GoldHMO

Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits

Issuer 86545

Starting at

$719

/month before subsidy

Key facts

Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits is a 2026 Gold HMO health insurance plan from Issuer 86545, sold on the ACA Marketplace in Connecticut under plan ID 86545CT1230027. The monthly premium starts at $719 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $2,000 ($2,000 for a family), and the individual out-of-pocket maximum is $8,000 ($8,000 for a family). After the deductible, coinsurance is 10% for covered in-network care. The plan is not HSA-eligible.

Plan ID
86545CT1230027
Plan year
2026
State
Connecticut
Metal level
Gold
Plan type
HMO
HSA-eligible
No

Individual Deductible

$2,000

Family: $2,000

Out-of-Pocket Max

$8,000

Family: $8,000

Coinsurance

10%

You pay after deductible

Network Type

HMO

CTN001

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 Gold HMO 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

$1,386/month

Annual Premium

$8,628

OOP Maximum

$8,000

💡 What this means:

With a $2,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 10% (coinsurance) until you hit $8,000 total. Then insurance covers everything else for the year.

More plans from Issuer 86545 in Connecticut

View all Marketplace plans in Connecticut

Frequently asked questions about Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits

How much does Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits cost per month?

Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits from Issuer 86545 starts at $719 per month before any subsidy in Connecticut. 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 HMO Pathway Enhanced with Adult Dental and Vision Benefits?

The individual medical deductible is $2,000, and the family deductible is $2,000. 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 Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits?

The most you would pay in a year for covered in-network care is $8,000 for an individual and $8,000 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits HSA-eligible?

No. Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits 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 HMO Pathway Enhanced with Adult Dental and Vision Benefits use?

Gold HMO Pathway Enhanced with Adult Dental and Vision Benefits 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

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.