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SilverHMO

NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care

Harvard Pilgrim Health Care

Starting at

$699

/month before subsidy

Key facts

NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care is a 2026 Silver HMO health insurance plan from Harvard Pilgrim Health Care, sold on the ACA Marketplace in New Hampshire under plan ID 59025NH0370106. The monthly premium starts at $699 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $3,500 ($7,000 for a family), and the individual out-of-pocket maximum is $8,200 ($16,400 for a family). After the deductible, coinsurance is 20% for covered in-network care. The plan is not HSA-eligible.

Plan ID
59025NH0370106
Plan year
2026
State
New Hampshire
Metal level
Silver
Plan type
HMO
HSA-eligible
No

Individual Deductible

$3,500

Family: $7,000

Out-of-Pocket Max

$8,200

Family: $16,400

Coinsurance

20%

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$40.00
Specialist Visit$80.00
Urgent Care$50.00
Emergency Room$500.00 Copay after deductible

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

$4,700

your estimated cost

Deductible
$3,500
Copays
$1,100
Coinsurance
$100

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
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 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

$1,382/month

Annual Premium

$8,388

OOP Maximum

$8,200

💡 What this means:

With a $3,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 20% (coinsurance) until you hit $8,200 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 Silver 3500 + $0 Rx list + $0 Virtual Urgent Care

How much does NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care cost per month?

NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care from Harvard Pilgrim Health Care starts at $699 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 Silver 3500 + $0 Rx list + $0 Virtual Urgent Care?

The individual medical deductible is $3,500, and the family deductible is $7,000. 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 NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care?

The most you would pay in a year for covered in-network care is $8,200 for an individual and $16,400 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 Silver 3500 + $0 Rx list + $0 Virtual Urgent Care HSA-eligible?

No. NH Local Choice HMO Silver 3500 + $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 Silver 3500 + $0 Rx list + $0 Virtual Urgent Care use?

NH Local Choice HMO Silver 3500 + $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.