Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.
AmeriHealth Caritas Next Silver Essential + No Referrals
AmeriHealth Caritas Next · 2026 plan year
Silver
- Ind. deductible
- $6,100
- Family deductible
- $12,200
- Ind. OOP max
- $9,000
- Family OOP max
- $18,000
Other cost-sharing reduction variants for this plan:
More AmeriHealth Caritas Next plans in DE
Monthly premiums by age
Rating Area 1
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $458 | $458 |
| 21 | $599 | $719 |
| 30 | $680 | $816 |
| 40 | $766 | $919 |
| 50 | $1,070 | $1,284 |
| 60 | $1,626 | $1,951 |
| 64 and over | $1,797 | $2,157 |
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 | $25.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $70.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 35.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 35.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $45.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $25.00 |
| Non-Preferred Brand Drugs | $125.00 Copay after deductible |
| Preferred Brand Drugs | $60.00 |
| Specialty Drugs | $150.00 Copay after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 35.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $25.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | No charge |
| Accidental Dental | 35.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $70.00 |
| Autism Spectrum Disorders | 35.00% Coinsurance after deductible |
| Bariatric Surgery | 50.00% Coinsurance after deductible |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Cancer Monitoring Test | 35.00% Coinsurance after deductible |
| Cardiac Rehabilitation | 35.00% Coinsurance after deductible |
| Chemotherapy | 35.00% Coinsurance after deductible |
| Chiropractic Care | $70.00 |
| Clinical Trials | 35.00% Coinsurance after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 35.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Dental Services for Children with Severe Disabilities | 35.00% Coinsurance after deductible |
| Diabetes Care Management | 35.00% Coinsurance after deductible |
| Diabetes Education | No charge |
| Dialysis | 35.00% Coinsurance after deductible |
| Doula | $70.00 |
| Durable Medical Equipment | 50.00% 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 | 35.00% Coinsurance after deductible |
| Home Health Care Services | 35.00% Coinsurance after deductible |
| Hospice Services | No Charge after deductible |
| Imaging (CT/PET Scans, MRIs) | 35.00% Coinsurance after deductible |
| Infertility Treatment | 35.00% Coinsurance after deductible |
| Infusion Therapy | 35.00% Coinsurance after deductible |
| Inherited Metabolic Disorder - PKU | 35.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 35.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 35.00% Coinsurance after deductible |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Newborn Hearing Screening | No charge |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25.00 |
| 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 | No charge |
| Private-Duty Nursing | 35.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| Prosthetic Devices | 50.00% Coinsurance after deductible |
| Pulmonary Rehabilitation | 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 |
| Reversible Contraceptives | 35.00% Coinsurance after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $70.00 |
| School Based Health Centers | 35.00% Coinsurance after deductible |
| Skilled Nursing Facility | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $25.00 |
| Transplant | 35.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 50.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| X-rays and Diagnostic Imaging | 35.00% Coinsurance after deductible |
Service area
This plan covers 1 geographic area.
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