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Oscar Simple Silver
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Oscar Simple Silver

Overview
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Oscar Simple Silver is an individual health health plan issued by Oscar Insurance Company and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Davidson county, Tennessee.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Oscar Insurance Company
Plan ID
23552TN0030001
Coverage area
Davidson County, Tennessee
Phone
Local Phone: 1-855-672-2755
Toll-Free: 1-855-672-2755
TTY: 1-855-672-2755
Plan type
EPO
Coverage type
Medical deductible
$7,900
Out-of-pocket maximum
$7,900
Generic drug co-pay
$15
Preferred brand drug co-pay
$75
Primary care physician visit cost
$25
Specialist doctor visit cost
$50
Doctor Visits
Primary Care Visit $25
Specialist Visit $50
Emergency Room Visit No Charge after Deductible
Inpatient Facility Visit No Charge after Deductible
Inpatient Physician Visit No Charge after Deductible
Prescription Drugs
Generic Drugs $15
Preferred Brand Drugs $75
Non-preferred Brand Drugs No Charge after Deductible
Specialty Drugs No Charge after Deductible
Medical Deductible
Medical Deductible (Individual) $7,900
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $15,800
Medical Maximum Out Of Pocket (Family) $15,800
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 99.93%
Premium Child Age 0-14 403
Premium Child Age 18 481
Premium Adult Individual Age 21 527
Premium Adult Individual Age 27 552
Premium Adult Individual Age 30 598
Premium Adult Individual Age 40 673
Premium Adult Individual Age 50 941
Premium Adult Individual Age 60 1,431
Premium Couple 21 1,054
Premium Couple 30 1,197
Premium Couple 40 1,347
Premium Couple 50 1,883
Premium Couple 60 2,862
Couple+1 child, Age 21 1,458
Couple+1 child, Age 30 1,600
Couple+1 child, Age 40 1,751
Couple+1 child, Age 50 2,287
Couple+2 children, Age 21 1,861
Couple+2 children, Age 30 2,003
Couple+2 children, Age 40 2,154
Couple+2 children, Age 50 2,690
Couple+3 or more Children, Age 21 2,264
Couple+3 or more Children, Age 30 2,407
Couple+3 or more Children, Age 40 2,558
Couple+3 or more Children, Age 50 3,093
Individual+1 child, Age 21 930
Individual+1 child, Age 30 1,001
Individual+1 child, Age 40 1,077
Individual+1 child, Age 50 1,345
Individual+2 children, Age 21 1,334
Individual+2 children, Age 30 1,405
Individual+2 children, Age 40 1,480
Individual+2 children, Age 50 1,748
Individual+3 or more children, Age 21 1,737
Individual+3 or more children, Age 30 1,808
Individual+3 or more children, Age 40 1,884
Individual+3 or more children, Age 50 2,152
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types