UnitedHealthcare
UHC Bronze Essential
Premium, age 40$610to $727 a month
Deductible$11,750$23,500 family
Out-of-pocket max$11,750$23,500 family
Having a baby$11,260CMS example
$0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals
UnitedHealthcare
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
Monthly premium, age 40
From $883
Up to $1,051 by area · before subsidies
Prices by age
Find a doctor in this plan
Summary of Benefits (PDF)
Plan ID69842LA0240022
Plan year2027Sold on HealthCare.gov
Plan typeEPONo referral needed
Metal levelSilverNot HSA-eligible
Sold in48 countiesof 64 in Louisiana
Deductible$0$0 family
Out-of-pocket max$10,150$20,300 family
Primary care visit$20in network
Generic drugs$15per prescription
11,273 Louisiana doctors and facilities in this plan's network · Directory updated Nov 4, 2026 · Premiums are full prices before subsidies (premium tax credits). NPI Profile does not sell insurance; HealthCare.gov lists premiums and handles enrollment.
Find a doctor in this plan
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What kind of doctor in ?
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Listed in UnitedHealthcare's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $0 deductible.
Doctor visits
- Primary care visit
- $20
- Specialist visit
- $85
- Nurse practitioner or PA visit
- 30%
- Preventive care and vaccines
- Free
- Urgent care
- $30
Prescription drugs
- Generic drugsLimit: 30 days a month
- $15
- Preferred brand drugsLimit: 30 days a month
- $85 after deductible
- Non-preferred brand drugsLimit: 30 days a month
- 40% after deductible
- Specialty drugsLimit: 30 days a month
- 50% after deductible
Tests and imaging
- Lab work
- $20
- X-rays
- $200
- MRI, CT and PET scans
- $200
Emergencies and hospital
- Emergency room
- $1,500
- Ambulance
- $1,500
- Hospital stay
- $2500 a day
- Outpatient surgery (facility)
- $500
Mental health
- Therapy and counseling visits
- $20
- Inpatient mental health care
- $2500 a day
Pregnancy
- Prenatal and postnatal care
- Free
- Delivery and hospital stay
- $2,500
Other care
- Physical and occupational therapy
- $75
- Chiropractic care
- 30%
- Eye exam for childrenLimit: 1 exam a year
- Free
- Glasses for childrenLimit: 1 item a year
- 30%
- Adult dental
- Not covered
$3,160Having a baby (CMS example)
$500Managing type 2 diabetes for a year
$2,510A simple fracture
Every service in the plan file (67)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | 30% | |
| Acupuncture | Not covered | |
| Allergy Testing | 30% | |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | 30% | |
| Chemotherapy | $750 | |
| Chiropractic Care | 30% | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | $2,500 | |
| Dental Check-Up for Children | Free | 2 exams a year |
| Diabetes Education | 30% | |
| Dialysis | $500 | |
| Durable Medical Equipment | 30% | |
| Emergency Room Services | $1,500 | |
| Emergency Transportation/Ambulance | $1,500 | |
| Eye Glasses for Children | 30% | 1 item a year |
| Generic Drugs | $15 | 30 days a month |
| Habilitation Services | $75 | |
| Hearing Aids | 30% | 1 item every 3 years |
| Home Health Care Services | 30% | |
| Hospice Services | 30% | |
| Imaging (CT/PET Scans, MRIs) | $200 | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | $150 | |
| Inpatient Hospital Services (e.g., Hospital Stay) | $2500 a day | |
| Inpatient Physician and Surgical Services | Free | |
| Laboratory Outpatient and Professional Services | $20 | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | 30% | |
| Mental/Behavioral Health Inpatient Services | $2500 a day | |
| Mental/Behavioral Health Outpatient Services | $20 | |
| Non-Preferred Brand Drugs | 40% after deductible | 30 days a month |
| Nutritional Counseling | 30% | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | 50% | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 30% | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $500 | |
| Outpatient Rehabilitation Services | $75 | |
| Outpatient Surgery Physician/Surgical Services | $375 | |
| Preferred Brand Drugs | $85 after deductible | 30 days a month |
| Prenatal and Postnatal Care | Free | |
| Preventive Care/Screening/Immunization | Free | |
| Primary Care Visit to Treat an Injury or Illness | $20 | |
| Private-Duty Nursing | 30% | 19 visits a year Inpatient Private Duty Nursing Service is not covered. |
| Prosthetic Devices | 30% | |
| Radiation | $200 | |
| Reconstructive Surgery | $500 | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $75 | |
| Rehabilitative Speech Therapy | $75 | |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | Free | 1 exam a year |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | $2500 a day | |
| Specialist Visit | $85 | |
| Specialty Drugs | 50% after deductible | 30 days a month |
| Substance Abuse Disorder Inpatient Services | $2500 a day | |
| Substance Abuse Disorder Outpatient Services | $20 | |
| Transplant | $2,500 | |
| Treatment for Temporomandibular Joint Disorders | Not covered | |
| Urgent Care Centers or Facilities | $30 | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| X-rays and Diagnostic Imaging | $200 |
How this plan works
EPO: Only doctors and hospitals in the network are covered, except emergencies. Referrals are usually not needed.
