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SilverHMO

Focused Silver

Ambetter Health

Starting at

$464

/month before subsidy

Key facts

Focused Silver is a 2026 Silver HMO health insurance plan from Ambetter Health, sold on the ACA Marketplace in Iowa under plan ID 48286IA0010019. The monthly premium starts at $464 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $6,300 ($12,600 for a family), and the individual out-of-pocket maximum is $8,400 ($16,800 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.

Plan ID
48286IA0010019
Plan year
2026
State
Iowa
Metal level
Silver
Plan type
HMO
HSA-eligible
No

Individual Deductible

$6,300

Family: $12,600

Out-of-Pocket Max

$8,400

Family: $16,800

Coinsurance

50%

You pay after deductible

Network Type

HMO

IAN001

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

Medical Services

Primary Care Visit$40.00
Specialist Visit$85.00
Urgent Care$60.00
Emergency Room50.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs45.00% Coinsurance after deductible
Specialty Drugs50.00% 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

$8,260

your estimated cost

Deductible
$6,300
Copays
$600
Coinsurance
$1,300

Managing type 2 diabetes

A year of routine care

$2,520

your estimated cost

Deductible
$800
Copays
$1,700
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,800

your estimated cost

Deductible
$2,500
Copays
$300
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 Ambetter Health. 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

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

$1,164/month

Annual Premium

$5,568

OOP Maximum

$8,400

💡 What this means:

With a $6,300 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $8,400 total. Then insurance covers everything else for the year.

More plans from Ambetter Health in Iowa

View all Marketplace plans in Iowa

Frequently asked questions about Focused Silver

How much does Focused Silver cost per month?

Focused Silver from Ambetter Health starts at $464 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 Focused Silver?

The individual medical deductible is $6,300, and the family deductible is $12,600. 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 Focused Silver?

The most you would pay in a year for covered in-network care is $8,400 for an individual and $16,800 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Focused Silver HSA-eligible?

No. Focused Silver 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 Focused Silver use?

Focused Silver 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.