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UnitedHealthcare

UHC Silver Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals)

Monthly premium, age 40 From $746 Up to $846 by area · before subsidies Prices by age
Find a doctor in this plan Summary of Benefits (PDF)
Plan ID80180WI0120002
Plan year2027Sold on HealthCare.gov
Plan typeHMONo referral needed
Metal levelSilverNot HSA-eligible
Sold in13 countiesof 72 in Wisconsin
Deductible$5,000$10,000 family
Out-of-pocket max$9,800$19,600 family
Primary care visit$35in network
Generic drugs$10per prescription

13,120 Wisconsin 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

Where do you want to see a doctor?

Monthly premium by age, before subsidies

The full monthly price for 2027, before premium tax credits. The price depends on where you live: this plan has 6 price regions (rating areas) in Wisconsin, so each row shows the lowest and highest.

AgeMonthly premiumTobacco user
Child (0 to 14)$447 to $507Same
Age 21$584 to $662$613 to $695
Age 27$612 to $694$642 to $729
Age 30$662 to $752$729 to $827
Age 40$746 to $846$821 to $931
Age 50$1,042 to $1,183$1,251 to $1,419
Age 60$1,584 to $1,797$1,901 to $2,157
64 and older$1,751 to $1,987$2,101 to $2,384

Most people who enroll through HealthCare.gov qualify for a subsidy (premium tax credit) based on household income, which lowers the monthly price. HealthCare.gov shows your price after any subsidy. NPI Profile does not sell 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 $5,000 deductible.

Doctor visits

Primary care visit
$35
Specialist visit
$90
Nurse practitioner or PA visit
40% after deductible
Preventive care and vaccines
Free
Urgent care
$50

Prescription drugs

Generic drugsLimit: 30 days a month
$10
Preferred brand drugsLimit: 30 days a month
$100 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
$30
X-rays
40% after deductible
MRI, CT and PET scans
40% after deductible

Emergencies and hospital

Emergency room
40% after deductible
Ambulance
40% after deductible
Hospital stay
40% after deductible
Outpatient surgery (facility)
40% after deductible

Mental health

Therapy and counseling visits
$35
Inpatient mental health care
40% after deductible

Pregnancy

Prenatal and postnatal care
Free
Delivery and hospital stay
40% after deductible

Other care

Physical and occupational therapyLimit: 20 visits a year
40% after deductible
Chiropractic care
$35
Eye exam for childrenLimit: 1 exam a year
Free
Glasses for childrenLimit: 1 item a year
40% after deductible
Adult dental
Not covered
$7,360Having a baby (CMS example)
$600Managing type 2 diabetes for a year
$2,700A simple fracture
Every service in the plan file (67)
ServiceYou payLimits and notes
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental40% after deductible
AcupunctureNot covered
Allergy TestingNot covered
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy40% after deductible
Chiropractic Care$35
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care40% after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education40% after deductible
Dialysis40% after deductible
Durable Medical Equipment40% after deductible
Emergency Room Services40% after deductible
Emergency Transportation/Ambulance40% after deductible
Eye Glasses for Children40% after deductible1 item a year
Generic Drugs$1030 days a month
Habilitation Services40% after deductible
Hearing Aids40% after deductible1 item every 3 years
Home Health Care Services40% after deductible60 visits a year
Hospice Services40% after deductible
Imaging (CT/PET Scans, MRIs)40% after deductible
Infertility TreatmentNot covered
Infusion Therapy40% after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% after deductible
Inpatient Physician and Surgical Services40% after deductible
Laboratory Outpatient and Professional Services$30
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Mental/Behavioral Health Inpatient Services40% after deductible
Mental/Behavioral Health Outpatient Services$35
Non-Preferred Brand Drugs40% after deductible30 days a month
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)40% after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40% after deductible
Outpatient Rehabilitation Services40% after deductible166 visits a year
Outpatient Surgery Physician/Surgical Services40% after deductible
Preferred Brand Drugs$100 after deductible30 days a month
Prenatal and Postnatal CareFree
Preventive Care/Screening/ImmunizationFree
Primary Care Visit to Treat an Injury or Illness$35
Private-Duty NursingNot covered
Prosthetic Devices40% after deductible
Radiation40% after deductible
Reconstructive Surgery40% after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy40% after deductible20 visits a year
Rehabilitative Speech Therapy40% after deductible20 visits a year
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenFree1 exam a year
Routine Foot CareNot covered
Skilled Nursing Facility40% after deductible30 days a stay
Specialist Visit$90
Specialty Drugs50% after deductible30 days a month
Substance Abuse Disorder Inpatient Services40% after deductible
Substance Abuse Disorder Outpatient Services$35
Transplant40% after deductible
Treatment for Temporomandibular Joint Disorders40% after deductible
Urgent Care Centers or Facilities$50
Weight Loss ProgramsNot covered
Well Baby Visits and CareFree
X-rays and Diagnostic Imaging40% after deductible

