Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care +No Referrals

AmeriHealth Caritas Next · 2027 plan year

Gold
Ind. deductible
$2,500
Family deductible
$5,000
Ind. OOP max
$8,600
Family OOP max
$17,200

More AmeriHealth Caritas Next plans in FL

Monthly premiums by age

Rating Area 30 — the lowest-priced of the 16 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$441$441
21$576$691
30$654$785
40$736$883
50$1,029$1,235
60$1,563$1,876
64 and over$1,728$2,074

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$30.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services25.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)25.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$45.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Non-Preferred Brand Drugs$60.00
Preferred Brand Drugs$30.00
Specialty Drugs$250.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services25.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental25.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$60.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Bone Marrow TransplantNot covered
Cardiac RehabilitationNot covered
Chemotherapy25.00% Coinsurance after deductible
Child Health SupervisionNot covered
Chiropractic Care$60.00
Congenital Anomaly, including Cleft Lip/PalateNot covered
Contraceptive InjectionsNot covered
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care25.00% Coinsurance after deductible
Dental AnesthesiaNot covered
Dental Check-Up for ChildrenNot covered
Diabetes Care ManagementNot covered
Diabetes EducationNo charge
Dialysis25.00% Coinsurance after deductible
DoulaNot covered
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance25.00% Coinsurance after deductible
Enteral FormulasNot covered
Eye Glasses for ChildrenNo charge
Habilitation Services$30.00
Hearing AidsNot covered
Home Health Care Services25.00% Coinsurance after deductible
Hospice ServicesNo Charge after deductible
Imaging (CT/PET Scans, MRIs)25.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy25.00% Coinsurance after deductible
Inpatient Physician and Surgical Services25.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services25.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
MammogramNot covered
MastectomyNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Orthotic DevicesNot covered
OsteoporosisNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Outpatient Rehabilitation Services$30.00
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices50.00% Coinsurance after deductible
Pulmonary RehabilitationNot covered
Radiation25.00% Coinsurance after deductible
Reconstructive Surgery25.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$30.00
Rehabilitative Speech Therapy$30.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$60.00
Skilled Nursing Facility25.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services25.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$30.00
Transplant25.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders25.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging25.00% Coinsurance after deductible

Service area

This plan covers 16 geographic areas.

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