Everyday Gold + Vision + Adult Dental

Ambetter from Sunflower 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 KS

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

BlueCare EPO Gold PlusBlue Cross and Blue Shield of Kansas, Inc. · Deductible $700 · Out-of-pocket max $8,300
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)UnitedHealthcare · Deductible $500 · Out-of-pocket max $7,000
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)UnitedHealthcare · Deductible $500 · Out-of-pocket max $7,000

Compare 4 plans Browse all Gold plans in KS

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Gold Off Exchange Plan Zero Cost Sharing Plan Variation

More Ambetter from Sunflower Health Plan plans in KS

Focused Silver Standard Silver

Monthly premiums by age

Rating Area 1 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$382	$382
21	$499	$574
30	$566	$651
40	$638	$733
50	$891	$1,025
60	$1,354	$1,558
64 and over	$1,497	$1,722

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
Substance Use Disorder Emergency Room	35.00% Coinsurance after deductible
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 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
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 ER Physician Fee	35.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Other 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 ER Physician Fee	35.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services	35.00% Coinsurance after deductible

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	35.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$55.00
Bariatric Surgery	Not covered
Basic Dental Care - Adult	50.00%
Basic Dental Care - Child	Not covered
Chemotherapy	35.00% Coinsurance after deductible
Chiropractic Care	$55.00
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	35.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
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
Home Health Care Services	35.00% Coinsurance after deductible
Hospice Services	35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	28.00% 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
Nutritional Counseling	$55.00
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	35.00% Coinsurance after deductible
Outpatient Rehabilitation Services	35.00% Coinsurance after deductible
Prenatal and Postnatal Care	$35.00
Private-Duty Nursing	35.00% Coinsurance after deductible
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	Not covered
Substance Abuse Disorder Inpatient Services	35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$35.00
Transplant	35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	35.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	35.00% Coinsurance after deductible