Silver Classic

Oscar Insurance Company · 2026 plan year

Silver
Ind. deductible
$5,600
Family deductible
$11,200
Ind. OOP max
$8,400
Family OOP max
$16,800

Compare with other Silver plans in MI

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

More Oscar Insurance Company plans in MI

Monthly premiums by age

Rating Area 12

AgeIndividualIndividual + tobacco
Under 15$285$285
21$372$372
30$422$443
40$476$518
50$665$724
60$1,010$1,136
64 and over$1,116$1,256

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$35.00

Specialist

BenefitIn-network
Specialist Visit$80.00

Hospital

BenefitIn-network
Emergency Room Services$750.00 Copay after deductible
Outpatient Surgery Physician/Surgical Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Urgent Care Centers or Facilities$80.00

Pharmacy

BenefitIn-network
Generic Drugs$3.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs$75.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$35.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental DentalNot covered
AcupunctureNot covered
Allergy Testing$80.00
Bariatric Surgery50.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$80.00
Cosmetic SurgeryNot covered
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes EducationNo charge
Dialysis50.00% Coinsurance after deductible
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance$750.00 Copay after deductible
Eye Glasses for Children50.00%
Gender Affirming Care50.00% Coinsurance after deductible
Habilitation Services$80.00
Hearing AidsNot covered
Home Health Care Services50.00% Coinsurance after deductible
Outpatient Rehabilitation Services$80.00
Hospice Services50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
Infertility Treatment50.00% Coinsurance after deductible
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$50.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling$35.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$35.00
Routine Eye Exam for ChildrenNo charge
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices50.00% Coinsurance after deductible
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$80.00
Rehabilitative Speech Therapy$80.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Foot CareNot covered
Skilled Nursing Facility50.00% Coinsurance after deductible
Specified Sex-trait Modification Procedures (SSTMP)50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$35.00
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders50.00% Coinsurance after deductible
Weight Loss Programs$35.00
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$70.00

Plan rules

Service area

This plan covers 4 geographic areas.

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