Standard Plus SELECT Silver HMO $6000 $40

Centene Corporation DBA Ambetter from Peach State Health Plan · 2026 plan year

Silver
Ind. deductible
$6,000
Family deductible
$12,000
Ind. OOP max
$8,900
Family OOP max
$17,800

Compare with other Silver plans in GA

Side by side: deductibles, out-of-pocket limits and copays.

More Centene Corporation DBA Ambetter from Peach State Health Plan plans in GA

Monthly premiums by age

Rating Area 3

AgeIndividualIndividual + tobacco
Under 15$455$455
21$594$683
30$674$776
40$759$873
50$1,061$1,221
60$1,613$1,855
64 and over$1,783$2,050

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$40.00

Specialist

BenefitIn-network
Specialist Visit$80.00

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Mental Behavioral Health  Emergency Room40.00% Coinsurance after deductible
Mental Behavioral Health Urgent Care$40.00
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Substance Use Disorder Emergency Room40.00% Coinsurance after deductible
Substance Use Disorder Urgent Care$40.00
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$20.00
Non-Preferred Brand Drugs$80.00 Copay after deductible
OFF_LABEL_DRUGS$350.00 Copay after deductible
Preferred Brand Drugs$40.00
Specialty Drugs$350.00 Copay after deductible

Mental Health

BenefitIn-network
Mental Behavioral Health  Emergency Transportation Ambulance40.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00
Substance Use Disorder Emergency Transportation Ambulance40.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services40.00% Coinsurance after deductible

Other

BenefitIn-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental40.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$80.00
Autism Spectrum Disorders40.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Bone Marrow Transplant40.00% Coinsurance after deductible
Chemotherapy40.00% Coinsurance after deductible
Chiropractic Care$80.00
CLINICAL_TRIALS40.00% Coinsurance after deductible
Cosmetic Surgery40.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
DENTAL_ANESTHESIA40.00% Coinsurance after deductible
Diabetes Care$80.00
Diabetes Education$80.00
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services$40.00
Hearing AidsNot covered
HEART_TRANSPLANT40.00% Coinsurance after deductible
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility Treatment40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
MENTAL_BEHAVIORAL_HEALTH_ER_PHYSICIAN_FEE40.00% Coinsurance after deductible
MENTAL_BEHAVIORAL_HEALTH_OUTPATIENT_OTHER_SERVICES40.00% Coinsurance after deductible
Nutritional Counseling$80.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal Care$40.00
Private-Duty NursingNot covered
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$80.00
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
SUBSTANCE_USE_DISORDER_ER_PHYSICIAN_FEE40.00% Coinsurance after deductible
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Weight Loss Programs$80.00
Well Baby Visits and CareNo charge
Well Child CareNo charge
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 14 geographic areas. 7 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.

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