Everyday Bronze with Atrium Health

Ambetter of North Carolina · 2026 plan year

Expanded BronzeHSA eligible
Ind. deductible
$8,450
Family deductible
$16,900
Ind. OOP max
$10,150
Family OOP max
$20,300

Compare with other Expanded Bronze plans in NC

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

More Ambetter of North Carolina plans in NC

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 4 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$251$251
21$329$378
30$373$429
40$420$483
50$587$675
60$892$1,026
64 and over$986$1,134

Live premium estimate

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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$90.00

Hospital

BenefitIn-network
Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Mental/Behavioral Health Emergency Room50.00% Coinsurance after deductible
Mental/Behavioral Health Urgent Care$40.00
Outpatient Surgery Physician/Surgical Services50.00% Coinsurance after deductible
Substance Use Disorder Emergency Room50.00% Coinsurance after deductible
Substance Use Disorder Urgent Care$40.00
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Non-Preferred Brand Drugs45.00% Coinsurance after deductible
Generic Drugs$3.00
Preferred Brand Drugs45.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible
Tier 1b Generic Drugs$30.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Mental/Behavioral Health ER Physician Fee50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Other Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00
Substance Use Disorder Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Substance Use Disorder ER Physician Fee50.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services50.00% Coinsurance after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$90.00
Bariatric Surgery50.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$90.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education$90.00
Dialysis50.00% Coinsurance after deductible
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services50.00% Coinsurance after deductible
Hearing Aids50.00% Coinsurance after deductible
Home Health Care Services50.00% Coinsurance after deductible
Hospice Services50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
Infertility Treatment50.00% Coinsurance after deductible
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$50.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling$90.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Outpatient Rehabilitation Services50.00% Coinsurance after deductible
Prenatal and Postnatal Care$40.00
Private-Duty Nursing50.00% Coinsurance after deductible
Prosthetic Devices50.00% Coinsurance after deductible
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy50.00% Coinsurance after deductible
Rehabilitative Speech Therapy50.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$90.00
Skilled Nursing Facility50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders50.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 16 geographic areas.

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