Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental
Starting at
$999999
/month before subsidy
Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental is a 2026 Gold EPO health insurance plan from Issuer 78124, sold on the ACA Marketplace in New York under plan ID 78124NY0940005. The monthly premium starts at $999,999 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $775 ($775 for a family), and the individual out-of-pocket maximum is $10,150 ($10,150 for a family). After the deductible, coinsurance is 0% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 78124NY0940005
- Plan year
- 2026
- State
- New York
- Metal level
- Gold
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$775
Family: $775
Out-of-Pocket Max
$10,150
Family: $10,150
Coinsurance
0%
You pay after deductible
Network Type
EPO
NYN011
Medical Services
Prescription Drugs
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This Gold 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.
If you max out this year
$1,000,845/month
Annual Premium
$11,999,988
OOP Maximum
$10,150
💡 What this means:
With a $775 deductible, you pay 100% of costs until you've spent that much. After that, you pay 0% (coinsurance) until you hit $10,150 total. Then insurance covers everything else for the year.
More plans from Issuer 78124 in New York
- Base Catastrophic, ST, INN, Excellus BCBS EPO, Dep25, Pediatric Dentalfrom $456/mo
- Bronze Secure Plus 3, Expanded Bronze, NS, INN, Excellus BCBS EPO, Dep25, Adult/Family Dental, Adult Vision, Acupuncturefrom $768/mo
- Bronze Secure Plus 3, Expanded Bronze, NS, INN, Excellus BCBS EPO, Dep29, Adult/Family Dental, Adult Vision, Acupuncturefrom $783/mo
- Bronze Secure Plus 3, Expanded Bronze, NS, INN, Univera EPO Local, Dep25, Adult/Family Dental, Adult Vision, Acupuncturefrom $677/mo
- Bronze Secure Plus 3, Expanded Bronze, NS, INN, Univera EPO Local, Dep29, Adult/Family Dental, Adult Vision, Acupuncturefrom $690/mo
- Bronze Select, Expanded Bronze, NS, INN, Excellus BCBS EPO, Dep25, Adult/Family Dental, Adult Vision, Preventive Rx, Acupuncturefrom $833/mo
- Bronze Select, Expanded Bronze, NS, INN, Excellus BCBS EPO, Dep29, Adult/Family Dental, Adult Vision, Preventive Rx, Acupuncturefrom $849/mo
- Bronze Select, Expanded Bronze, NS, INN, Univera EPO Local, Dep25, Adult/Family Dental, Adult Vision, Preventive Rx, Acupuncturefrom $735/mo
Frequently asked questions about Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental
How much does Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental cost per month?
Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental from Issuer 78124 starts at $999,999 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 Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental?
The individual medical deductible is $775, and the family deductible is $775. 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 Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental?
The most you would pay in a year for covered in-network care is $10,150 for an individual and $10,150 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental HSA-eligible?
No. Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental 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 Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental use?
Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental 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.