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.
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)
UnitedHealthcare · 2026 plan year
Gold
- Ind. deductible
- $750
- Family deductible
- $1,500
- Ind. OOP max
- $8,000
- Family OOP max
- $16,000
Other cost-sharing reduction variants for this plan:
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Monthly premiums by age
Rating Area 1 — the lowest-priced of the 12 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $327 | $327 |
| 21 | $516 | $541 |
| 30 | $585 | $644 |
| 40 | $659 | $725 |
| 50 | $921 | $1,105 |
| 60 | $1,399 | $1,679 |
| 64 and over | $1,547 | $1,856 |
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 | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $75.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $500.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | $300.00 Copay after deductible |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $5.00 |
| Non-Preferred Brand Drugs | 30.00% Coinsurance after deductible |
| Preferred Brand Drugs | $50.00 |
| Specialty Drugs | 40.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 35.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $20.00 |
Other
| Benefit | In-network |
|---|---|
| Weight Loss Programs | Not covered |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 35.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | 35.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | 35.00% Coinsurance after deductible |
| Chemotherapy | $500.00 Copay after deductible |
| Chiropractic Care | 35.00% Coinsurance after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 35.00% Coinsurance after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Education | 35.00% Coinsurance after deductible |
| Dialysis | $300.00 Copay after deductible |
| Durable Medical Equipment | 35.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | $500.00 Copay after deductible |
| Eye Glasses for Children | 35.00% Coinsurance after deductible |
| Gender Affirming Care | $600.00 Copay after deductible |
| Habilitation Services | $75.00 Copay after deductible |
| Hearing Aids | Not covered |
| Home Health Care Services | 35.00% Coinsurance after deductible |
| Hospice Services | 35.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $350.00 Copay after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | $75.00 Copay after deductible |
| Inpatient Physician and Surgical Services | 35.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | $20.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | 35.00% Coinsurance after deductible |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 35.00% Coinsurance after deductible |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $600.00 Copay after deductible |
| Outpatient Rehabilitation Services | $75.00 Copay after deductible |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 35.00% Coinsurance after deductible |
| Radiation | $75.00 Copay after deductible |
| Reconstructive Surgery | $600.00 Copay after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $75.00 Copay after deductible |
| Rehabilitative Speech Therapy | $75.00 Copay after deductible |
| 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 | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $20.00 |
| Transplant | 35.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $65.00 Copay after deductible |
Service area
This plan covers 56 geographic areas.
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