Silver Simple Diabetes
Starting at
$560
/month before subsidy
Silver Simple Diabetes is a 2026 Silver EPO health insurance plan from Oscar Insurance Company, sold on the ACA Marketplace in Iowa under plan ID 45819IA0010064. The monthly premium starts at $560 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $6,500 ($13,000 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 not HSA-eligible.
- Plan ID
- 45819IA0010064
- Plan year
- 2026
- State
- Iowa
- Metal level
- Silver
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$6,500
Family: $13,000
Out-of-Pocket Max
$10,000
Family: $20,000
Coinsurance
50%
You pay after deductible
Network Type
EPO
IAN002
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
$8,600
your estimated cost
- Deductible
- $6,500
- Copays
- $200
- Coinsurance
- $1,900
Managing type 2 diabetes
A year of routine care
$4,400
your estimated cost
- Deductible
- $4,200
- Copays
- $200
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,680
your estimated cost
- Deductible
- $2,600
- Copays
- $80
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver EPO 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.
If you max out this year
$1,393/month
Annual Premium
$6,720
OOP Maximum
$10,000
💡 What this means:
With a $6,500 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 Oscar Insurance Company in Iowa
Frequently asked questions about Silver Simple Diabetes
How much does Silver Simple Diabetes cost per month?
Silver Simple Diabetes from Oscar Insurance Company starts at $560 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 Silver Simple Diabetes?
The individual medical deductible is $6,500, and the family deductible is $13,000. 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 Silver Simple Diabetes?
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 Silver Simple Diabetes HSA-eligible?
No. Silver 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 Silver Simple Diabetes use?
Silver Simple Diabetes is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.
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.