ACA plans available
62
Plan year
2026 data Public-data reference. official source
Waukesha, Wisconsin Health Insurance
Open-data reference.
62 ACA plans from 5 issuers — Plan year 2026
Waukesha, Wisconsin offers 62 ACA marketplace plans from 5 issuers for plan year 2026. Bronze plans start at $411/mo and Silver plans start at $472/mo (age 27, before subsidies). Use the tables below to compare premiums, deductibles, and issuers across all metal tiers.
$519
Avg Silver Premium/mo
$473
Benchmark Premium/mo
+21.4%
Year-over-Year Change
$4,796
Avg Deductible
What the Numbers Say About Waukesha
Waukesha, Wisconsin has 62 ACA marketplace plans offered by 5 issuers for plan year 2026. The average Silver-tier premium comes in at $519/mo for a 27-year-old non-tobacco user, with the lowest Silver at $472 and the highest at $576. Bronze plans start at $411/mo — useful for healthy enrollees who want catastrophic protection with the lowest monthly outlay.
The benchmark (second-lowest Silver) premium is $473/mo, the figure the IRS uses to calculate your Advance Premium Tax Credit. Enrollees whose expected income-based contribution falls below this amount receive a subsidy for the difference. Across all plans, the average annual deductible is $4,796 and the average out-of-pocket maximum is $8,999 — numbers that matter more than the sticker premium once you actually use care. Year-over-year, average premiums in Waukesha shifted by +21.4%, a signal of how local issuer pricing and risk-pool dynamics are trending.
Issuer count is one of the strongest predictors of affordability: with 5 issuers active in Waukesha, consumers have meaningful competition to pressure premiums lower. This page is informational only and is not insurance, medical, or tax advice — verify your eligibility, network coverage, and final pricing at HealthCare.gov before enrolling. Source: CMS Marketplace PUF, plan year 2026.
Premiums by Metal Level
Bronze
1 plan$411/mo avg
$411 — $411
Silver
20 plans$519/mo avg
$472 — $576
Gold
20 plans$572/mo avg
$538 — $603
Benchmark Premium & Subsidies
The benchmark premium (2nd-lowest Silver plan) in Waukesha is $473/mo for a 27-year-old. This is the amount used to calculate your premium tax credit. If your expected contribution (based on income) is less than the benchmark, you receive a subsidy for the difference. The higher the benchmark, the larger the potential subsidy.
Issuers in market
5
Competitive market
Benchmark Silver
$473 /mo
Sets your subsidy ceiling
Avg deductible
$4,796
Across all metal tiers
Waukesha ACA plans by premium and deductible
Each marker is the Waukesha average for one metal tier (and the local Bronze low / Silver high extremes where data is available). The dashed line marks the federal out-of-pocket-maximum ceiling.
Source: CMS Marketplace PUF for Waukesha, plan year 2026. Bronze = catastrophic-only zone (high deductible). Gold/Platinum = premium-heavy zone (low deductible).
Issuers in Waukesha
| Issuer | Plans | Avg Premium (Age 27) |
|---|---|---|
| CareSource (Common Ground Healthcare) | 18 | $477/mo |
| UnitedHealthcare | 13 | $526/mo |
| Network Health | 13 | $508/mo |
| Dean Health Plan | 9 | $505/mo |
| Anthem Blue Cross and Blue Shield | 9 | $457/mo |
All Plans in Waukesha
| Plan Name | Metal | Type | Premium (27) | Premium (40) | Deductible | OOP Max |
|---|---|---|---|---|---|---|
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) UnitedHealthcare | Bronze | HMO | $410.53 | $500.63 | $10,600 | $10,600 |
| Dean Bronze Share Dean Health Plan | Expanded Bronze | HMO | $346.64 | $422.72 | $8,000 | $10,600 |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $366.22 | $446.60 | $5,000 | $10,600 |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $370.30 | $451.57 | $8,450 | $8,450 |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $370.90 | $452.30 | $7,500 | $10,000 |
| Dean Bronze $0 Copay PCP Visits Dean Health Plan | Expanded Bronze | HMO | $381.10 | $464.74 | $7,500 | $10,600 |
| CareSource (Common Ground Healthcare) Bronze Standard $7500 CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $390.39 | $476.07 | $7,500 | $10,000 |
| CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $390.57 | $476.29 | $9,600 | $9,600 |
| CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $391.35 | $477.23 | $7,500 | $10,000 |
| CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $391.53 | $477.46 | $9,600 | $9,600 |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $392.71 | $478.89 | $0 | $10,600 |
| Prestige Bronze Essential + 3 Free PCP Visits Network Health | Expanded Bronze | HMO | $401.69 | $489.85 | $7,750 | $9,500 |
| Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits Network Health | Expanded Bronze | HMO | $405.82 | $494.89 | $7,750 | $9,500 |
| Dean Expanded Bronze Standard Dean Health Plan | Expanded Bronze | HMO | $407.77 | $497.26 | $7,500 | $10,000 |
| CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $408.49 | $498.14 | $0 | $9,500 |
| CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam CareSource (Common Ground Healthcare) | Expanded Bronze | EPO | $409.44 | $499.30 | $0 | $9,500 |
| Prestige Bronze Plus Network Health | Expanded Bronze | HMO | $418.49 | $510.34 | $7,500 | $10,000 |
| UHC Bronze Standard (No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $428.95 | $523.09 | $7,500 | $10,000 |
| Prestige Bronze $0 Medical Deductible Network Health | Expanded Bronze | HMO | $434.46 | $529.81 | $0 | $9,200 |
| Prestige Bronze $0 Medical Deductible + Dental + Vision Network Health | Expanded Bronze | HMO | $438.93 | $535.26 | $0 | $9,200 |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $448.57 | $547.01 | $0 | $10,600 |
| UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $461.37 | $562.63 | $0 | $10,600 |
| CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded CareSource (Common Ground Healthcare) | Silver | EPO | $471.72 | $575.25 | $5,000 | $10,600 |
| CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam CareSource (Common Ground Healthcare) | Silver | EPO | $472.68 | $576.42 | $5,000 | $10,600 |
| CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded CareSource (Common Ground Healthcare) | Silver | EPO | $476.14 | $580.64 | $4,700 | $10,600 |
| CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam CareSource (Common Ground Healthcare) | Silver | EPO | $477.10 | $581.80 | $4,700 | $10,600 |
| CareSource (Common Ground Healthcare) Silver Standard $6000 CareSource (Common Ground Healthcare) | Silver | EPO | $477.83 | $582.70 | $6,000 | $8,900 |
| CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam CareSource (Common Ground Healthcare) | Silver | EPO | $478.79 | $583.86 | $6,000 | $8,900 |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $493.44 | $601.73 | $6,000 | $8,900 |
| Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $493.55 | $601.86 | $4,000 | $9,400 |
| Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $493.80 | $602.17 | $5,500 | $9,200 |
| Prestige Silver Network Health | Silver | HMO | $531.92 | $648.65 | $6,000 | $8,900 |
| UHC Silver Standard (No Referrals) UnitedHealthcare | Silver | HMO | $534.98 | $652.39 | $6,000 | $8,900 |
| UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) UnitedHealthcare | Silver | HMO | $535.00 | $652.42 | $4,000 | $8,750 |
| UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Silver | HMO | $541.43 | $660.25 | $3,500 | $9,800 |
| UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Silver | HMO | $547.81 | $668.04 | $4,000 | $8,750 |
| Prestige Silver Essential + 3 Free PCP Visits Network Health | Silver | HMO | $549.60 | $670.22 | $4,600 | $9,100 |
| Dean Silver $0 Copay PCP Visits Dean Health Plan | Silver | HMO | $550.65 | $671.50 | $3,500 | $10,450 |
| UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Silver | HMO | $554.24 | $675.87 | $3,500 | $9,800 |
| Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits Network Health | Silver | HMO | $555.25 | $677.11 | $4,600 | $9,100 |
| Dean Silver Share Dean Health Plan | Silver | HMO | $563.00 | $686.56 | $3,525 | $8,850 |
| Dean Silver Standard Dean Health Plan | Silver | HMO | $576.06 | $702.49 | $6,000 | $8,900 |
| CareSource (Common Ground Healthcare) Gold $3300 CareSource (Common Ground Healthcare) | Gold | EPO | $538.19 | $656.31 | $3,300 | $8,500 |
| CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam CareSource (Common Ground Healthcare) | Gold | EPO | $539.15 | $657.48 | $3,300 | $8,500 |
| CareSource (Common Ground Healthcare) Gold Standard $2000 CareSource (Common Ground Healthcare) | Gold | EPO | $543.53 | $662.81 | $2,000 | $8,200 |
| CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam CareSource (Common Ground Healthcare) | Gold | EPO | $544.48 | $663.98 | $2,000 | $8,200 |
| Prestige Gold Network Health | Gold | HMO | $554.65 | $676.38 | $2,000 | $8,200 |
| Dean Gold Share Dean Health Plan | Gold | HMO | $555.24 | $677.09 | $2,500 | $5,900 |
| Prestige Gold Essential + 3Free PCP Visits Network Health | Gold | HMO | $555.40 | $677.29 | $1,750 | $8,950 |
| Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits Network Health | Gold | HMO | $561.11 | $684.26 | $1,750 | $8,950 |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Gold | HMO | $566.85 | $691.26 | $1,000 | $7,200 |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Gold | HMO | $566.91 | $691.32 | $2,000 | $8,200 |
