QHP Index

Standard Gold + Vision + Adult Dental

Gold · EPO · Ambetter Health · Nebraska

At age 40 it costs between $727.98 and $866.46 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.

What CMS publishes about it

Plan ID13484NE0100006
InsurerAmbetter Health
Metal levelGold
Plan typeEPO
Standardised designDesign 1 — a plan CMS defined the benefits of, so it can be compared like for like
Deductible (individual)$2,000
Deductible (family)$4,000
Drug deductibleIncluded in the medical deductible
Most you could pay in a year$8,200
Family maximum$16,400
Primary care visit$30
Specialist visit$60
Emergency room25% Coinsurance after deductible
Inpatient stay25% Coinsurance after deductible
Generic drugs$15
Preferred brand drugs$30
Specialty drugs$250
Adult dental includedYes
Child dental includedNo
Share of premium buying essential health benefits97.67%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-833-890-0329 · TTY 1-833-890-0329

Where it is sold, and what it costs there

93 counties. The premium is the price before any tax credit; what you pay depends on your income.

CountyAt 21At 30At 40At 50At 60
Cass County $569.63$646.52 $727.98$1,017.35 $1,545.96
Fillmore County $569.63$646.52 $727.98$1,017.35 $1,545.96
Gage County $569.63$646.52 $727.98$1,017.35 $1,545.96
Jefferson County $569.63$646.52 $727.98$1,017.35 $1,545.96
Johnson County $569.63$646.52 $727.98$1,017.35 $1,545.96
Lancaster County $569.63$646.52 $727.98$1,017.35 $1,545.96
Nemaha County $569.63$646.52 $727.98$1,017.35 $1,545.96
Otoe County $569.63$646.52 $727.98$1,017.35 $1,545.96
Pawnee County $569.63$646.52 $727.98$1,017.35 $1,545.96
Richardson County $569.63$646.52 $727.98$1,017.35 $1,545.96
Saline County $569.63$646.52 $727.98$1,017.35 $1,545.96
Seward County $569.63$646.52 $727.98$1,017.35 $1,545.96
Thayer County $569.63$646.52 $727.98$1,017.35 $1,545.96
York County $569.63$646.52 $727.98$1,017.35 $1,545.96
Burt County $584.52$663.42 $747$1,043.93 $1,586.36
Dodge County $584.52$663.42 $747$1,043.93 $1,586.36
Douglas County $584.52$663.42 $747$1,043.93 $1,586.36
Sarpy County $584.52$663.42 $747$1,043.93 $1,586.36
Saunders County $584.52$663.42 $747$1,043.93 $1,586.36
Thurston County $584.52$663.42 $747$1,043.93 $1,586.36
Washington County $584.52$663.42 $747$1,043.93 $1,586.36
Adams County $638.21$724.36 $815.62$1,139.83 $1,732.08
Antelope County $638.21$724.36 $815.62$1,139.83 $1,732.08
Blaine County $638.21$724.36 $815.62$1,139.83 $1,732.08
Boone County $638.21$724.36 $815.62$1,139.83 $1,732.08
Boyd County $638.21$724.36 $815.62$1,139.83 $1,732.08
Buffalo County $638.21$724.36 $815.62$1,139.83 $1,732.08
Butler County $638.21$724.36 $815.62$1,139.83 $1,732.08
Cedar County $638.21$724.36 $815.62$1,139.83 $1,732.08
Clay County $638.21$724.36 $815.62$1,139.83 $1,732.08
Colfax County $638.21$724.36 $815.62$1,139.83 $1,732.08
Cuming County $638.21$724.36 $815.62$1,139.83 $1,732.08
Custer County $638.21$724.36 $815.62$1,139.83 $1,732.08
Dakota County $638.21$724.36 $815.62$1,139.83 $1,732.08
Dawson County $638.21$724.36 $815.62$1,139.83 $1,732.08
Dixon County $638.21$724.36 $815.62$1,139.83 $1,732.08
Franklin County $638.21$724.36 $815.62$1,139.83 $1,732.08
Furnas County $638.21$724.36 $815.62$1,139.83 $1,732.08
