Balance by Medica Expanded Bronze Standard
Starting at
$486
/month before subsidy
Balance by Medica Expanded Bronze Standard is a 2026 Expanded_bronze EPO health insurance plan from Medica, sold on the ACA Marketplace in Missouri under plan ID 53461MO0080073. The monthly premium starts at $486 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $7,500 ($15,000 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 HSA-eligible, so it can be paired with a Health Savings Account.
- Plan ID
- 53461MO0080073
- Plan year
- 2026
- State
- Missouri
- Metal level
- Expanded_bronze
- Plan type
- EPO
- HSA-eligible
- Yes
Individual Deductible
$7,500
Family: $15,000
Out-of-Pocket Max
$10,000
Family: $20,000
Coinsurance
50%
You pay after deductible
Network Type
EPO
MON008
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
$9,370
your estimated cost
- Deductible
- $7,500
- Copays
- $10
- Coinsurance
- $1,800
Managing type 2 diabetes
A year of routine care
$2,100
your estimated cost
- Deductible
- $1,100
- Copays
- $1,000
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,800
your estimated cost
- Deductible
- $2,600
- Copays
- $200
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
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.
If you max out this year
$1,319/month
Annual Premium
$5,832
OOP Maximum
$10,000
💡 What this means:
With a $7,500 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 Medica in Missouri
- Balance by Medica Bronze $0 Copay PCP Visitsfrom $482/mo
- Balance by Medica Bronze Premierfrom $491/mo
- Medica with MU Health Care Bronze $0 Copay PCP Visitsfrom $558/mo
- Medica with MU Health Care Bronze Premierfrom $568/mo
- Medica with MU Health Care Expanded Bronze Standardfrom $562/mo
- Medica with SSM Health Bronze $0 Copay PCP Visitsfrom $487/mo
- Medica with SSM Health Bronze Sharefrom $468/mo
- Medica with SSM Health Expanded Bronze Standardfrom $491/mo
Frequently asked questions about Balance by Medica Expanded Bronze Standard
How much does Balance by Medica Expanded Bronze Standard cost per month?
Balance by Medica Expanded Bronze Standard from Medica starts at $486 per month before any subsidy in Missouri. 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 Balance by Medica Expanded Bronze Standard?
The individual medical deductible is $7,500, and the family deductible is $15,000. 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 Balance by Medica Expanded Bronze Standard?
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 Balance by Medica Expanded Bronze Standard HSA-eligible?
Yes. Balance by Medica Expanded Bronze Standard 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 Balance by Medica Expanded Bronze Standard use?
Balance by Medica Expanded Bronze Standard 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.