Standard Gold with Atrium Health
Gold · HMO · Ambetter of North Carolina · North Carolina
At age 40 it costs between $558.35 and $655.06 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 | 77264NC0010061 |
|---|---|
| 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
16 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 |
|---|---|---|---|---|---|
| Davidson County | $436.90 | $495.88 | $558.35 | $780.29 | $1,185.73 |
| Davie County | $436.90 | $495.88 | $558.35 | $780.29 | $1,185.73 |
| Forsyth County | $436.90 | $495.88 | $558.35 | $780.29 | $1,185.73 |
| Stokes County | $436.90 | $495.88 | $558.35 | $780.29 | $1,185.73 |
| Yadkin County | $436.90 | $495.88 | $558.35 | $780.29 | $1,185.73 |
| Guilford County | $438.83 | $498.06 | $560.81 | $783.73 | $1,190.96 |
| Randolph County | $438.83 | $498.06 | $560.81 | $783.73 | $1,190.96 |
| Anson County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Cabarrus County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Mecklenburg County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Rowan County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Stanly County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Union County | $482.89 | $548.07 | $617.13 | $862.43 | $1,310.55 |
| Cleveland County | $512.57 | $581.76 | $655.06 | $915.44 | $1,391.10 |
| Gaston County | $512.57 | $581.76 | $655.06 | $915.44 | $1,391.10 |
| Lincoln County | $512.57 | $581.76 | $655.06 | $915.44 | $1,391.10 |
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.