- Referral for specialists
- Not required
- Coinsurance
- 30% after the deductible
- Works with an HSA
- No
- Network
- Individual Exchange Benefit Plan Network (LAN011)
- Sold in
- 48 Louisiana counties
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other UnitedHealthcare plans on the same network
The same doctors and hospitals, with different costs.
UnitedHealthcare
UHC Bronze Standard
Premium, age 40$624to $743 a month
Deductible$7,500$15,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$9,360CMS example
Virtual UC, HSA, $0 Insulin, No Referrals
UnitedHealthcare
UHC Bronze Standard+
Premium, age 40$639to $761 a month
Deductible$7,500$15,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$9,360CMS example
Virtual UC, HSA, $0 Insulin, Dental + Vision, No Referrals
UnitedHealthcare
UHC Bronze Copay Focus $0 Indiv Med Ded
Premium, age 40$665to $792 a month
Deductible$0$0 family
Out-of-pocket max$11,400$22,800 family
Having a baby$3,660CMS example
$0 Virtual UC, HSA, $0 Insulin, No Referrals
UnitedHealthcare
UHC Bronze Copay Focus+ $0 Indiv Med Ded
Premium, age 40$679to $809 a month
Deductible$0$0 family
Out-of-pocket max$11,400$22,800 family
Having a baby$3,660CMS example
$0 Virtual UC, HSA, $0 Insulin, Dental + Vision, No Referrals
UnitedHealthcare
UHC Silver Value
Premium, age 40$837to $996 a month
Deductible$4,000$8,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$6,660CMS example
$0 Virtual Urgent Care, $0 Insulin, No Referrals
UnitedHealthcare
UHC Silver Standard
Premium, age 40$842to $1,003 a month
Deductible$6,400$12,800 family
Out-of-pocket max$10,300$20,600 family
Having a baby$8,360CMS example
Virtual Urgent Care, $0 Insulin, No Referrals
UnitedHealthcare
UHC Silver Value+
Premium, age 40$851to $1,014 a month
Deductible$4,000$8,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$6,660CMS example
$0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals
UnitedHealthcare
UHC Gold Standard
Premium, age 40$876to $1,043 a month
Deductible$2,500$5,000 family
Out-of-pocket max$8,700$17,400 family
Having a baby$4,760CMS example
Virtual Urgent Care, $0 Insulin, No Referrals
UnitedHealthcare
UHC Silver Copay Focus+ $0 Indiv Med Ded
Premium, age 40$897to $1,069 a month
Deductible$0$0 family
Out-of-pocket max$10,150$20,300 family
Having a baby$3,160CMS example
$0 Virtual Urgent Care, $0 Insulin, Dental + Vision, No Referrals
UnitedHealthcare
UHC Gold Copay Focus $0 Ded
Premium, age 40$898to $1,070 a month
Deductible$0$0 family
Out-of-pocket max$9,250$18,500 family
Having a baby$2,460CMS example
$0 Virtual UC, $3 Tier 2 Rx, $0 Insulin, No Referrals
UnitedHealthcare
UHC Gold Advantage
Premium, age 40$905to $1,078 a month
Deductible$950$1,900 family
Out-of-pocket max$9,600$19,200 family
Having a baby$5,210CMS example
$0 Virtual UC, $3 Tier 2 Rx, $0 Insulin, No Referrals
UnitedHealthcare
UHC Gold Copay Focus+ $0 Ded
Premium, age 40$913to $1,087 a month
Deductible$0$0 family
Out-of-pocket max$9,250$18,500 family
Having a baby$2,460CMS example
$0 Virtual UC, $3 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals
UnitedHealthcare
UHC Gold Advantage+
Premium, age 40$920to $1,095 a month
Deductible$950$1,900 family
Out-of-pocket max$9,600$19,200 family
Having a baby$5,210CMS example
$0 Virtual UC, $3 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals
Questions about UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)
Does UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers UnitedHealthcare lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?
It is an EPO plan: only doctors and hospitals in the network are covered, except emergencies. Referrals are usually not needed. It is a Silver plan.
How much is a doctor visit with UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?
A primary care visit costs $20. A specialist visit costs $85. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $0 deductible.
Where is UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) sold?
It is sold to people who live in 48 Louisiana counties, through HealthCare.gov. UnitedHealthcare's directory can also list providers outside these counties, such as pharmacies and specialists, but the plan itself is only for people who live in its area.
How much does UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) cost a month?
Before subsidies (premium tax credits), UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) costs $883 to $1,051 a month for a 40-year-old in 2027, depending on where in Louisiana you live. A 21-year-old pays $691 to $823 and someone 64 or older $2,072 to $2,468. Tobacco users pay more. Most people who enroll through HealthCare.gov qualify for a subsidy (premium tax credit) that lowers the monthly price, and HealthCare.gov shows your price after any subsidy.
About this data
These pages combine public files from CMS and from insurers. NPI Profile does not contract with insurers and does not decide who is in network.
| Source | What it provides here | Source date |
|---|---|---|
| CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Rate, Service Area) | This plan's premiums, costs, covered services, coverage examples and the counties where it is sold | Plan year 2027 |
| UnitedHealthcare's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Louisiana are counted. | Updated November 4, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 10, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less.
- Premiums are the full monthly price before subsidies (premium tax credits). They depend on age, tobacco use and where you live (the plan's rating area). HealthCare.gov shows your price after any subsidy.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
