Gold PPO Standard Pathway
Starting at
$1243
/month before subsidy
Gold PPO Standard Pathway is a 2026 Gold PPO health insurance plan from Issuer 86545, sold on the ACA Marketplace in Connecticut under plan ID 86545CT1330003. The monthly premium starts at $1,243 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,200 ($1,200 for a family), and the individual out-of-pocket maximum is $7,375 ($7,375 for a family). After the deductible, coinsurance is 0% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 86545CT1330003
- Plan year
- 2026
- State
- Connecticut
- Metal level
- Gold
- Plan type
- PPO
- HSA-eligible
- No
Individual Deductible
$1,200
Family: $1,200
Out-of-Pocket Max
$7,375
Family: $7,375
Coinsurance
0%
You pay after deductible
Network Type
PPO
CTN002
Medical Services
Prescription Drugs
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This Gold PPO 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
$1,858/month
Annual Premium
$14,916
OOP Maximum
$7,375
💡 What this means:
With a $1,200 deductible, you pay 100% of costs until you've spent that much. After that, you pay 0% (coinsurance) until you hit $7,375 total. Then insurance covers everything else for the year.
More plans from Issuer 86545 in Connecticut
- Catastrophic HMO Pathway Enhancedfrom $325/mo
- Bronze HMO Pathway Enhancedfrom $557/mo
- Bronze HMO Pathway Enhanced with Adult Dental and Vision Benefitsfrom $562/mo
- Bronze PPO Pathway with PreventiveRx HSAfrom $590/mo
- Bronze PPO Standard Pathwayfrom $638/mo
- Bronze PPO Standard Pathway HSAfrom $599/mo
- Silver PPO Standard Pathwayfrom $677/mo
- Gold HMO Pathway Enhanced with Adult Dental and Vision Benefitsfrom $719/mo
Frequently asked questions about Gold PPO Standard Pathway
How much does Gold PPO Standard Pathway cost per month?
Gold PPO Standard Pathway from Issuer 86545 starts at $1,243 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 PPO Standard Pathway?
The individual medical deductible is $1,200, and the family deductible is $1,200. 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 PPO Standard Pathway?
The most you would pay in a year for covered in-network care is $7,375 for an individual and $7,375 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Gold PPO Standard Pathway HSA-eligible?
No. Gold PPO Standard Pathway 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 PPO Standard Pathway use?
Gold PPO Standard Pathway is a PPO plan. PPO plans let you see specialists without a referral and use out-of-network providers (at higher cost), offering the most flexibility.
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.