UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals)

UnitedHealthcare · 2026 plan year

Gold
Ind. deductible
$1,500
Family deductible
$3,000
Ind. OOP max
$7,000
Family OOP max
$14,000

Compare with other Gold plans in WI

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

More UnitedHealthcare plans in WI

Monthly premiums by age

Rating Area 14 — the lowest-priced of the 6 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$432$432
21$564$593
30$641$705
40$721$793
50$1,008$1,210
60$1,532$1,838
64 and over$1,693$2,032

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$25.00

Specialist

BenefitIn-network
Specialist Visit$85.00

Hospital

BenefitIn-network
Emergency Room Services$650.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services$125.00 Copay after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs$65.00
Specialty Drugs40.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$25.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental35.00% Coinsurance after deductible
AcupunctureNot covered
Allergy TestingNot covered
Bariatric SurgeryNot covered
Basic Dental Care - Adult50.00%
Basic Dental Care - Child35.00% Coinsurance after deductible
Chemotherapy$500.00 Copay after deductible
Chiropractic Care35.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care35.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Education35.00% Coinsurance after deductible
Dialysis$300.00 Copay after deductible
Durable Medical Equipment35.00% Coinsurance after deductible
Emergency Transportation/Ambulance$650.00 Copay after deductible
Eye Glasses for Children35.00% Coinsurance after deductible
Gender Affirming Care$300.00 Copay after deductible
Habilitation Services$50.00 Copay after deductible
Hearing Aids35.00% Coinsurance after deductible
Home Health Care Services35.00% Coinsurance after deductible
Hospice Services35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$175.00 Copay after deductible
Infertility TreatmentNot covered
Infusion Therapy$75.00 Copay after deductible
Inpatient Physician and Surgical Services35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$20.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - Child35.00% Coinsurance after deductible
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - Child50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)35.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$300.00 Copay after deductible
Outpatient Rehabilitation Services$50.00 Copay after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices35.00% Coinsurance after deductible
Radiation$75.00 Copay after deductible
Reconstructive Surgery$300.00 Copay after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$50.00 Copay after deductible
Rehabilitative Speech Therapy$50.00 Copay after deductible
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)No charge
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$25.00
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 Imaging$65.00 Copay after deductible

Plan rules

Service area

This plan covers 13 geographic areas.

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