Focused Silver HMO $6300 $40 + Vision + Adult Dental

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

Silver

Ind. deductible: $6,300
Family deductible: $12,600
Ind. OOP max: $8,400
Family OOP max: $16,800

Compare with other Silver plans in GA

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

Low Premium Silver HMO 6200 $40 and Adult Vision and FitnessCareSource Georgia Co. · Deductible $6,200 · Out-of-pocket max $9,800
Silver Simple Breathe Easy with Enhanced COPD Benefits HMO $6200 $0Oscar Health Plan of Georgia · Deductible $6,200 · Out-of-pocket max $9,600
Low Premium Silver HMO 6200 $40CareSource Georgia Co. · Deductible $6,200 · Out-of-pocket max $9,800

Compare 4 plans Browse all Silver plans in GA

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan 94% AV Level Silver 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	$328	$328
21	$428	$493
30	$486	$559
40	$547	$630
50	$765	$880
60	$1,163	$1,337
64 and over	$1,285	$1,478

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	$40.00

Specialist

Benefit	In-network
Specialist Visit	$85.00

Hospital

Benefit	In-network
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Mental Behavioral Health Emergency Room	50.00% Coinsurance after deductible
Mental Behavioral Health Urgent Care	$40.00
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Substance Use Disorder Emergency Room	50.00% Coinsurance after deductible
Substance Use Disorder Urgent Care	$40.00
Urgent Care Centers or Facilities	$60.00

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	$75.00
Specialty Drugs	50.00% Coinsurance after deductible
TIER_1B_GENERIC_DRUGS	$15.00

Mental Health

Benefit	In-network
Mental Behavioral Health Emergency Transportation Ambulance	50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$40.00
Substance Use Disorder Emergency Transportation Ambulance	50.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services	50.00% Coinsurance after deductible

Other

Benefit	In-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	50.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$85.00
Autism Spectrum Disorders	50.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	50.00%
Basic Dental Care - Child	Not covered
Bone Marrow Transplant	50.00% Coinsurance after deductible
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$85.00
CLINICAL_TRIALS	50.00% Coinsurance after deductible
Cosmetic Surgery	50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
DENTAL_ANESTHESIA	50.00% Coinsurance after deductible
Diabetes Care	$85.00
Diabetes Education	$85.00
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00% Coinsurance after deductible
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	50.00% Coinsurance after deductible
Hearing Aids	Not covered
HEART_TRANSPLANT	50.00% Coinsurance after deductible
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infertility Treatment	50.00% Coinsurance after deductible
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$50.00
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	50.00% Coinsurance after deductible
MENTAL_BEHAVIORAL_HEALTH_OUTPATIENT_OTHER_SERVICES	50.00% Coinsurance after deductible
Nutritional Counseling	$85.00
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$40.00
Outpatient Rehabilitation Services	50.00% Coinsurance after deductible
Prenatal and Postnatal Care	$40.00
Private-Duty Nursing	Not covered
Prosthetic Devices	50.00% Coinsurance after deductible
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	50.00% Coinsurance after deductible
Rehabilitative Speech Therapy	50.00% 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	$85.00
Skilled Nursing Facility	50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$40.00
SUBSTANCE_USE_DISORDER_ER_PHYSICIAN_FEE	50.00% Coinsurance after deductible
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Weight Loss Programs	$85.00
Well Baby Visits and Care	No charge
Well Child Care	No charge
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible