Standard Gold + Vision + Adult Dental
Starting at
$774
/month before subsidy
Standard Gold + Vision + Adult Dental is a 2026 Gold EPO health insurance plan from Ambetter Health of Delaware, sold on the ACA Marketplace in Delaware under plan ID 64004DE0100012. The monthly premium starts at $774 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $2,000 ($4,000 for a family), and the individual out-of-pocket maximum is $8,300 ($16,600 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 64004DE0100012
- Plan year
- 2026
- State
- Delaware
- Metal level
- Gold
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$2,000
Family: $4,000
Out-of-Pocket Max
$8,300
Family: $16,600
Coinsurance
25%
You pay after deductible
Network Type
EPO
DEN001
Medical Services
Prescription Drugs
Having a baby
Normal delivery
$4,100
your estimated cost
- Deductible
- $2,000
- Copays
- $40
- Coinsurance
- $2,000
Managing type 2 diabetes
A year of routine care
$1,820
your estimated cost
- Deductible
- $900
- Copays
- $900
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,320
your estimated cost
- Deductible
- $2,000
- Copays
- $300
- Coinsurance
- $20
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
$1,466/month
Annual Premium
$9,288
OOP Maximum
$8,300
💡 What this means:
With a $2,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 25% (coinsurance) until you hit $8,300 total. Then insurance covers everything else for the year.
More plans from Ambetter Health of Delaware in Delaware
- Everyday Bronzefrom $559/mo
- Everyday Bronze + Vision + Adult Dentalfrom $580/mo
- Principal Bronze HSAfrom $595/mo
- Principal Bronze HSA + Vision + Adult Dentalfrom $618/mo
- Standard Expanded Bronzefrom $561/mo
- Standard Expanded Bronze + Vision + Adult Dentalfrom $582/mo
- Elite Silverfrom $736/mo
- Elite Silver + Vision + Adult Dentalfrom $764/mo
Frequently asked questions about Standard Gold + Vision + Adult Dental
How much does Standard Gold + Vision + Adult Dental cost per month?
Standard Gold + Vision + Adult Dental from Ambetter Health of Delaware starts at $774 per month before any subsidy in Delaware. 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 Standard Gold + Vision + Adult Dental?
The individual medical deductible is $2,000, and the family deductible is $4,000. 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 Standard Gold + Vision + Adult Dental?
The most you would pay in a year for covered in-network care is $8,300 for an individual and $16,600 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Standard Gold + Vision + Adult Dental HSA-eligible?
No. Standard 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 Standard Gold + Vision + Adult Dental use?
Standard 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.