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NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care

Harvard Pilgrim Health Care

Starting at

$716

/month before subsidy

Key facts

NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care is a 2026 Gold HMO health insurance plan from Harvard Pilgrim Health Care, sold on the ACA Marketplace in New Hampshire under plan ID 59025NH0370103. The monthly premium starts at $716 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 $8,700 ($17,400 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.

Plan ID
59025NH0370103
Plan year
2026
State
New Hampshire
Metal level
Gold
Plan type
HMO
HSA-eligible
No

Individual Deductible

$0

Family: $0

Out-of-Pocket Max

$8,700

Family: $17,400

Coinsurance

25%

You pay after deductible

Network Type

HMO

NHN001

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

Medical Services

Primary Care Visit$25.00
Specialist Visit$50.00
Urgent Care$35.00
Emergency Room25.00%

Prescription Drugs

Generic Drugs$10.00
Brand Name Drugs35.00% 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

$3,160

your estimated cost

Deductible
$0
Copays
$60
Coinsurance
$3,100

Managing type 2 diabetes

A year of routine care

$1,830

your estimated cost

Deductible
$1,000
Copays
$800
Coinsurance
$30

A simple fracture

ER visit + follow-up

$900

your estimated cost

Deductible
$0
Copays
$300
Coinsurance
$600
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 Harvard Pilgrim Health Care. 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 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

$1,441/month

Annual Premium

$8,592

OOP Maximum

$8,700

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 25% (coinsurance) until you hit $8,700 total. Then insurance covers everything else for the year.

More plans from Harvard Pilgrim Health Care in New Hampshire

View all Marketplace plans in New Hampshire

Frequently asked questions about NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care

How much does NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care cost per month?

NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care from Harvard Pilgrim Health Care starts at $716 per month before any subsidy in New Hampshire. 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 NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care?

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 NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care?

The most you would pay in a year for covered in-network care is $8,700 for an individual and $17,400 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care HSA-eligible?

No. NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care 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 NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care use?

NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care 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.