Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
Silver · HMO · Ambetter of North Carolina · North Carolina
At age 40 it costs between $631.91 and $804.05 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $5,900 | $8,150 | $40 | $3 |
| up to 150% of the federal poverty level | $100 | $1,500 | No Charge | No Charge |
| 150% to 200% | $850 | $3,250 | $10 | No Charge |
| 200% to 250% | $5,150 | $7,900 | $25 | $3 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 77264NC0020004 |
|---|---|
| Insurer | Ambetter of North Carolina |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $5,900 |
| Deductible (family) | $11,800 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,150 |
| Family maximum | $16,300 |
| Primary care visit | $40 |
| Specialist visit | $60 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $75 |
| Specialty drugs | 50% Coinsurance after deductible |
| Adult dental included | Yes |
| Child dental included | No |
| Share of premium buying essential health benefits | 96.74% |
| 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 | $494.46 | $561.20 | $631.91 | $883.09 | $1,341.94 |
| Burke County | $494.46 | $561.20 | $631.91 | $883.09 | $1,341.94 |
| Caldwell County | $494.46 | $561.20 | $631.91 | $883.09 | $1,341.94 |
| Catawba County | $494.46 | $561.20 | $631.91 | $883.09 | $1,341.94 |
| Iredell County | $494.46 | $561.20 | $631.91 | $883.09 | $1,341.94 |
| Franklin County | $520.03 | $590.22 | $664.58 | $928.75 | $1,411.33 |
| Johnston County | $520.03 | $590.22 | $664.58 | $928.75 | $1,411.33 |
| Wake County | $520.03 | $590.22 | $664.58 | $928.75 | $1,411.33 |
| Caswell County | $522 | $592.46 | $667.11 | $932.28 | $1,416.68 |
| Durham County | $522 | $592.46 | $667.11 | $932.28 | $1,416.68 |
| Lee County | $522 | $592.46 | $667.11 | $932.28 | $1,416.68 |
| Orange County | $522 | $592.46 | $667.11 | $932.28 | $1,416.68 |
| Person County | $522 | $592.46 | $667.11 | $932.28 | $1,416.68 |
| Granville County | $531.82 | $603.61 | $679.66 | $949.82 | $1,443.34 |
| Vance County | $531.82 | $603.61 | $679.66 | $949.82 | $1,443.34 |
| Warren County | $531.82 | $603.61 | $679.66 | $949.82 | $1,443.34 |
| Bladen County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Cumberland County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Harnett County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Hoke County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Richmond County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Robeson County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Sampson County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Scotland County | $538.68 | $611.39 | $688.42 | $962.07 | $1,461.96 |
| Alleghany County | $562.27 | $638.17 | $718.57 | $1,004.20 | $1,525.99 |
| Wilkes County | $562.27 | $638.17 | $718.57 | $1,004.20 | $1,525.99 |
| Brunswick County | $569.19 | $646.01 | $727.41 | $1,016.55 | $1,544.74 |
| Columbus County | $569.19 | $646.01 | $727.41 | $1,016.55 | $1,544.74 |
| New Hanover County | $569.19 | $646.01 | $727.41 | $1,016.55 | $1,544.74 |
| Pender County | $569.19 | $646.01 | $727.41 | $1,016.55 | $1,544.74 |
| Avery County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Buncombe County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Clay County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Graham County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Haywood County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Jackson County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Macon County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Madison County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| McDowell County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Mitchell County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Polk County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Rutherford County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Swain County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Transylvania County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Yancey County | $582.96 | $661.64 | $745.01 | $1,041.14 | $1,582.12 |
| Montgomery County | $629.15 | $714.08 | $804.05 | $1,123.65 | $1,707.50 |
| Moore County | $629.15 | $714.08 | $804.05 | $1,123.65 | $1,707.50 |
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.