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Expanded_bronzeHMOHSA Eligible

Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx

Antidote Health Plan of Ohio, Inc.

Starting at

$413

/month before subsidy

Key facts

Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx is a 2026 Expanded_bronze HMO health insurance plan from Antidote Health Plan of Ohio, Inc., sold on the ACA Marketplace in Ohio under plan ID 31981OH0030010. The monthly premium starts at $413 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $8,000 ($16,000 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 40% for covered in-network care. The plan is HSA-eligible, so it can be paired with a Health Savings Account.

Plan ID
31981OH0030010
Plan year
2026
State
Ohio
Metal level
Expanded_bronze
Plan type
HMO
HSA-eligible
Yes

Individual Deductible

$8,000

Family: $16,000

Out-of-Pocket Max

$10,600

Family: $21,200

Coinsurance

40%

You pay after deductible

Network Type

HMO

OHN001

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

Medical Services

Primary Care Visit$0.00
Specialist Visit$100.00
Urgent Care40.00% Coinsurance after deductible
Emergency Room40.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$35.00
Brand Name Drugs40.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible
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

$8,160

your estimated cost

Deductible
$6,500
Copays
$700
Coinsurance
$900

Managing type 2 diabetes

A year of routine care

$3,220

your estimated cost

Deductible
$800
Copays
$2,400
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,800

your estimated cost

Deductible
$2,100
Copays
$700
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 Antidote Health Plan of Ohio, Inc.. 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

$1,296/month

Annual Premium

$4,956

OOP Maximum

$10,600

💡 What this means:

With a $8,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 40% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.

More plans from Antidote Health Plan of Ohio, Inc. in Ohio

View all Marketplace plans in Ohio

Frequently asked questions about Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx

How much does Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx cost per month?

Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx from Antidote Health Plan of Ohio, Inc. starts at $413 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 Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx?

The individual medical deductible is $8,000, and the family deductible is $16,000. 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 Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx?

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 Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HSA-eligible?

Yes. Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx 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 Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx use?

Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx 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

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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.