GoldHMO

Gold Elite Saver Plus | Cleveland Clinic

Oscar Insurance Corporation of Ohio

Starting at

$859

/month before subsidy

Key facts

Gold Elite Saver Plus | Cleveland Clinic is a 2026 Gold HMO health insurance plan from Oscar Insurance Corporation of Ohio, sold on the ACA Marketplace in Ohio under plan ID 45845OH0100035. The monthly premium starts at $859 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $0, and the individual out-of-pocket maximum is $8,900 ($17,800 for a family). After the deductible, coinsurance is 20% for covered in-network care. The plan is not HSA-eligible.

Plan ID
45845OH0100035
Plan year
2026
State
Ohio
Metal level
Gold
Plan type
HMO
HSA-eligible
No

Individual Deductible

$0

Family: $0

Out-of-Pocket Max

$8,900

Family: $17,800

Coinsurance

20%

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$25.00
Urgent Care$50.00
Emergency Room$550.00

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% 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.
5.0overall
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

$1,700

your estimated cost

Deductible
$0
Copays
$1,700
Coinsurance
$0

Managing type 2 diabetes

A year of routine care

$1,950

your estimated cost

Deductible
$250
Copays
$1,700
Coinsurance
$0

A simple fracture

ER visit + follow-up

$1,350

your estimated cost

Deductible
$0
Copays
$1,300
Coinsurance
$50
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 Oscar Insurance Corporation of Ohio. These are the authoritative source for coverage details.
Who This Plan Is Best For

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.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,601/month

Annual Premium

$10,308

OOP Maximum

$8,900

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 20% (coinsurance) until you hit $8,900 total. Then insurance covers everything else for the year.

More plans from Oscar Insurance Corporation of Ohio in Ohio

View all Marketplace plans in Ohio

Frequently asked questions about Gold Elite Saver Plus | Cleveland Clinic

How much does Gold Elite Saver Plus | Cleveland Clinic cost per month?

Gold Elite Saver Plus | Cleveland Clinic from Oscar Insurance Corporation of Ohio starts at $859 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 Elite Saver Plus | Cleveland Clinic?

The individual medical deductible is $0. 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 Elite Saver Plus | Cleveland Clinic?

The most you would pay in a year for covered in-network care is $8,900 for an individual and $17,800 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Gold Elite Saver Plus | Cleveland Clinic HSA-eligible?

No. Gold Elite Saver Plus | Cleveland Clinic 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 Elite Saver Plus | Cleveland Clinic use?

Gold Elite Saver Plus | Cleveland Clinic 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.