How this plan works

HMO: You pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies.

Referral for specialists
Not required
Coinsurance
40% after the deductible
Works with an HSA
No
Network
Individual Exchange Benefit Plan Network (WIN011)
Sold in
13 Wisconsin 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 Essential-

BronzeHMOHSA
Premium, age 40$557to $632 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
Plan ID 80180WI0120001Sold in 13 Wisconsin countiesNo coinsuranceNo referral neededDetails
UnitedHealthcare

UHC Bronze Essential

BronzeHMOHSA
Premium, age 40$562to $637 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
Plan ID 80180WI0100022Sold in 13 Wisconsin countiesNo coinsuranceNo referral neededDetails
UnitedHealthcare

UHC Bronze Standard

Expanded BronzeHMOHSA
Premium, age 40$596to $677 a month
Deductible$7,500$15,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$9,360CMS example
HSA, $0 Insulin, No Referrals
Plan ID 80180WI0100001Sold in 13 Wisconsin counties50% coinsuranceNo referral neededDetails
UnitedHealthcare

UHC Bronze Copay Focus $0 Ded

Expanded BronzeHMOHSA
Premium, age 40$642to $728 a month
Deductible$0$0 family
Out-of-pocket max$12,000$24,000 family
Having a baby$3,760CMS example
$0 Virtual Urgent Care, HSA, $0 Insulin, No Referrals
Plan ID 80180WI0100019Sold in 13 Wisconsin counties50% coinsuranceNo referral neededDetails
UnitedHealthcare

UHC Bronze Copay Focus+ $0 Ded

Expanded BronzeHMOHSA
Premium, age 40$658to $747 a month
Deductible$0$0 family
Out-of-pocket max$12,000$24,000 family
Having a baby$3,760CMS example
$0 Virtual Urgent Care, HSA, $0 Insulin, Dental + Vision, No Referrals
Plan ID 80180WI0110005Sold in 13 Wisconsin counties50% coinsuranceNo referral neededDetails

Compare all 234 Wisconsin plans

Questions about UHC Silver Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals)

Does UHC Silver Value- ($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 Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?
It is an HMO plan: you pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies. It is a Silver plan.
How much is a doctor visit with UHC Silver Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?
A primary care visit costs $35. A specialist visit costs $90. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $5,000 deductible.
Where is UHC Silver Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals) sold?
It is sold to people who live in 13 Wisconsin 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 Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals) cost a month?
Before subsidies (premium tax credits), UHC Silver Value- ($0 Virtual Urgent Care, $0 Insulin, No Referrals) costs $746 to $846 a month for a 40-year-old in 2027, depending on where in Wisconsin you live. A 21-year-old pays $584 to $662 and someone 64 or older $1,751 to $1,987. 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.

SourceWhat it provides hereSource 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 soldPlan year 2027
UnitedHealthcare's provider directoryThe doctors and facilities listed in this plan's network. Only providers with an address in Wisconsin are counted.Updated November 4, 2026
NPPES NPI registryProvider names, practice addresses and primary specialtiesMatched 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.