SilverHMO

Streamlined Silver

Ambetter Health

Starting at

$471

/month before subsidy

Key facts

Streamlined Silver is a 2027 Silver HMO health insurance plan from Ambetter Health, sold on the ACA Marketplace in Iowa under plan ID 48286IA0010025. The monthly premium starts at $471 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $4,700 ($9,400 for a family), and the individual out-of-pocket maximum is $11,300 ($22,600 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.

Plan ID
48286IA0010025
Plan year
2027
State
Iowa
Metal level
Silver
Plan type
HMO
HSA-eligible
No

Individual Deductible

$4,700

Family: $9,400

Out-of-Pocket Max

$11,300

Family: $22,600

Coinsurance

30%

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$20.00
Specialist Visit$60.00
Urgent Care$55.00
Emergency Room30.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs40.00% Coinsurance after deductible
Specialty Drugs45.00% 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

$6,560

your estimated cost

Deductible
$4,700
Copays
$600
Coinsurance
$1,200

Managing type 2 diabetes

A year of routine care

$4,420

your estimated cost

Deductible
$3,900
Copays
$500
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,700

your estimated cost

Deductible
$2,500
Copays
$200
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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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

$1,413/month

Annual Premium

$5,652

OOP Maximum

$11,300

💡 What this means:

With a $4,700 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $11,300 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 Streamlined Silver

How much does Streamlined Silver cost per month?

Streamlined Silver from Ambetter Health starts at $471 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 Streamlined Silver?

The individual medical deductible is $4,700, and the family deductible is $9,400. 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 Streamlined Silver?

The most you would pay in a year for covered in-network care is $11,300 for an individual and $22,600 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Streamlined Silver HSA-eligible?

No. Streamlined 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 Streamlined Silver use?

Streamlined 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

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.