Elite Silver + Vision + Adult Dental
Starting at
$764
/month before subsidy
Elite Silver + Vision + Adult Dental is a 2026 Silver EPO health insurance plan from Ambetter Health of Delaware, sold on the ACA Marketplace in Delaware under plan ID 64004DE0100013. The monthly premium starts at $764 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 $8,350 ($16,700 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 64004DE0100013
- Plan year
- 2026
- State
- Delaware
- Metal level
- Silver
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$0
Family: $0
Out-of-Pocket Max
$8,350
Family: $16,700
Coinsurance
50%
You pay after deductible
Network Type
EPO
DEN001
Medical Services
Prescription Drugs
Having a baby
Normal delivery
$5,060
your estimated cost
- Deductible
- $0
- Copays
- $600
- Coinsurance
- $4,400
Managing type 2 diabetes
A year of routine care
$3,420
your estimated cost
- Deductible
- $1,500
- Copays
- $800
- Coinsurance
- $1,100
A simple fracture
ER visit + follow-up
$1,500
your estimated cost
- Deductible
- $0
- Copays
- $300
- Coinsurance
- $1,200
Enter your ZIP code first to search nearby doctors.
This Silver EPO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.
Consider this plan if you:
- Visit the doctor a few times per year
- Take regular prescription medications
- Want moderate protection against high medical bills
- May qualify for Cost-Sharing Reductions (CSR) to lower deductibles
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,460/month
Annual Premium
$9,168
OOP Maximum
$8,350
💡 What this means:
With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $8,350 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
- Focused Silverfrom $692/mo
Frequently asked questions about Elite Silver + Vision + Adult Dental
How much does Elite Silver + Vision + Adult Dental cost per month?
Elite Silver + Vision + Adult Dental from Ambetter Health of Delaware starts at $764 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 Elite Silver + 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 Silver + Vision + Adult Dental?
The most you would pay in a year for covered in-network care is $8,350 for an individual and $16,700 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Elite Silver + Vision + Adult Dental HSA-eligible?
No. Elite Silver + 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 Silver + Vision + Adult Dental use?
Elite Silver + 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.