Oak $1,300 Gold

HealthPartners · 2026 plan year

Gold
Ind. deductible
$1,300
Family deductible
$2,600
Ind. OOP max
$8,600
Family OOP max
$17,200

Compare with other Gold plans in WI

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

Other cost-sharing reduction variants for this plan:

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Monthly premiums by age

The same in all 3 areas this plan covers.

AgeIndividualIndividual + tobacco
Under 15$436$436
21$570$656
30$647$745
40$729$839
50$1,018$1,172
60$1,547$1,782
64 and over$1,710$1,969

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$15.00

Specialist

BenefitIn-network
Specialist Visit$35.00

Hospital

BenefitIn-network
Emergency Room Services20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services20.00% Coinsurance after deductible
Urgent Care Centers or Facilities$35.00

Pharmacy

BenefitIn-network
Generic Drugs$25.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs20.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$15.00

Other

BenefitIn-network
Dialysis20.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental20.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$35.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy20.00% Coinsurance after deductible
Chiropractic Care$35.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care20.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes EducationNo charge
Durable Medical Equipment20.00% Coinsurance after deductible
Emergency Transportation/Ambulance20.00% Coinsurance after deductible
Eye Glasses for Children20.00% Coinsurance after deductible
Habilitation Services20.00% Coinsurance after deductible
Hearing Aids20.00% Coinsurance after deductible
Home Health Care Services$35.00
Hospice Services20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)20.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services20.00% Coinsurance after deductible
Laboratory Outpatient and Professional ServicesNo charge
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20.00% Coinsurance after deductible
Outpatient Rehabilitation Services20.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices20.00% Coinsurance after deductible
Radiation20.00% Coinsurance after deductible
Reconstructive Surgery20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy20.00% Coinsurance after deductible
Rehabilitative Speech Therapy20.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility20.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$15.00
Transplant20.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders20.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 10 geographic areas.

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