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Gold
HMO

Everyday Gold + Vision + Adult Dental

Ambetter Health · Mississippi Marketplace plan for 2026

What you pay before the plan starts sharing costs

Deductible (individual)

$800

$1,600 for a family

Out-of-pocket maximum (individual)

$7,250

$14,500 for a family

The out-of-pocket maximum is the most you can pay in a year for covered in-network care. After you reach it, the plan pays everything else.

What you pay for common care

In-network cost sharing for common services on Everyday Gold + Vision + Adult Dental, 2026
ServiceYou pay (in-network)
Primary Care Visit to Treat an Injury or Illness$35
Specialist Visit$55
Emergency Room Services35% Coinsurance after deductible
Generic Drugs$3
Preferred Brand Drugs$60
Inpatient Hospital Services (e.g., Hospital Stay)35% Coinsurance after deductible
Laboratory Outpatient and Professional Services$35
X-rays and Diagnostic Imaging35% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$35

Where this plan is sold in Mississippi

Available in 13 of the rating areas we cover. Premiums differ by area, so check the one you live in.

Benton CountyColumbus Area (Northeast Mississippi)Hattiesburg Area (South Mississippi)Jackson Metro Area (Mississippi)Lafayette CountyMemphis Metro Area (Mississippi Side)Mississippi (Northeast & Southern Rural Counties)Mississippi Delta & Central CountiesMississippi Gulf Coast (Biloxi & Gulfport)Natchez & Starkville Area (Mississippi)Panola CountySouth Central Mississippi (Copiah & Simpson Counties)Tupelo Area (Northeast Mississippi)

Everything Everyday Gold + Vision + Adult Dental covers

Covered benefits and in-network cost sharing for Everyday Gold + Vision + Adult Dental
BenefitYou pay (in-network)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)35% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services35% Coinsurance after deductible
Hospice Services35% Coinsurance after deductible
Routine Dental Services (Adult)Limit: 1000 dollars per yearNo Charge
Routine Eye Exam (Adult)Limit: 1 exams per yearNo Charge
Urgent Care Centers Or Facilities$45
Home Health Care Services35% Coinsurance after deductible
Emergency Room Services35% Coinsurance after deductible
Emergency Transportation/Ambulance35% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35% Coinsurance after deductible
Inpatient Physician and Surgical Services35% Coinsurance after deductible
Skilled Nursing FacilityLimit: 60 days per year35% Coinsurance after deductible
Prenatal And Postnatal Care$35
Delivery And All Inpatient Services For Maternity Care35% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$35
Mental/Behavioral Health Inpatient Services35% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$35
Substance Abuse Disorder Inpatient Services35% Coinsurance after deductible
Primary Care Visit to Treat an Injury or Illness$35
Specialist Visit$55
Other Practitioner Office Visit Nurse Physician Assistant$35
Generic Drugs$3
Preferred Brand Drugs$60
Non-Preferred Brand Drugs45% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible
Outpatient Rehabilitation ServicesLimit: 20 visits per year35% Coinsurance after deductible
Habilitation ServicesLimit: 20 visits per year35% Coinsurance after deductible
Chiropractic CareLimit: 20 visits per year$55
Durable Medical Equipment35% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30%
Preventive Care/Screening/ImmunizationNo Charge
Routine Foot Care$55
Routine Eye Exam for ChildrenLimit: 1 exams per yearNo Charge
Eye Glasses for ChildrenLimit: 1 items per yearNo Charge
Rehabilitative Speech TherapyLimit: 20 visits per year35% Coinsurance after deductible
Rehabilitative Occupational And Rehabilitative Physical TherapyLimit: 20 visits per year35% Coinsurance after deductible
Well Baby Visits And CareNo Charge
Laboratory Outpatient and Professional Services$35
X-rays and Diagnostic Imaging35% Coinsurance after deductible
Basic Dental Care - AdultLimit: 1000 dollars per year50%
Major Dental Care - AdultLimit: 1000 dollars per year50%
Transplant35% Coinsurance after deductible
Accidental Dental35% Coinsurance after deductible
Dialysis35% Coinsurance after deductible
Allergy Testing$55
Chemotherapy35% Coinsurance after deductible
Radiation35% Coinsurance after deductible
Diabetes Education$55
Prosthetic Devices35% Coinsurance after deductible
Infusion Therapy35% Coinsurance after deductible
Treatment For Temporomandibular Joint Disorders35% Coinsurance after deductible
Nutritional Counseling$55
Reconstructive Surgery35% Coinsurance after deductible

Not covered by this plan

  • Infertility Treatment
  • Long Term Custodial Nursing Home Care
  • Private-Duty Nursing
  • Bariatric Surgery
  • Cosmetic Surgery
  • Hearing Aids
  • Acupuncture
  • Weight Loss Programs
  • Dental Check-Up for Children
  • Basic Dental Care - Child
  • Orthodontia - Child
  • Major Dental Care - Child
  • Orthodontia - Adult
  • Abortion Services

Official plan documents

What this page does not show

No premium and no subsidy estimate. Both depend on your age, household size, income and county, not on the plan, so any figure here would be wrong for almost everyone. Check what you would actually pay for Everyday Gold + Vision + Adult Dental in your area:

See your price for this planEstimate your subsidy

Coverage and cost sharing come from the official Marketplace record for plan 90714MS0030060, 2026 plan year. Always confirm against the Summary of Benefits before enrolling.

Plans shown based on input. Not insurance advice. Policymage is not a licensed broker or agent.