Focused Silver with Atrium Health + Vision + Adult Dental
Silver · HMO · Ambetter of North Carolina · North Carolina
At age 40 it costs between $564 and $661.68 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 | $6,300 | $8,400 | $40 | $3 |
| up to 150% of the federal poverty level | $0 | $1,500 | No Charge | No Charge |
| 150% to 200% | $0 | $3,350 | $20 | $3 |
| 200% to 250% | $5,150 | $7,200 | $35 | $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 | 77264NC0020051 |
|---|---|
| Insurer | Ambetter of North Carolina |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $6,300 |
| Deductible (family) | $12,600 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,400 |
| Family maximum | $16,800 |
| Primary care visit | $40 |
| Specialist visit | $85 |
| 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
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 | $441.32 | $500.89 | $564 | $788.18 | $1,197.72 |
| Davie County | $441.32 | $500.89 | $564 | $788.18 | $1,197.72 |
| Forsyth County | $441.32 | $500.89 | $564 | $788.18 | $1,197.72 |
| Stokes County | $441.32 | $500.89 | $564 | $788.18 | $1,197.72 |
| Yadkin County | $441.32 | $500.89 | $564 | $788.18 | $1,197.72 |
| Guilford County | $443.27 | $503.10 | $566.48 | $791.66 | $1,203 |
| Randolph County | $443.27 | $503.10 | $566.48 | $791.66 | $1,203 |
| Anson County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Cabarrus County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Mecklenburg County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Rowan County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Stanly County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Union County | $487.78 | $553.61 | $623.37 | $871.15 | $1,323.80 |
| Cleveland County | $517.76 | $587.64 | $661.68 | $924.70 | $1,405.16 |
| Gaston County | $517.76 | $587.64 | $661.68 | $924.70 | $1,405.16 |
| Lincoln County | $517.76 | $587.64 | $661.68 | $924.70 | $1,405.16 |
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.
Get told when this changes
When this plan’s price or benefits change.
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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.