Gold Simple Diabetes
Starting at
$636
/month before subsidy
Gold Simple Diabetes is a 2027 Gold HMO health insurance plan from Oscar Health Insurance, sold on the ACA Marketplace in Ohio under plan ID 29341OH0100096. The monthly premium starts at $636 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,000 ($2,000 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 20% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 29341OH0100096
- Plan year
- 2027
- State
- Ohio
- Metal level
- Gold
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$1,000
Family: $2,000
Out-of-Pocket Max
$10,600
Family: $21,200
Coinsurance
20%
You pay after deductible
Network Type
HMO
OHN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Not rated
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$3,000
your estimated cost
- Deductible
- $1,000
- Copays
- $100
- Coinsurance
- $1,900
Managing type 2 diabetes
A year of routine care
$1,800
your estimated cost
- Deductible
- $0
- Copays
- $1,800
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$1,300
your estimated cost
- Deductible
- $1,000
- Copays
- $100
- Coinsurance
- $200
Enter your ZIP code first to search nearby doctors.
This Gold HMO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.
Consider this plan if you:
- Have ongoing health conditions requiring regular care
- Take multiple prescription medications
- Prefer lower costs at the time of service
- Want peace of mind with comprehensive coverage
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,519/month
Annual Premium
$7,632
OOP Maximum
$10,600
💡 What this means:
With a $1,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 20% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.
More plans from Oscar Health Insurance in Ohio
- Bronze Classic 4700from $438/mo
- Bronze Classic Standardfrom $440/mo
- Bronze Elite + PCP Saver Plusfrom $461/mo
- Bronze Simple Breathe Easy with Enhanced COPD Benefitsfrom $449/mo
- Bronze Simple Chronic Care CKMfrom $453/mo
- Bronze Simple Diabetesfrom $447/mo
- Bronze Simple Diabetes with Adult Dental & Visionfrom $479/mo
- Silver Classic Standardfrom $572/mo
Frequently asked questions about Gold Simple Diabetes
How much does Gold Simple Diabetes cost per month?
Gold Simple Diabetes from Oscar Health Insurance starts at $636 per month before any subsidy in Ohio. 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 Gold Simple Diabetes?
The individual medical deductible is $1,000, and the family deductible is $2,000. 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 Gold Simple Diabetes?
The most you would pay in a year for covered in-network care is $10,600 for an individual and $21,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Gold Simple Diabetes HSA-eligible?
No. Gold Simple Diabetes 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 Gold Simple Diabetes use?
Gold Simple Diabetes 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
- The SLCSP benchmark
The Silver plan that sets your subsidy and Form 1095-A
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.