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Gold
HMO
Standardized plan

Standard Gold

Ambetter Health · Mississippi Marketplace plan for 2026

What you pay before the plan starts sharing costs

Deductible (individual)

$2,000

$4,000 for a family

Out-of-pocket maximum (individual)

$8,200

$16,400 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 Standard Gold, 2026
ServiceYou pay (in-network)
Primary Care Visit to Treat an Injury or Illness$30
Specialist Visit$60
Emergency Room Services25% Coinsurance after deductible
Generic Drugs$15
Preferred Brand Drugs$30
Inpatient Hospital Services (e.g., Hospital Stay)25% Coinsurance after deductible
Laboratory Outpatient and Professional Services25% Coinsurance after deductible
X-rays and Diagnostic Imaging25% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$30

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 Standard Gold covers

Covered benefits and in-network cost sharing for Standard Gold
BenefitYou pay (in-network)
Routine Eye Exam for ChildrenLimit: 1 exams per yearNo Charge
Preventive Care/Screening/ImmunizationNo Charge
Routine Foot Care$60
Rehabilitative Speech TherapyLimit: 20 visits per year$30
Habilitation ServicesLimit: 20 visits per year$30
Chiropractic CareLimit: 20 visits per year$60
Durable Medical Equipment25% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)25% Coinsurance after deductible
Primary Care Visit to Treat an Injury or Illness$30
Specialist Visit$60
Other Practitioner Office Visit Nurse Physician Assistant$30
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25% Coinsurance after deductible
Hospice Services25% Coinsurance after deductible
Urgent Care Centers Or Facilities$45
Home Health Care Services25% Coinsurance after deductible
Emergency Room Services25% Coinsurance after deductible
Emergency Transportation/Ambulance25% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)25% Coinsurance after deductible
Inpatient Physician and Surgical Services25% Coinsurance after deductible
Skilled Nursing FacilityLimit: 60 days per year25% Coinsurance after deductible
Prenatal And Postnatal Care$30
Delivery And All Inpatient Services For Maternity Care25% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$30
Mental/Behavioral Health Inpatient Services25% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$30
Substance Abuse Disorder Inpatient Services25% Coinsurance after deductible
Generic Drugs$15
Preferred Brand Drugs$30
Non-Preferred Brand Drugs$60
Specialty Drugs$250
Outpatient Rehabilitation ServicesLimit: 20 visits per year$30
Eye Glasses for ChildrenLimit: 1 items per yearNo Charge
Rehabilitative Occupational And Rehabilitative Physical TherapyLimit: 20 visits per year$30
Well Baby Visits And CareNo Charge
Laboratory Outpatient and Professional Services25% Coinsurance after deductible
X-rays and Diagnostic Imaging25% Coinsurance after deductible
Transplant25% Coinsurance after deductible
Accidental Dental25% Coinsurance after deductible
Dialysis25% Coinsurance after deductible
Allergy Testing$60
Chemotherapy25% Coinsurance after deductible
Radiation25% Coinsurance after deductible
Diabetes Education$60
Prosthetic Devices25% Coinsurance after deductible
Infusion Therapy25% Coinsurance after deductible
Treatment For Temporomandibular Joint Disorders25% Coinsurance after deductible
Nutritional Counseling$60
Reconstructive Surgery25% Coinsurance after deductible

Not covered by this plan

  • Weight Loss Programs
  • Acupuncture
  • Hearing Aids
  • Routine Dental Services (Adult)
  • Infertility Treatment
  • Long Term Custodial Nursing Home Care
  • Private-Duty Nursing
  • Routine Eye Exam (Adult)
  • Bariatric Surgery
  • Cosmetic Surgery
  • Dental Check-Up for Children
  • Basic Dental Care - Child
  • Orthodontia - Child
  • Major Dental Care - Child
  • Basic Dental Care - Adult
  • Orthodontia - Adult
  • Major Dental Care - 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 Standard Gold in your area:

See your price for this planEstimate your subsidy

Coverage and cost sharing come from the official Marketplace record for plan 90714MS0010065, 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.