Silver $5,000 w/ Adult Dental ON-EX
Starting at
$561
/month before subsidy
Silver $5,000 w/ Adult Dental ON-EX is a 2026 Silver HMO health insurance plan from MedMutual, sold on the ACA Marketplace in Ohio under plan ID 99969OH0080549. The monthly premium starts at $561 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,000 ($10,000 for a family), and the individual out-of-pocket maximum is $8,500 ($17,000 for a family). After the deductible, coinsurance is 35% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 99969OH0080549
- Plan year
- 2026
- State
- Ohio
- Metal level
- Silver
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$5,000
Family: $10,000
Out-of-Pocket Max
$8,500
Family: $17,000
Coinsurance
35%
You pay after deductible
Network Type
HMO
OHN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$7,350
your estimated cost
- Deductible
- $5,000
- Copays
- $90
- Coinsurance
- $2,200
Managing type 2 diabetes
A year of routine care
$1,220
your estimated cost
- Deductible
- $0
- Copays
- $1,200
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,300
your estimated cost
- Deductible
- $2,100
- Copays
- $200
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver HMO 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.
If you max out this year
$1,269/month
Annual Premium
$6,732
OOP Maximum
$8,500
💡 What this means:
With a $5,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 35% (coinsurance) until you hit $8,500 total. Then insurance covers everything else for the year.
More plans from MedMutual in Ohio
- Bronze $8,300 w/ Adult Dental ON-EXfrom $397/mo
- Bronze $8,300 w/ Virtual & Wellness ON-EXfrom $389/mo
- Bronze HSA $7,300 ON-EXfrom $409/mo
- Bronze Standard w/ Virtual & Wellnessfrom $406/mo
- Silver $5,000 w/ Virtual & Wellness ON-EXfrom $550/mo
- Silver $5,800 w/ Virtual & Wellness ON-EXfrom $536/mo
- Silver Standard w/ Virtual & Wellnessfrom $550/mo
- Gold $1,000 w/ Adult Dental ON-EXfrom $634/mo
Frequently asked questions about Silver $5,000 w/ Adult Dental ON-EX
How much does Silver $5,000 w/ Adult Dental ON-EX cost per month?
Silver $5,000 w/ Adult Dental ON-EX from MedMutual starts at $561 per month before any subsidy in Ohio. 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 $5,000 w/ Adult Dental ON-EX?
The individual medical deductible is $5,000, and the family deductible is $10,000. 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 Silver $5,000 w/ Adult Dental ON-EX?
The most you would pay in a year for covered in-network care is $8,500 for an individual and $17,000 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Silver $5,000 w/ Adult Dental ON-EX HSA-eligible?
No. Silver $5,000 w/ Adult Dental ON-EX 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 $5,000 w/ Adult Dental ON-EX use?
Silver $5,000 w/ Adult Dental ON-EX 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
- 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.