Gold Standard, Gold, Child Only, ST, INN, Univera EPO Local, Pediatric Dental
Excellus · 2026 plan year
GoldChild-only plan — for enrollees under 21
- Ind. medical deductible
- $775
- Rx deductible (separate)
- $0
- Family deductible
- $1,550
- Ind. OOP max
- $10,150
- Family OOP max
- $20,300
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Only children can enroll in this plan, so its premium is a child’s premium. It is not counted in the cheapest or “from” prices we quote for adults.
Compare with other Gold plans in NY
Side by side: deductibles, out-of-pocket limits and copays.
More Excellus plans in NY
Bronze Standard HSA, Expanded Bronze, ST, INN, Excellus BCBS EPO, Dep29, Pediatric DentalBronze Standard HSA, Expanded Bronze, ST, INN, Excellus BCBS EPO, Dep25, Pediatric DentalBronze Standard HSA, Expanded Bronze, Child Only, ST, INN, Excellus BCBS EPO, Pediatric DentalBronze Standard HSA, Expanded Bronze, ST, INN, Univera EPO Local, Dep29, Pediatric DentalBronze Standard HSA, Expanded Bronze, ST, INN, Univera EPO Local, Dep25, Pediatric Dental
Monthly premiums by age
Rating Area 2
| Age | Individual |
|---|---|
| Under 15 | $512 |
| 21 | $512 |
| 30 | $512 |
| 40 | $512 |
| 50 | $512 |
| 60 | $512 |
| 64 and over | $512 |
Live premium estimate
Service area
This plan covers 8 geographic areas.
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