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Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health

Oscar Health Plan of North Carolina, Inc

Starting at

$461

/month before subsidy

Key facts

Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health is a 2026 Expanded_bronze HMO health insurance plan from Oscar Health Plan of North Carolina, Inc, sold on the ACA Marketplace in North Carolina under plan ID 69803NC0010058. The monthly premium starts at $461 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,500 ($11,000 for a family), and the individual out-of-pocket maximum is $10,150 ($20,300 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
69803NC0010058
Plan year
2026
State
North Carolina
Metal level
Expanded_bronze
Plan type
HMO
HSA-eligible
Yes

Individual Deductible

$5,500

Family: $11,000

Out-of-Pocket Max

$10,150

Family: $20,300

Coinsurance

50%

You pay after deductible

Network Type

HMO

NCN001

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

Medical Services

Primary Care Visit$50.00
Specialist Visit$150.00
Urgent Care$200.00
Emergency Room50.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs50.00% 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

$8,300

your estimated cost

Deductible
$5,500
Copays
$0
Coinsurance
$2,800

Managing type 2 diabetes

A year of routine care

$5,100

your estimated cost

Deductible
$4,600
Copays
$500
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 Oscar Health Plan of North Carolina, Inc. 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

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.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,307/month

Annual Premium

$5,532

OOP Maximum

$10,150

💡 What this means:

With a $5,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $10,150 total. Then insurance covers everything else for the year.

More plans from Oscar Health Plan of North Carolina, Inc in North Carolina

View all Marketplace plans in North Carolina

Frequently asked questions about Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health

How much does Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health cost per month?

Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health from Oscar Health Plan of North Carolina, Inc starts at $461 per month before any subsidy in North Carolina. 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 Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health?

The individual medical deductible is $5,500, and the family deductible is $11,000. 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 Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health?

The most you would pay in a year for covered in-network care is $10,150 for an individual and $20,300 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health HSA-eligible?

Yes. Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health 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 Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health use?

Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health 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.