Elite Bronze + Vision + Adult Dental

Ambetter from Absolute Total Care · 2026 plan year

Expanded BronzeHSA eligible
Ind. medical deductible
$0
Rx deductible (separate)
$3,800
Family deductible
$0
Ind. OOP max
$10,500
Family OOP max
$21,000

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

Compare with other Expanded Bronze plans in SC

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

More Ambetter from Absolute Total Care plans in SC

Monthly premiums by age

Rating Area 1 — the lowest-priced of the 46 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$252$252
21$330$379
30$374$430
40$421$484
50$589$677
60$894$1,029
64 and over$989$1,137

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$60.00

Specialist

BenefitIn-network
Specialist Visit$120.00

Hospital

BenefitIn-network
Emergency Room Services$2,500.00
Inpatient Hospital Services (e.g., Hospital Stay)50.00%
Mental/Behavioral Health Emergency Room$1,250.00
Mental/Behavioral Health Urgent Care$60.00
Outpatient Surgery Physician/Surgical Services50.00%
Substance Use Disorder Emergency Room$1,250.00
Substance Use Disorder Urgent Care$60.00
Urgent Care Centers or Facilities$65.00

Pharmacy

BenefitIn-network
Generic Drugs$3.00
Non-Preferred Brand Drugs45.00% Coinsurance after deductible
Preferred Brand Drugs$195.00
Specialty Drugs50.00% Coinsurance after deductible
Tier 1b Generic Drugs$40.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Emergency Transportation/Ambulance$1,250.00
Mental/Behavioral Health ER Physician Fee$1,250.00
Mental/Behavioral Health Inpatient Services50.00%
Mental/Behavioral Health Outpatient Other Services50.00%
Mental/Behavioral Health Outpatient Services$60.00
Substance Use Disorder Emergency Transportation/Ambulance$1,250.00
Substance Use Disorder ER Physician Fee$1,250.00
Substance Use Disorder Outpatient Other Services50.00%

Other

BenefitIn-network
Routine Foot Care$120.00
Cosmetic SurgeryNot covered
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00%
AcupunctureNot covered
Allergy Testing$120.00
Bariatric SurgeryNot covered
Basic Dental Care - Adult50.00%
Basic Dental Care - ChildNot covered
Chemotherapy50.00%
Chiropractic Care$80.00
Delivery and All Inpatient Services for Maternity Care50.00%
Dental Check-Up for ChildrenNot covered
Diabetes Education$120.00
Dialysis50.00%
Durable Medical Equipment50.00%
Emergency Transportation/Ambulance50.00%
Eye Glasses for ChildrenNo charge
Habilitation Services50.00%
Hearing AidsNot covered
Home Health Care Services50.00%
Hospice Services50.00%
Imaging (CT/PET Scans, MRIs)50.00%
Infertility TreatmentNot covered
Infusion Therapy50.00%
Inpatient Physician and Surgical Services50.00%
Laboratory Outpatient and Professional Services$65.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - ChildNot covered
Routine Eye Exam for ChildrenNo charge
Nutritional Counseling$120.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$60.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00%
Outpatient Rehabilitation Services50.00%
Prenatal and Postnatal Care$60.00
Private-Duty NursingNot covered
Prosthetic Devices50.00%
Radiation50.00%
Reconstructive Surgery50.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy50.00%
Rehabilitative Speech Therapy50.00%
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)No charge
Skilled Nursing Facility50.00%
Substance Abuse Disorder Inpatient Services50.00%
Substance Abuse Disorder Outpatient Services$60.00
Transplant50.00%
Treatment for Temporomandibular Joint Disorders50.00%
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging50.00%

Plan rules

Service area

This plan covers 1 geographic area.

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