Garfield County $638.21$724.36 $815.62$1,139.83 $1,732.08
Gosper County $638.21$724.36 $815.62$1,139.83 $1,732.08
Greeley County $638.21$724.36 $815.62$1,139.83 $1,732.08
Hall County $638.21$724.36 $815.62$1,139.83 $1,732.08
Hamilton County $638.21$724.36 $815.62$1,139.83 $1,732.08
Harlan County $638.21$724.36 $815.62$1,139.83 $1,732.08
Holt County $638.21$724.36 $815.62$1,139.83 $1,732.08
Howard County $638.21$724.36 $815.62$1,139.83 $1,732.08
Kearney County $638.21$724.36 $815.62$1,139.83 $1,732.08
Keya Paha County $638.21$724.36 $815.62$1,139.83 $1,732.08
Knox County $638.21$724.36 $815.62$1,139.83 $1,732.08
Loup County $638.21$724.36 $815.62$1,139.83 $1,732.08
Madison County $638.21$724.36 $815.62$1,139.83 $1,732.08
Merrick County $638.21$724.36 $815.62$1,139.83 $1,732.08
Nance County $638.21$724.36 $815.62$1,139.83 $1,732.08
Nuckolls County $638.21$724.36 $815.62$1,139.83 $1,732.08
Phelps County $638.21$724.36 $815.62$1,139.83 $1,732.08
Pierce County $638.21$724.36 $815.62$1,139.83 $1,732.08
Platte County $638.21$724.36 $815.62$1,139.83 $1,732.08
Polk County $638.21$724.36 $815.62$1,139.83 $1,732.08
Rock County $638.21$724.36 $815.62$1,139.83 $1,732.08
Sherman County $638.21$724.36 $815.62$1,139.83 $1,732.08
Stanton County $638.21$724.36 $815.62$1,139.83 $1,732.08
Valley County $638.21$724.36 $815.62$1,139.83 $1,732.08
Wayne County $638.21$724.36 $815.62$1,139.83 $1,732.08
Webster County $638.21$724.36 $815.62$1,139.83 $1,732.08
Wheeler County $638.21$724.36 $815.62$1,139.83 $1,732.08
Arthur County $677.99$769.51 $866.46$1,210.88 $1,840.05
Banner County $677.99$769.51 $866.46$1,210.88 $1,840.05
Box Butte County $677.99$769.51 $866.46$1,210.88 $1,840.05
Brown County $677.99$769.51 $866.46$1,210.88 $1,840.05
Chase County $677.99$769.51 $866.46$1,210.88 $1,840.05
Cherry County $677.99$769.51 $866.46$1,210.88 $1,840.05
Cheyenne County $677.99$769.51 $866.46$1,210.88 $1,840.05
Dawes County $677.99$769.51 $866.46$1,210.88 $1,840.05
Deuel County $677.99$769.51 $866.46$1,210.88 $1,840.05
Dundy County $677.99$769.51 $866.46$1,210.88 $1,840.05
Frontier County $677.99$769.51 $866.46$1,210.88 $1,840.05
Garden County $677.99$769.51 $866.46$1,210.88 $1,840.05
Grant County $677.99$769.51 $866.46$1,210.88 $1,840.05
Hayes County $677.99$769.51 $866.46$1,210.88 $1,840.05
Hitchcock County $677.99$769.51 $866.46$1,210.88 $1,840.05
Hooker County $677.99$769.51 $866.46$1,210.88 $1,840.05
Keith County $677.99$769.51 $866.46$1,210.88 $1,840.05
Kimball County $677.99$769.51 $866.46$1,210.88 $1,840.05
Lincoln County $677.99$769.51 $866.46$1,210.88 $1,840.05
Logan County $677.99$769.51 $866.46$1,210.88 $1,840.05
McPherson County $677.99$769.51 $866.46$1,210.88 $1,840.05
Morrill County $677.99$769.51 $866.46$1,210.88 $1,840.05
Perkins County $677.99$769.51 $866.46$1,210.88 $1,840.05
Red Willow County $677.99$769.51 $866.46$1,210.88 $1,840.05
Scotts Bluff County $677.99$769.51 $866.46$1,210.88 $1,840.05
Sheridan County $677.99$769.51 $866.46$1,210.88 $1,840.05
Sioux County $677.99$769.51 $866.46$1,210.88 $1,840.05
Thomas County $677.99$769.51 $866.46$1,210.88 $1,840.05

Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.

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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.