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GoldEPO

UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

UnitedHealthcare

Starting at

$606

/month before subsidy

Key facts

UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) is a 2026 Gold EPO health insurance plan from UnitedHealthcare, sold on the ACA Marketplace in Missouri under plan ID 95426MO0420001. The monthly premium starts at $606 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,500 ($3,000 for a family), and the individual out-of-pocket maximum is $8,100 ($16,200 for a family). After the deductible, coinsurance is 35% for covered in-network care. The plan is not HSA-eligible.

Plan ID
95426MO0420001
Plan year
2026
State
Missouri
Metal level
Gold
Plan type
EPO
HSA-eligible
No

Individual Deductible

$1,500

Family: $3,000

Out-of-Pocket Max

$8,100

Family: $16,200

Coinsurance

35%

You pay after deductible

Network Type

EPO

MON011

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

Medical Services

Primary Care Visit$15.00
Specialist Visit$65.00
Urgent Care$50.00
Emergency Room$500.00 Copay after deductible

Prescription Drugs

Generic Drugs$10.00
Brand Name Drugs30.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
3.0overall
Medical care

How well doctors manage and coordinate care

Member experience
Not rated

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$4,660

your estimated cost

Deductible
$1,500
Copays
$100
Coinsurance
$3,000

Managing type 2 diabetes

A year of routine care

$500

your estimated cost

Deductible
$200
Copays
$300
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,210

your estimated cost

Deductible
$1,500
Copays
$700
Coinsurance
$10
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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Official Plan Documents
Published by UnitedHealthcare. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

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.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,281/month

Annual Premium

$7,272

OOP Maximum

$8,100

💡 What this means:

With a $1,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 35% (coinsurance) until you hit $8,100 total. Then insurance covers everything else for the year.

More plans from UnitedHealthcare in Missouri

View all Marketplace plans in Missouri

Frequently asked questions about UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

How much does UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) cost per month?

UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) from UnitedHealthcare starts at $606 per month before any subsidy in Missouri. 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 UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals)?

The individual medical deductible is $1,500, and the family deductible is $3,000. 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 UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals)?

The most you would pay in a year for covered in-network care is $8,100 for an individual and $16,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HSA-eligible?

No. UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) 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 UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) use?

UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) 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

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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.