Complete Silver HMO $5950 $30 + Vision + Adult Dental

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

Silver

Ind. deductible: $5,950
Family deductible: $11,900
Ind. OOP max: $8,850
Family OOP max: $17,700

Compare with other Silver plans in GA

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

Silver Simple MultiCondition Guided Care HMO $5900 $0Oscar Health Plan of Georgia · Deductible $5,900 · Out-of-pocket max $10,150
KP GA Signature Silver HMO $6000 $50Kaiser Foundation Health Plan of Georgia, Inc. · Deductible $6,000 · Out-of-pocket max $8,600
Anthem Silver Blue Value HMO 6000 $10 $0 Virtual PCP $0 Select DrugsAnthem Blue Cross and Blue Shield · Deductible $6,000 · Out-of-pocket max $9,000

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	$429	$493
30	$487	$560
40	$548	$631
50	$766	$881
60	$1,165	$1,339
64 and over	$1,287	$1,480

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	$30.00

Specialist

Benefit	In-network
Specialist Visit	$60.00

Hospital

Benefit	In-network
Emergency Room Services	40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	40.00% Coinsurance after deductible
Mental Behavioral Health Emergency Room	40.00% Coinsurance after deductible
Mental Behavioral Health Urgent Care	$30.00
Outpatient Surgery Physician/Surgical Services	40.00% Coinsurance after deductible
Substance Use Disorder Emergency Room	40.00% Coinsurance after deductible
Substance Use Disorder Urgent Care	$30.00
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	$55.00
Specialty Drugs	50.00% Coinsurance after deductible
TIER_1B_GENERIC_DRUGS	$20.00

Mental Health

Benefit	In-network
Mental Behavioral Health Emergency Transportation Ambulance	40.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$30.00
Substance Use Disorder Emergency Transportation Ambulance	40.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services	40.00% Coinsurance after deductible

Other

Benefit	In-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	40.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	40.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$60.00
Autism Spectrum Disorders	40.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	50.00%
Basic Dental Care - Child	Not covered
Bone Marrow Transplant	40.00% Coinsurance after deductible
Chemotherapy	40.00% Coinsurance after deductible
Chiropractic Care	$60.00
CLINICAL_TRIALS	40.00% Coinsurance after deductible
Cosmetic Surgery	40.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	40.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
DENTAL_ANESTHESIA	40.00% Coinsurance after deductible
Diabetes Care	$60.00
Diabetes Education	$60.00
Dialysis	40.00% Coinsurance after deductible
Durable Medical Equipment	40.00% Coinsurance after deductible
Emergency Transportation/Ambulance	40.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	40.00% Coinsurance after deductible
Hearing Aids	Not covered
HEART_TRANSPLANT	40.00% Coinsurance after deductible
Home Health Care Services	40.00% Coinsurance after deductible
Hospice Services	40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	40.00% Coinsurance after deductible
Infusion Therapy	40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$30.00
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	40.00% Coinsurance after deductible
MENTAL_BEHAVIORAL_HEALTH_OUTPATIENT_OTHER_SERVICES	40.00% Coinsurance after deductible
Nutritional Counseling	$60.00
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$30.00
Outpatient Rehabilitation Services	40.00% Coinsurance after deductible
Prenatal and Postnatal Care	$30.00
Private-Duty Nursing	Not covered
Prosthetic Devices	40.00% Coinsurance after deductible
Radiation	40.00% Coinsurance after deductible
Reconstructive Surgery	40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	40.00% Coinsurance after deductible
Rehabilitative Speech Therapy	40.00% 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	$60.00
Skilled Nursing Facility	40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$30.00
SUBSTANCE_USE_DISORDER_ER_PHYSICIAN_FEE	40.00% Coinsurance after deductible
Transplant	40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	40.00% Coinsurance after deductible
Weight Loss Programs	$60.00
Well Baby Visits and Care	No charge
Well Child Care	No charge
X-rays and Diagnostic Imaging	40.00% Coinsurance after deductible