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.

Silver $5,000 w/ Virtual & Wellness ON-EX

MedMutual · 2026 plan year

Silver
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$8,500
Family OOP max
$17,000

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Monthly premiums by age

Rating Area 3 — the lowest-priced of the 17 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$329$329
21$430$452
30$488$537
40$550$632
50$769$884
60$1,168$1,343
64 and over$1,291$1,485

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$30.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services35.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services35.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic DrugsNo charge
Non-Preferred Brand Drugs35.00% Coinsurance after deductible
Preferred Brand Drugs$60.00 Copay after deductible
Specialty Drugs35.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Hospice Services35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)35.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental35.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing35.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNo charge
Chemotherapy35.00% Coinsurance after deductible
Chiropractic Care$30.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care35.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes EducationNo charge
Dialysis35.00% Coinsurance after deductible
Durable Medical Equipment35.00% Coinsurance after deductible
Emergency Transportation/Ambulance35.00% Coinsurance after deductible
Eye Glasses for Children35.00% Coinsurance after deductible
Habilitation Services$30.00
Hearing AidsNo charge
Home Health Care Services35.00% Coinsurance after deductible
Infertility Treatment35.00% Coinsurance after deductible
Infusion Therapy35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$60.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNo charge
Nutritional Counseling35.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNo charge
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)35.00% Coinsurance after deductible
Outpatient Rehabilitation Services35.00% Coinsurance after deductible
Prenatal and Postnatal Care35.00% Coinsurance after deductible
Private-Duty Nursing35.00% Coinsurance after deductible
Prosthetic Devices35.00% Coinsurance after deductible
Radiation35.00% Coinsurance after deductible
Reconstructive Surgery35.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$30.00
Rehabilitative Speech Therapy$30.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility35.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$30.00
Transplant35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders35.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging35.00% Coinsurance after deductible

Service area

This plan covers 1 geographic area.

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