Everyday Gold HMO $800 $35 + Vision + Adult Dental

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

Gold

Ind. deductible: $800
Family deductible: $1,600
Ind. OOP max: $7,250
Family OOP max: $14,500

Compare with other Gold plans in GA

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

KP GA Signature Gold HMO $1000 $20Kaiser Foundation Health Plan of Georgia, Inc. · Deductible $1,000 medical + $500 Rx (separate) · Out-of-pocket max $8,000
Gold Elite Saver Plus HMO $1000 $10Oscar Health Plan of Georgia · Deductible $1,000 medical + $200 Rx (separate) · Out-of-pocket max $8,500
SoloCare Gold PPO $1000 20% ChiroAlliant Health Plans, Inc. · Deductible $1,000 · Out-of-pocket max $7,500

Compare 4 plans Browse all Gold plans in GA

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Zero Cost Sharing Plan Variation

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

Standard Silver HMO $6000 $40 + Vision + Adult Dental Standard Gold HMO $2000 $30 + Vision + Adult Dental Standard Gwinnett Clinic SELECT Gold HMO $2000 $30 Clear Bronze HMO $9000 0%Complete Silver HMO $5950 $30

Monthly premiums by age

Rating Area 10 — the lowest-priced of the 16 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$340	$340
21	$445	$512
30	$505	$581
40	$568	$654
50	$794	$914
60	$1,207	$1,388
64 and over	$1,334	$1,535

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$35.00

Specialist

Benefit	In-network
Specialist Visit	$55.00

Hospital

Benefit	In-network
Emergency Room Services	35.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	35.00% Coinsurance after deductible
Mental Behavioral Health Emergency Room	35.00% Coinsurance after deductible
Mental Behavioral Health Urgent Care	$35.00
Outpatient Surgery Physician/Surgical Services	35.00% Coinsurance after deductible
Substance Use Disorder Emergency Room	35.00% Coinsurance after deductible
Substance Use Disorder Urgent Care	$35.00
Urgent Care Centers or Facilities	$45.00

Pharmacy

Benefit	In-network
Generic Drugs	$3.00
Non-Preferred Brand Drugs	45.00% Coinsurance after deductible
OFF_LABEL_DRUGS	50.00% Coinsurance after deductible
Preferred Brand Drugs	$60.00
Specialty Drugs	50.00% Coinsurance after deductible
TIER_1B_GENERIC_DRUGS	$15.00

Mental Health

Benefit	In-network
Mental Behavioral Health Emergency Transportation Ambulance	35.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$35.00
Substance Use Disorder Emergency Transportation Ambulance	35.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services	35.00% Coinsurance after deductible

Other

Benefit	In-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	35.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	35.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$55.00
Autism Spectrum Disorders	35.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	50.00%
Basic Dental Care - Child	Not covered
Bone Marrow Transplant	35.00% Coinsurance after deductible
Chemotherapy	35.00% Coinsurance after deductible
Chiropractic Care	$55.00
CLINICAL_TRIALS	35.00% Coinsurance after deductible
Cosmetic Surgery	35.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	35.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
DENTAL_ANESTHESIA	35.00% Coinsurance after deductible
Diabetes Care	$55.00
Diabetes Education	$55.00
Dialysis	35.00% Coinsurance after deductible
Durable Medical Equipment	35.00% Coinsurance after deductible
Emergency Transportation/Ambulance	35.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	35.00% Coinsurance after deductible
Hearing Aids	Not covered
HEART_TRANSPLANT	35.00% Coinsurance after deductible
Home Health Care Services	35.00% Coinsurance after deductible
Hospice Services	35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	35.00% Coinsurance after deductible
Infertility Treatment	35.00% Coinsurance after deductible
Infusion Therapy	35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$35.00
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	50.00%
Major Dental Care - Child	Not covered
MENTAL_BEHAVIORAL_HEALTH_ER_PHYSICIAN_FEE	35.00% Coinsurance after deductible
MENTAL_BEHAVIORAL_HEALTH_OUTPATIENT_OTHER_SERVICES	35.00% Coinsurance after deductible
Nutritional Counseling	$55.00
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$35.00
Outpatient Rehabilitation Services	35.00% Coinsurance after deductible
Prenatal and Postnatal Care	$35.00
Private-Duty Nursing	Not covered
Prosthetic Devices	35.00% Coinsurance after deductible
Radiation	35.00% Coinsurance after deductible
Reconstructive Surgery	35.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	35.00% Coinsurance after deductible
Rehabilitative Speech Therapy	35.00% Coinsurance after deductible
Routine Dental Services (Adult)	No charge
Routine Eye Exam (Adult)	No charge
Routine Eye Exam for Children	No charge
Routine Foot Care	$55.00
Skilled Nursing Facility	35.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$35.00
SUBSTANCE_USE_DISORDER_ER_PHYSICIAN_FEE	35.00% Coinsurance after deductible
Transplant	35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	35.00% Coinsurance after deductible
Weight Loss Programs	$55.00
Well Baby Visits and Care	No charge
Well Child Care	No charge
X-rays and Diagnostic Imaging	35.00% Coinsurance after deductible