QHP Index

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 ID77264NC0020057
InsurerAmbetter of North Carolina
Metal levelGold
Plan typeHMO
Standardised designDesign 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 deductibleIncluded 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 room25% Coinsurance after deductible
Inpatient stay25% Coinsurance after deductible
Generic drugs$15
Preferred brand drugs$30
Specialty drugs$250
Adult dental includedYes
Child dental includedNo
Share of premium buying essential health benefits96.74%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-833-863-1310 · 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.

CountyAt 21At 30At 40At 50At 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.