual Deductible

$7,500

Family: $15,000

Out-of-Pocket Max

$10,000

Family: $20,000

Coinsurance

50%

You pay after deductible

Network Type

PPO

OKN001

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$75.00
Emergency Room50.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$25.00
Brand Name Drugs$100.00 Copay after deductible
Specialty Drugs$500.00 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.
1.0overall
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

$9,370

your estimated cost

Deductible
$7,500
Copays
$10
Coinsurance
$1,800

Managing type 2 diabetes

A year of routine care

$2,100

your estimated cost

Deductible
$1,100
Copays
$1,000
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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Official Plan Documents
Published by Medica. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

Review the plan details above to determine if this plan fits your healthcare needs and budget.

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

$1,492/month

Annual Premium

$7,908

OOP Maximum

$10,000

💡 What this means:

With a $7,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $10,000 total. Then insurance covers everything else for the year.

More plans from Medica in Oklahoma

View all Marketplace plans in Oklahoma

Frequently asked questions about Harmony by Medica Expanded Bronze Standard + Adult Eye Exam

How much does Harmony by Medica Expanded Bronze Standard + Adult Eye Exam cost per month?

Harmony by Medica Expanded Bronze Standard + Adult Eye Exam from Medica starts at $659 per month before any subsidy in Oklahoma. 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 Harmony by Medica Expanded Bronze Standard + Adult Eye Exam?

The individual medical deductible is $7,500, and the family deductible is $15,000. 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 Harmony by Medica Expanded Bronze Standard + Adult Eye Exam?

The most you would pay in a year for covered in-network care is $10,000 for an individual and $20,000 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Harmony by Medica Expanded Bronze Standard + Adult Eye Exam HSA-eligible?

Yes. Harmony by Medica Expanded Bronze Standard + Adult Eye Exam is a qualified high-deductible health plan, so you can pair it with a Health Savings Account (HSA) and pay for eligible medical expenses with pre-tax dollars.

What type of network does Harmony by Medica Expanded Bronze Standard + Adult Eye Exam use?

Harmony by Medica Expanded Bronze Standard + Adult Eye Exam is a PPO plan. PPO plans let you see specialists without a referral and use out-of-network providers (at higher cost), offering the most flexibility.

Understand what you'd actually pay

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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.