AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
AmeriHealth Caritas Next · 2027 plan year
Gold
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $9,000
- Family OOP max
- $18,000
Compare with other Gold plans in FL
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More AmeriHealth Caritas Next plans in FL
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No ReferralsAmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care +No ReferralsAmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
Monthly premiums by age
Rating Area 30 — the lowest-priced of the 16 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $447 | $447 |
| 21 | $584 | $701 |
| 30 | $663 | $795 |
| 40 | $746 | $895 |
| 50 | $1,043 | $1,251 |
| 60 | $1,584 | $1,901 |
| 64 and over | $1,751 | $2,102 |
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 | No charge |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $35.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $1,000.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $1500.00 Copay per Day |
| Outpatient Surgery Physician/Surgical Services | $250.00 |
| Urgent Care Centers or Facilities | $60.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $5.00 |
| Non-Preferred Brand Drugs | 35.00% |
| Non-Preferred Generic Drugs | $25.00 |
| Non-Preferred Specialty Drugs | 50.00% |
| Preferred Brand Drugs | $60.00 |
| Specialty Drugs | 40.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $1500.00 Copay per Day |
| Mental/Behavioral Health Outpatient Services | No charge |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 20.00% |
| Acupuncture | Not covered |
| Allergy Testing | $35.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Bone Marrow Transplant | 20.00% |
| Cardiac Rehabilitation | 20.00% |
| Chemotherapy | 20.00% |
| Child Health Supervision | No charge |
| Chiropractic Care | $35.00 |
| Congenital Anomaly, including Cleft Lip/Palate | 20.00% |
| Contraceptive Injections | 20.00% |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 20.00% |
| Dental Anesthesia | 20.00% |
| Dental Check-Up for Children | Not covered |
| Diabetes Care Management | 20.00% |
| Diabetes Education | No charge |
| Dialysis | 20.00% |
| Doula | $35.00 |
| Durable Medical Equipment | 50.00% |
| Emergency Transportation/Ambulance | 20.00% |
| Enteral Formulas | 20.00% |
| Eye Glasses for Children | No charge |
| Habilitation Services | $35.00 |
| Hearing Aids | Not covered |
| Home Health Care Services | 20.00% |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $300.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | 20.00% |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | $50.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Mammogram | No charge |
| Mastectomy | 20.00% |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Orthotic Devices | 50.00% |
| Osteoporosis | 20.00% |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | No charge |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $500.00 |
| Outpatient Rehabilitation Services | $35.00 |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 50.00% |
| Pulmonary Rehabilitation | 20.00% |
| Radiation | 20.00% |
| Reconstructive Surgery | 20.00% |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $35.00 |
| Rehabilitative Speech Therapy | $35.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $35.00 |
| Skilled Nursing Facility | $1500.00 Copay per Day |
| Substance Abuse Disorder Inpatient Services | $1500.00 Copay per Day |
| Substance Abuse Disorder Outpatient Services | No charge |
| Transplant | 20.00% |
| Treatment for Temporomandibular Joint Disorders | 20.00% |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $65.00 |
Plan rules
Service area
This plan covers 16 geographic areas.
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