GoldEPO

Elite Gold + Vision + Adult Dental

Ambetter of Tennessee

Starting at

$769

/month before subsidy

Key facts

Elite Gold + Vision + Adult Dental is a 2026 Gold EPO health insurance plan from Ambetter of Tennessee, sold on the ACA Marketplace in Tennessee under plan ID 70111TN0120034. The monthly premium starts at $769 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
70111TN0120034
Plan year
2026
State
Tennessee
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

TNN001

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

Medical Services

Primary Care Visit$5.00
Specialist Visit$60.00
Urgent Care$35.00
Emergency Room30.00%

Prescription Drugs

Generic Drugs$3.00
Brand Name Drugs45.00%
Specialty Drugs50.00%
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.
3.0overall
Medical care

How well doctors manage and coordinate care

Member experience

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

$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
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 Ambetter of Tennessee. These are the authoritative source for coverage details.
Who This Plan Is Best For

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.

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

If you max out this year

$1,311/month

Annual Premium

$9,228

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 of Tennessee in Tennessee

View all Marketplace plans in Tennessee

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 of Tennessee starts at $769 per month before any subsidy in Tennessee. 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

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.