Standard Gold
Gold · HMO · Ambetter of North Carolina · North Carolina
At age 40 it costs between $615.90 and $783.67 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 ID | 77264NC0010046 |
|---|---|
| Insurer | Ambetter of North Carolina |
| Metal level | Gold |
| Plan type | HMO |
| Standardised design | Design 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 deductible | Included 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 room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-833-863-1310 · TTY 1-833-863-1310 |
Where it is sold, and what it costs there
47 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Alexander County | $481.93 | $546.98 | $615.90 | $860.71 | $1,307.93 |
| Burke County | $481.93 | $546.98 | $615.90 | $860.71 | $1,307.93 |
| Caldwell County | $481.93 | $546.98 | $615.90 | $860.71 | $1,307.93 |
| Catawba County | $481.93 | $546.98 | $615.90 | $860.71 | $1,307.93 |
| Iredell County | $481.93 | $546.98 | $615.90 | $860.71 | $1,307.93 |
| Franklin County | $506.85 | $575.26 | $647.74 | $905.22 | $1,375.56 |
| Johnston County | $506.85 | $575.26 | $647.74 | $905.22 | $1,375.56 |
| Wake County | $506.85 | $575.26 | $647.74 | $905.22 | $1,375.56 |
| Caswell County | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Durham County | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Lee County | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Orange County | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Person County | $508.77 | $577.45 | $650.20 | $908.65 | $1,380.79 |
| Granville County | $518.35 | $588.31 | $662.44 | $925.75 | $1,406.77 |
| Vance County | $518.35 | $588.31 | $662.44 | $925.75 | $1,406.77 |
| Warren County | $518.35 | $588.31 | $662.44 | $925.75 | $1,406.77 |
| Bladen County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Cumberland County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Harnett County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Hoke County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Richmond County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Robeson County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Sampson County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Scotland County | $525.03 | $595.90 | $670.98 | $937.69 | $1,424.91 |
| Alleghany County | $548.03 | $622 | $700.37 | $978.76 | $1,487.32 |
| Wilkes County | $548.03 | $622 | $700.37 | $978.76 | $1,487.32 |
| Brunswick County | $554.76 | $629.65 | $708.98 | $990.79 | $1,505.60 |
| Columbus County | $554.76 | $629.65 | $708.98 | $990.79 | $1,505.60 |
| New Hanover County | $554.76 | $629.65 | $708.98 | $990.79 | $1,505.60 |
| Pender County | $554.76 | $629.65 | $708.98 | $990.79 | $1,505.60 |
| Avery County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Buncombe County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Clay County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Graham County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Haywood County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Jackson County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Macon County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Madison County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| McDowell County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Mitchell County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Polk County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Rutherford County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Swain County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Transylvania County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Yancey County | $568.19 | $644.88 | $726.13 | $1,014.76 | $1,542.03 |
| Montgomery County | $613.21 | $695.98 | $783.67 | $1,095.18 | $1,664.23 |
| Moore County | $613.21 | $695.98 | $783.67 | $1,095.18 | $1,664.23 |
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.