Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.
Bronze Elite + PCP Saver Plus
Oscar Health Plan of North Carolina, Inc · 2026 plan year
Expanded BronzeHSA eligible
- Ind. medical deductible
- $0
- Rx deductible (separate)
- $7,000
- Family deductible
- $0
- Ind. OOP max
- $10,600
- Family OOP max
- $21,200
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Other cost-sharing reduction variants for this plan:
More Oscar Health Plan of North Carolina, Inc plans in NC
Monthly premiums by age
Rating Area 7 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $305 | $305 |
| 21 | $399 | $399 |
| 30 | $452 | $475 |
| 40 | $509 | $555 |
| 50 | $712 | $776 |
| 60 | $1,082 | $1,217 |
| 64 and over | $1,196 | $1,345 |
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 | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $125.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $2,000.00 |
| Outpatient Surgery Physician/Surgical Services | $350.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $3000.00 Copay per Day |
| 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 | $100.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $3000.00 Copay per Day |
| Mental/Behavioral Health Outpatient Services | $125.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | $350.00 |
| Acupuncture | Not covered |
| Allergy Testing | $125.00 |
| Bariatric Surgery | $3,000.00 |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | 50.00% |
| Chiropractic Care | $125.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $3,000.00 |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | No charge |
| Dialysis | 50.00% |
| Durable Medical Equipment | 50.00% |
| Emergency Transportation/Ambulance | $2,000.00 |
| Eye Glasses for Children | 50.00% |
| Habilitation Services | $125.00 |
| Hearing Aids | 50.00% |
| Home Health Care Services | 50.00% |
| Hospice Services | 50.00% |
| Imaging (CT/PET Scans, MRIs) | $750.00 |
| Infertility Treatment | 50.00% |
| Infusion Therapy | 50.00% |
| Inpatient Physician and Surgical Services | $350.00 |
| Laboratory Outpatient and Professional Services | $50.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | $50.00 |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $1,200.00 |
| Outpatient Rehabilitation Services | $125.00 |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | 50.00% |
| Prosthetic Devices | 50.00% |
| Radiation | 50.00% |
| Reconstructive Surgery | $3,000.00 |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $125.00 |
| Rehabilitative Speech Therapy | $125.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | $3000.00 Copay per Day |
| Substance Abuse Disorder Inpatient Services | $3000.00 Copay per Day |
| Substance Abuse Disorder Outpatient Services | $125.00 |
| Transplant | $3,000.00 |
| Treatment for Temporomandibular Joint Disorders | 50.00% |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $135.00 |
Service area
This plan covers 11 geographic areas.
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