PlatinumEPO

Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture

Issuer 78124

Starting at

$1488

/month before subsidy

Key facts

Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture is a 2026 Platinum EPO health insurance plan from Issuer 78124, sold on the ACA Marketplace in New York under plan ID 78124NY0930007. The monthly premium starts at $1,488 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 $6,350 ($6,350 for a family). After the deductible, coinsurance is 0% for covered in-network care. The plan is not HSA-eligible.

Plan ID
78124NY0930007
Plan year
2026
State
New York
Metal level
Platinum
Plan type
EPO
HSA-eligible
No

Individual Deductible

$0

Family: $0

Out-of-Pocket Max

$6,350

Family: $6,350

Coinsurance

0%

You pay after deductible

Network Type

EPO

NYN011

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

Medical Services

Primary Care VisitSee plan details
Specialist VisitSee plan details
Urgent CareSee plan details
Emergency RoomSee plan details

Prescription Drugs

Generic DrugsSee plan details
Brand Name DrugsSee plan details
Specialty DrugsSee plan details
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 Platinum EPO 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

$2,017/month

Annual Premium

$17,856

OOP Maximum

$6,350

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 0% (coinsurance) until you hit $6,350 total. Then insurance covers everything else for the year.

More plans from Issuer 78124 in New York

View all Marketplace plans in New York

Frequently asked questions about Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture

How much does Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture cost per month?

Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture from Issuer 78124 starts at $1,488 per month before any subsidy in New York. 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 Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture?

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 Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture?

The most you would pay in a year for covered in-network care is $6,350 for an individual and $6,350 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture HSA-eligible?

No. Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture 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 Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture use?

Platinum Select, Platinum, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncture 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

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.