Standard Gold + Vision + Adult Dental
Starting at
$637
/month before subsidy
Standard Gold + Vision + Adult Dental is a 2026 Gold HMO health insurance plan from Ambetter of North Carolina, sold on the ACA Marketplace in North Carolina under plan ID 77264NC0020057. The monthly premium starts at $637 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 $8,200 ($16,400 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 77264NC0020057
- Plan year
- 2026
- State
- North Carolina
- Metal level
- Gold
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$2,000
Family: $4,000
Out-of-Pocket Max
$8,200
Family: $16,400
Coinsurance
25%
You pay after deductible
Network Type
HMO
NCN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
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 HMO 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
$1,320/month
Annual Premium
$7,644
OOP Maximum
$8,200
💡 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 $8,200 total. Then insurance covers everything else for the year.
More plans from Ambetter of North Carolina in North Carolina
- Elite Bronzefrom $527/mo
- Elite Bronze + Vision + Adult Dentalfrom $544/mo
- Elite Bronze with Atrium Healthfrom $477/mo
- Elite Bronze with Atrium Health + Vision + Adult Dentalfrom $493/mo
- Everyday Bronzefrom $463/mo
- Everyday Bronze + Vision + Adult Dentalfrom $479/mo
- Everyday Bronze with Atrium Healthfrom $420/mo
- Everyday Bronze with Atrium Health + Vision + Adult Dentalfrom $434/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 of North Carolina starts at $637 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 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 $8,200 for an individual and $16,400 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 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
- 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.