Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental
Starting at
$455
/month before subsidy
Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental is a 2026 Bronze HMO health insurance plan from Issuer 25303, sold on the ACA Marketplace in New York under plan ID 25303NY0620001. The monthly premium starts at $455 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,500 ($5,500 for a family), and the individual out-of-pocket maximum is $8,050 ($8,050 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
- 25303NY0620001
- Plan year
- 2026
- State
- New York
- Metal level
- Bronze
- Plan type
- HMO
- HSA-eligible
- Yes
Individual Deductible
$5,500
Family: $5,500
Out-of-Pocket Max
$8,050
Family: $8,050
Coinsurance
50%
You pay after deductible
Network Type
HMO
NYN001
Medical Services
Prescription Drugs
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This Bronze HMO plan is ideal for healthy individuals who want the lowest monthly premium and can handle higher out-of-pocket costs if they need care.
Consider this plan if you:
- Rarely visit the doctor beyond annual checkups
- Have savings to cover the $5,500 deductible if needed
- Primarily need coverage for unexpected emergencies
- Want to minimize monthly healthcare expenses
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,126/month
Annual Premium
$5,460
OOP Maximum
$8,050
💡 What this means:
With a $5,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $8,050 total. Then insurance covers everything else for the year.
More plans from Issuer 25303 in New York
- Ambetter from Fidelis Care Catastrophic, Catastrophic, ST, INN, Fidelis Care HBX Network, Free Telemedicine Prgroam, Pediatric Dentalfrom $185/mo
- Ambetter from Fidelis Care Bronze for Children, Child-Only, ST, INN, Fidelis Care HBX Network, Free Telemedicine Program, Pediatric Dental
- Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep25, Free Telemedicine Program, Pediatric Dentalfrom $434/mo
- Ambetter from Fidelis Care Bronze, Bronze, ST, INN, Fidelis Care HBX Network, Dep25, Free Telemedicine Program, Pediatric Dentalfrom $448/mo
- Ambetter from Fidelis Care Bronze, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dentalfrom $471/mo
- Ambetter from Fidelis Care Silver for Children, Child-Only, ST, INN, Fidelis Care HBX Network, Free Telemedicine Program, Pediatric Dental
- Ambetter from Fidelis Care Silver One, Silver, NS, INN, Fidelis Care HBX Network, Dep25, Free Telemedicine Program, Family Dentalfrom $807/mo
- Ambetter from Fidelis Care Silver One, Silver, NS, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Family Dentalfrom $847/mo
Frequently asked questions about Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental
How much does Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental cost per month?
Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental from Issuer 25303 starts at $455 per month before any subsidy in New York. 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 Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental?
The individual medical deductible is $5,500, and the family deductible is $5,500. 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 Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental?
The most you would pay in a year for covered in-network care is $8,050 for an individual and $8,050 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental HSA-eligible?
Yes. Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental 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 Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental use?
Ambetter from Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network, Dep29, Free Telemedicine Program, Pediatric Dental 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
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.