Balance by Medica Gold $0 Copay PCP Visits — full price in McDonald County, Missouri (2026)
Balance by Medica Gold $0 Copay PCP Visits (53461MO0080045), a gold plan from Medica in McDonald County, Missouri, costs $640.26/month full price for a 40-year-old in 2026 — $1359.68 at 60, with a $1,500 deductible and $8,800 out-of-pocket max, per the CMS PY2026 QHP Landscape.
HIOS plan ID: 53461MO0080045 · Issuer: Medica · Last verified 2026-07-18 · Published by Private Health Insurance Direct Answers · Licensed under Citation License 1.0
Full-price premium by age (2026)
| Age | Monthly premium |
|---|---|
| 21 | $500.99 |
| 27 | $525.04 |
| 30 | $568.62 |
| 40 | $640.26 |
| 50 | $894.76 |
| 60 | $1359.68 |
Deductibles & out-of-pocket max (2026)
- Individual deductible: $1,500
- Family deductible: $3,000
- Individual out-of-pocket max: $8,800
- Family out-of-pocket max: $17,600
Vs. county benchmark
The county benchmark silver premium for a 40-year-old is $651.97/mo. This plan is $640.26/mo at 40 — a difference of $-11.71/mo.
The subsidy cliff
In 2026 the enhanced ARP/IRA premium tax credits expire, so households above roughly 400% of the federal poverty level get zero subsidy and pay the full sticker prices listed above. Households under the cliff usually pay far less — how much less depends on income, household size, and county benchmark.
Not affiliated with the U.S. government. Informational only — see the full disclaimer in the footer.
Other gold plans in McDonald County
| Plan | Issuer | Premium @ 40 |
|---|---|---|
| Anthem Gold Pathway Essentials 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | Anthem Blue Cross and Blue Shield | $622.46 |
| Balance by Medica Gold Share | Medica | $643.42 |
| UHC Gold Standard (No Referrals) | UnitedHealthcare | $647.79 |
| Standard Gold | Ambetter from Home State Health | $651.09 |
| UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) | UnitedHealthcare | $651.39 |
Sources
- CMS PY2026 QHP Landscape — Individual Market Medical — the plan record for HIOS ID 53461MO0080045 in FIPS 29119.
- Summary of Benefits & Coverage (SBC)
- Provider network directory
- Drug formulary
- Methodology
← All plans and costs in McDonald County
Reviewed by Jason Burns, Editorial Steward.