SilverEPO

Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental

Issuer 78124

Starting at

$994

/month before subsidy

Key facts

Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental is a 2026 Silver EPO health insurance plan from Issuer 78124, sold on the ACA Marketplace in New York under plan ID 78124NY0940007. The monthly premium starts at $994 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $2,450 ($2,450 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
78124NY0940007
Plan year
2026
State
New York
Metal level
Silver
Plan type
EPO
HSA-eligible
No

Individual Deductible

$2,450

Family: $2,450

Out-of-Pocket Max

$10,150

Family: $10,150

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 Silver EPO 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

$1,840/month

Annual Premium

$11,928

OOP Maximum

$10,150

💡 What this means:

With a $2,450 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

View all Marketplace plans in New York

Frequently asked questions about Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental

How much does Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental cost per month?

Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental from Issuer 78124 starts at $994 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 Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental?

The individual medical deductible is $2,450, and the family deductible is $2,450. 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 Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, 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 Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental HSA-eligible?

No. Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, 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 Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, Pediatric Dental use?

Silver Standard, Silver, ST, INN, Univera EPO Local, Dep29, 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

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.