Standard Gold + Vision + Adult Dental
Gold · HMO · Ambetter of North Carolina · North Carolina
At age 40 it costs between $636.62 and $810.04 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 | 77264NC0020057 |
|---|---|
| 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 | 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 | $498.15 | $565.38 | $636.62 | $889.67 | $1,351.94 |
| Burke County | $498.15 | $565.38 | $636.62 | $889.67 | $1,351.94 |
| Caldwell County | $498.15 | $565.38 | $636.62 | $889.67 | $1,351.94 |
| Catawba County | $498.15 | $565.38 | $636.62 | $889.67 | $1,351.94 |
| Iredell County | $498.15 | $565.38 | $636.62 | $889.67 | $1,351.94 |
| Franklin County | $523.90 | $594.62 | $669.54 | $935.67 | $1,421.85 |
| Johnston County | $523.90 | $594.62 | $669.54 | $935.67 | $1,421.85 |
| Wake County | $523.90 | $594.62 | $669.54 | $935.67 | $1,421.85 |
| Caswell County | $525.89 | $596.88 | $672.08 | $939.23 | $1,427.25 |
| Durham County | $525.89 | $596.88 | $672.08 | $939.23 | $1,427.25 |
| Lee County | $525.89 | $596.88 | $672.08 | $939.23 | $1,427.25 |
| Orange County | $525.89 | $596.88 | $672.08 | $939.23 | $1,427.25 |
| Person County | $525.89 | $596.88 | $672.08 | $939.23 | $1,427.25 |
| Granville County | $535.79 | $608.11 | $684.72 | $956.90 | $1,454.10 |
| Vance County | $535.79 | $608.11 | $684.72 | $956.90 | $1,454.10 |
| Warren County | $535.79 | $608.11 | $684.72 | $956.90 | $1,454.10 |
| Bladen County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Cumberland County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Harnett County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Hoke County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Richmond County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Robeson County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Sampson County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Scotland County | $542.70 | $615.95 | $693.56 | $969.24 | $1,472.86 |
| Alleghany County | $566.47 | $642.93 | $723.93 | $1,011.69 | $1,537.36 |
| Wilkes County | $566.47 | $642.93 | $723.93 | $1,011.69 | $1,537.36 |
| Brunswick County | $573.43 | $650.83 | $732.83 | $1,024.13 | $1,556.26 |
| Columbus County | $573.43 | $650.83 | $732.83 | $1,024.13 | $1,556.26 |
| New Hanover County | $573.43 | $650.83 | $732.83 | $1,024.13 | $1,556.26 |
| Pender County | $573.43 | $650.83 | $732.83 | $1,024.13 | $1,556.26 |
| Avery County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Buncombe County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Clay County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Graham County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Haywood County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Jackson County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Macon County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Madison County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| McDowell County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Mitchell County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Polk County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Rutherford County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Swain County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Transylvania County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Yancey County | $587.30 | $666.58 | $750.56 | $1,048.90 | $1,593.91 |
| Montgomery County | $633.84 | $719.40 | $810.04 | $1,132.03 | $1,720.23 |
| Moore County | $633.84 | $719.40 | $810.04 | $1,132.03 | $1,720.23 |
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.