| Dean Gold Standard Dean Health Plan | Gold | HMO | $575.69 | $702.03 | $2,000 | $8,200 |
| UHC Gold Standard (No Referrals) UnitedHealthcare | Gold | HMO | $585.42 | $713.90 | $2,000 | $8,200 |
| Dean Gold HSA Dean Health Plan | Gold | HMO | $588.65 | $717.84 | $3,400 | $4,400 |
| UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Gold | HMO | $589.81 | $719.25 | $1,500 | $7,000 |
| Prestige Gold 50 + 1 Free PCP Visit Network Health | Gold | HMO | $592.40 | $722.41 | $1,000 | $4,300 |
| CareSource (Common Ground Healthcare) Gold $0 Ded CareSource (Common Ground Healthcare) | Gold | EPO | $593.33 | $723.55 | $0 | $9,000 |
| CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam CareSource (Common Ground Healthcare) | Gold | EPO | $594.28 | $724.70 | $0 | $9,000 |
| Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit Network Health | Gold | HMO | $598.50 | $729.84 | $1,000 | $4,300 |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Gold | HMO | $602.18 | $734.34 | $0 | $8,500 |
| UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Gold | HMO | $602.62 | $734.87 | $1,500 | $7,000 |
Silver Premium Trend (2022-2026)
| Year | Avg Premium | Min | Max | Plans | Issuers |
|---|---|---|---|---|---|
| 2022 | $421/mo | $331 | $590 | 48 | 8 |
| 2023 | $470/mo | $350 | $615 | 52 | 7 |
| 2024 | $459/mo | $359 | $576 | 46 | 8 |
| 2025 | $469/mo | $363 | $598 | 36 | 8 |
| 2026 | $519/mo | $472 | $576 | 20 | 5 |
Health Insurance Guides
Choosing a Metal Level
Bronze vs Silver vs Gold vs Platinum — which tier fits your needs and budget
Understanding ACA Subsidies
How premium tax credits work and how to estimate your subsidy amount
Related Health & Cost Data
Find Doctors
PlainDoctor — Healthcare providers in Wisconsin
Hospital Quality Ratings
PlainHospital — CMS star ratings and safety scores
Medicare Plans
PlainMedicare — Medicare Advantage and Part D data
Community Health Data
PlainHealth — CDC community health indicators
Health Access Metrics
PlainHealthAccess — Uninsured rates and provider shortages
Cost of Living
PlainCost — BEA regional price parities
Homeowners Insurance
PlainInsure — Treasury FIO premiums
Frequently Asked Questions
How many ACA plans are available in Waukesha, WI?
There are 62 ACA marketplace plans available in Waukesha from 5 insurance issuers for plan year 2026.
What is the cheapest health insurance plan in Waukesha?
The lowest-premium plan in Waukesha starts at $411/mo (Bronze tier, age 27). Silver plans start at $472/mo. Actual premiums vary by age and may be reduced by premium tax credits.
What is the benchmark premium for Waukesha?
The benchmark (second-lowest Silver) premium in Waukesha is $473/mo for a 27-year-old. This amount determines how much premium tax credit subsidy you may be eligible for.
How have premiums changed in Waukesha?
Average premiums in Waukesha changed by +21.4% year-over-year. Premium trends are tracked from 2022 to 2026 across all metal levels.
What is the average deductible and out-of-pocket maximum in Waukesha?
The average annual deductible across all plans in Waukesha is $4,796, and the average out-of-pocket maximum is $8,999. Bronze plans generally have higher deductibles but lower premiums, while Gold and Platinum plans have lower deductibles but higher monthly costs.
Which insurance companies offer plans in Waukesha?
There are 5 insurance issuers offering ACA marketplace plans in Waukesha, including CareSource (Common Ground Healthcare), UnitedHealthcare, Network Health, and others. Competition among issuers affects plan variety and pricing. More issuers generally mean more choices and potentially lower premiums.
Disclaimer: This page is for informational purposes only and does not constitute insurance or financial advice. Premiums shown are for a 27-year-old non-tobacco user unless otherwise noted. Your actual premium depends on age, location, tobacco use, and subsidy eligibility. Visit HealthCare.gov for official enrollment. Source: CMS Marketplace PUF, PY2026.
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- U.S. Census Bureau ACS — demographic + housing + income data. census.gov/programs-surveys/acs
- BLS Occupational Employment and Wage Statistics (OEWS) — wage + employment by occupation. bls.gov/oes
- BEA Regional Economic Accounts — GDP + personal income by state/metro. bea.gov/data/regional
- U.S. Census Bureau County Business Patterns — establishment + employment by industry. census.gov/cbp
- IRS Statistics of Income (SOI) — tax-return aggregate data. irs.gov/statistics
- data.gov — U.S. federal open-data portal — discovery layer for additional federal sources. data.gov
Related
Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by PlainHealthPlan Editorial
