Elite Gold + Vision + Adult Dental
Starting at
$826
/month before subsidy
Elite Gold + Vision + Adult Dental is a 2026 Gold EPO health insurance plan from Ambetter Health, sold on the ACA Marketplace in Nebraska under plan ID 13484NE0100005. The monthly premium starts at $826 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $0, and the individual out-of-pocket maximum is $6,500 ($13,000 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 13484NE0100005
- Plan year
- 2026
- State
- Nebraska
- Metal level
- Gold
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$0
Family: $0
Out-of-Pocket Max
$6,500
Family: $13,000
Coinsurance
30%
You pay after deductible
Network Type
EPO
NEN001
Medical Services
Prescription Drugs
Having a baby
Normal delivery
$3,160
your estimated cost
- Deductible
- $0
- Copays
- $600
- Coinsurance
- $2,500
Managing type 2 diabetes
A year of routine care
$1,320
your estimated cost
- Deductible
- $0
- Copays
- $1,100
- Coinsurance
- $200
A simple fracture
ER visit + follow-up
$1,100
your estimated cost
- Deductible
- $0
- Copays
- $500
- Coinsurance
- $600
Enter your ZIP code first to search nearby doctors.
This Gold EPO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.
Consider this plan if you:
- Have ongoing health conditions requiring regular care
- Take multiple prescription medications
- Prefer lower costs at the time of service
- Want peace of mind with comprehensive coverage
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,368/month
Annual Premium
$9,912
OOP Maximum
$6,500
💡 What this means:
With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $6,500 total. Then insurance covers everything else for the year.
More plans from Ambetter Health in Nebraska
- Choice Bronze HSAfrom $577/mo
- Choice Bronze HSA + Vision + Adult Dentalfrom $591/mo
- Elite Bronzefrom $607/mo
- Elite Bronze + Vision + Adult Dentalfrom $621/mo
- Standard Expanded Bronzefrom $533/mo
- Standard Expanded Bronze + Vision + Adult Dentalfrom $545/mo
- Focused Silverfrom $701/mo
- Focused Silver + Vision + Adult Dentalfrom $718/mo
Frequently asked questions about Elite Gold + Vision + Adult Dental
How much does Elite Gold + Vision + Adult Dental cost per month?
Elite Gold + Vision + Adult Dental from Ambetter Health starts at $826 per month before any subsidy in Nebraska. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Elite Gold + Vision + Adult Dental?
The individual medical deductible is $0. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Elite Gold + Vision + Adult Dental?
The most you would pay in a year for covered in-network care is $6,500 for an individual and $13,000 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Elite Gold + Vision + Adult Dental HSA-eligible?
No. Elite Gold + Vision + Adult Dental is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Elite Gold + Vision + Adult Dental use?
Elite Gold + Vision + Adult Dental is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.