Silver Simple Women's Health with Menopause Benefits

Oscar Insurance Company · 2026 plan year

Silver

Ind. deductible: $6,000
Family deductible: $12,000
Ind. OOP max: $10,150
Family OOP max: $20,300

Compare with other Silver plans in MO

Side by side: deductibles, out-of-pocket limits and copays.

Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Blue Cross and Blue Shield · Deductible $6,000 · Out-of-pocket max $8,900
Cox HealthPlans Silver ConnectCox HealthPlans · Deductible $6,000 · Out-of-pocket max $7,000
UHC Silver Standard+ (Dental + Vision, No Referrals)UnitedHealthcare · Deductible $6,000 · Out-of-pocket max $8,900

Compare 4 plans Browse all Silver plans in MO

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan 94% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Zero Cost Sharing Plan Variation

More Oscar Insurance Company plans in MO

Silver Simple Diabetes Bronze Elite + PCP Saver Plus Silver Simple PCP Saver Silver Elite Saver Plus

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 4 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$337	$337
21	$440	$440
30	$499	$524
40	$562	$613
50	$786	$857
60	$1,194	$1,344
64 and over	$1,320	$1,485

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	No charge

Specialist

Benefit	In-network
Specialist Visit	$40.00

Hospital

Benefit	In-network
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$75.00

Pharmacy

Benefit	In-network
Generic Drugs	$3.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	$75.00 Copay after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	No charge

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Major Dental Care - Child	Not covered
Major Dental Care - Adult	Not covered
Accidental Dental	50.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$40.00
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$40.00
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	No charge
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00% Coinsurance after deductible
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	50.00%
Habilitation Services	No charge
Hearing Aids	50.00% Coinsurance after deductible
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$40.00
Long-Term/Custodial Nursing Home Care	Not covered
Nutritional Counseling	No charge
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Outpatient Rehabilitation Services	No charge
Prenatal and Postnatal Care	No charge
Private-Duty Nursing	50.00% Coinsurance after deductible
Prosthetic Devices	50.00% Coinsurance after deductible
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	No charge
Rehabilitative Speech Therapy	No charge
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	No charge
Routine Foot Care	$40.00
Skilled Nursing Facility	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	No charge
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible