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Expanded_bronzeHMOHSA Eligible

AmeriHealth Caritas Next Bronze Premier + No Referrals

AmeriHealth Caritas Next

Starting at

$465

/month before subsidy

Key facts

AmeriHealth Caritas Next Bronze Premier + No Referrals is a 2026 Expanded_bronze HMO health insurance plan from AmeriHealth Caritas Next, sold on the ACA Marketplace in North Carolina under plan ID 17414NC0010011. The monthly premium starts at $465 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $3,850 ($7,700 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is HSA-eligible, so it can be paired with a Health Savings Account.

Plan ID
17414NC0010011
Plan year
2026
State
North Carolina
Metal level
Expanded_bronze
Plan type
HMO
HSA-eligible
Yes

Individual Deductible

$3,850

Family: $7,700

Out-of-Pocket Max

$10,600

Family: $21,200

Coinsurance

50%

You pay after deductible

Network Type

HMO

NCN001

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$40.00
Specialist Visit$100.00
Urgent Care$75.00
Emergency Room50.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$25.00
Brand Name Drugs$100.00 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
2.0overall
Medical care

How well doctors manage and coordinate care

Member experience
Not rated

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$7,020

your estimated cost

Deductible
$3,850
Copays
$70
Coinsurance
$3,100

Managing type 2 diabetes

A year of routine care

$4,560

your estimated cost

Deductible
$3,850
Copays
$700
Coinsurance
$10

A simple fracture

ER visit + follow-up

$2,700

your estimated cost

Deductible
$2,300
Copays
$400
Coinsurance
$0
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Official Plan Documents
Published by AmeriHealth Caritas Next. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

Review the plan details above to determine if this plan fits your healthcare needs and budget.

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,348/month

Annual Premium

$5,580

OOP Maximum

$10,600

💡 What this means:

With a $3,850 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.

More plans from AmeriHealth Caritas Next in North Carolina

View all Marketplace plans in North Carolina

Frequently asked questions about AmeriHealth Caritas Next Bronze Premier + No Referrals

How much does AmeriHealth Caritas Next Bronze Premier + No Referrals cost per month?

AmeriHealth Caritas Next Bronze Premier + No Referrals from AmeriHealth Caritas Next starts at $465 per month before any subsidy in North Carolina. 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 AmeriHealth Caritas Next Bronze Premier + No Referrals?

The individual medical deductible is $3,850, and the family deductible is $7,700. 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 AmeriHealth Caritas Next Bronze Premier + No Referrals?

The most you would pay in a year for covered in-network care is $10,600 for an individual and $21,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is AmeriHealth Caritas Next Bronze Premier + No Referrals HSA-eligible?

Yes. AmeriHealth Caritas Next Bronze Premier + No Referrals is a qualified high-deductible health plan, so you can pair it with a Health Savings Account (HSA) and pay for eligible medical expenses with pre-tax dollars.

What type of network does AmeriHealth Caritas Next Bronze Premier + No Referrals use?

AmeriHealth Caritas Next Bronze Premier + No Referrals is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.

Understand what you'd actually pay

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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.