SilverHMO

Wellmark Silver Primary Care | UnityPoint Health

Wellmark Health Plan of Iowa, Inc.

Starting at

$487

/month before subsidy

Key facts

Wellmark Silver Primary Care | UnityPoint Health is a 2026 Silver HMO health insurance plan from Wellmark Health Plan of Iowa, Inc., sold on the ACA Marketplace in Iowa under plan ID 25896IA0370010. The monthly premium starts at $487 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,700 ($11,400 for a family), and the individual out-of-pocket maximum is $8,000 ($16,000 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.

Plan ID
25896IA0370010
Plan year
2026
State
Iowa
Metal level
Silver
Plan type
HMO
HSA-eligible
No

Individual Deductible

$5,700

Family: $11,400

Out-of-Pocket Max

$8,000

Family: $16,000

Coinsurance

30%

You pay after deductible

Network Type

HMO

IAN002

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

Medical Services

Primary Care Visit$10.00
Specialist Visit$80.00
Urgent Care$25.00
Emergency Room30.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$10.00
Brand Name Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance 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.
4.0overall
Medical care

How well doctors manage and coordinate care

Member experience

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

$6,570

your estimated cost

Deductible
$5,700
Copays
$10
Coinsurance
$800

Managing type 2 diabetes

A year of routine care

$4,620

your estimated cost

Deductible
$4,300
Copays
$300
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 Wellmark Health Plan of Iowa, Inc.. These are the authoritative source for coverage details.
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

$1,154/month

Annual Premium

$5,844

OOP Maximum

$8,000

💡 What this means:

With a $5,700 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $8,000 total. Then insurance covers everything else for the year.

More plans from Wellmark Health Plan of Iowa, Inc. in Iowa

View all Marketplace plans in Iowa

Frequently asked questions about Wellmark Silver Primary Care | UnityPoint Health

How much does Wellmark Silver Primary Care | UnityPoint Health cost per month?

Wellmark Silver Primary Care | UnityPoint Health from Wellmark Health Plan of Iowa, Inc. starts at $487 per month before any subsidy in Iowa. 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 Wellmark Silver Primary Care | UnityPoint Health?

The individual medical deductible is $5,700, and the family deductible is $11,400. 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 Wellmark Silver Primary Care | UnityPoint Health?

The most you would pay in a year for covered in-network care is $8,000 for an individual and $16,000 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Wellmark Silver Primary Care | UnityPoint Health HSA-eligible?

No. Wellmark Silver Primary Care | UnityPoint Health 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 Wellmark Silver Primary Care | UnityPoint Health use?

Wellmark Silver Primary Care | UnityPoint Health 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

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.