Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental

Ambetter of Alabama · 2026 plan year

Silver

Ind. deductible: $5,000
Family deductible: $10,000
Ind. OOP max: $8,650
Family OOP max: $17,300

Compare with other Silver plans in AL

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

Blue Cross Select SilverBlue Cross and Blue Shield of Alabama · Deductible $5,000 · Out-of-pocket max $10,600
Silver Simple Chronic Care CKMOscar Insurance Company · Deductible $5,900 · Out-of-pocket max $10,150
Blue Saver Silver EPOBlue Cross and Blue Shield of Alabama · Deductible $4,000 · Out-of-pocket max $9,450

Compare 4 plans Browse all Silver plans in AL

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 Standard Silver Off Exchange Plan Zero Cost Sharing Plan Variation

More Ambetter of Alabama plans in AL

Standard Silver Standard Expanded Bronze + Vision + Adult Dental Complete Gold

Monthly premiums by age

Rating Area 13 — the lowest-priced of the 11 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$338	$338
21	$532	$612
30	$604	$694
40	$680	$782
50	$950	$1,092
60	$1,444	$1,660
64 and over	$1,596	$1,835

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	$50.00

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	$30.00
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$50.00
Substance Use Disorder Emergency Room	50.00% Coinsurance after deductible
Substance Use Disorder Urgent Care	$30.00

Pharmacy

Benefit	In-network
Enhanced Diabetes $0 Drug Options	No charge
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	$20.00

Mental Health

Benefit	In-network
Mental/Behavioral Health Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Mental/Behavioral Health ER Physician Fee	50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Other Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$30.00
Substance Use Disorder Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Substance Use Disorder ER Physician Fee	50.00% Coinsurance after deductible
Substance Use Disorder Outpatient Other Services	50.00% Coinsurance after deductible

Other

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