Ambetter Health
Elite Gold (QualChoice) + Vision + Adult Dental
Plan ID70525AR0210002
Plan year2027Sold on HealthCare.gov
Plan typePOSNo referral needed
Metal levelGoldNot HSA-eligible
Sold inEvery countyStatewide
Deductible$0$0 family
Out-of-pocket max$8,150$16,300 family
Primary care visit$25in network
Generic drugs$3per prescription
15,487 Arkansas doctors and facilities in this plan's network · Directory updated Nov 4, 2026 · Monthly premiums are not shown: they depend on age, county and income. HealthCare.gov lists them for your household.
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Listed in Ambetter Health's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $0 deductible.
Doctor visits
- Primary care visit
- $25
- Specialist visit
- $70
- Nurse practitioner or PA visit
- $25
- Preventive care and vaccines
- Free
- Urgent care
- $35
Prescription drugs
- Generic drugs
- $3
- Preferred brand drugs
- $50
- Non-preferred brand drugs
- 45%
- Specialty drugs
- 50%
Tests and imaging
- Lab work
- $40
- X-rays
- $75
- MRI, CT and PET scans
- $75
Emergencies and hospital
- Emergency room
- 30%
- Ambulance
- 30%
- Hospital stay
- 30%
- Outpatient surgery (facility)
- $200
Mental health
- Therapy and counseling visits
- $25
- Inpatient mental health care
- 30%
Pregnancy
- Prenatal and postnatal care
- $25
- Delivery and hospital stay
- 30%
Other care
- Physical and occupational therapyLimit: 30 visits a year
- $50
- Chiropractic careLimit: 30 visits a year
- $70
- Eye exam for childrenLimit: 1 exam a year
- Free
- Glasses for childrenLimit: 1 item a year
- Free
- Adult dentalLimit: $1,000 a year
- Free
$3,260Having a baby (CMS example)
$1,520Managing type 2 diabetes for a year
$1,100A simple fracture
Every service in the plan file (88)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | $200 | |
| Acupuncture | Not covered | |
| Allergy Testing | $70 | |
| Applied Behavior Analysis Based Therapies | $200 | |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | 50% | $1,000 a year |
| Basic Dental Care - Child | Not covered | |
| Cardiac Rehabilitation | $50 | 36 visits a year |
| Chemotherapy | 30% | |
| Chiropractic Care | $70 | 30 visits a year |
| Cochlear Implants | 30% | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | 30% | |
| Dental Anesthesia | $200 | |
| Dental Check-Up for Children | Not covered | |
| Diabetes Care Management | $70 | |
| Diabetes Education | $70 | |
| Dialysis | $200 | |
| Durable Medical Equipment | 30% | |
| Emergency Room Services | 30% | |
| Emergency Transportation/Ambulance | 30% | |
| Eye Glasses for Children | Free | 1 item a year |
| Gastric Electrical Stimulation | 30% | |
| Generic Drugs | $3 | |
| Habilitation Services | $50 | 30 visits a year |
| Hearing Aids | 30% | 2 items every 3 years |
| Home Health Care Services | 30% | 50 visits a year |
| Hospice Services | 30% | |
| Imaging (CT/PET Scans, MRIs) | $75 | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | $200 | |
| Inherited Metabolic Disorder - PKU | $40 | |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30% | |
| Inpatient Physician and Surgical Services | 30% | |
| Laboratory Outpatient and Professional Services | $40 | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | 50% | $1,000 a year |
| Major Dental Care - Child | Not covered | |
| Mental/Behavioral Health Emergency Room | 30% | |
| Mental/Behavioral Health Emergency Transportation/Ambulance | 30% | |
| Mental/Behavioral Health ER Physician Fee | 30% | |
| Mental/Behavioral Health Inpatient Services | 30% | |
| Mental/Behavioral Health Outpatient Other Services | $200 | |
| Mental/Behavioral Health Outpatient Services | $25 | |
| Mental/Behavioral Health Urgent Care | $25 | |
| Non-Preferred Brand Drugs | 45% | |
| Nutritional Counseling | $70 | |
| Off Label Prescription Drugs | 50% | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | Not covered | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25 | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $200 | |
| Outpatient Rehabilitation Services | $50 | 30 visits a year |
| Outpatient Surgery Physician/Surgical Services | $200 | |
| Preferred Brand Drugs | $50 | |
| Prenatal and Postnatal Care | $25 | |
| Preventative Drugs | Free | |
| Preventive Care/Screening/Immunization | Free | |
| Primary Care Visit to Treat an Injury or Illness | $25 | |
| Private-Duty Nursing | Not covered | |
| Prosthetic Devices | 30% | |
| Radiation | $200 | |
| Reconstructive Surgery | 30% | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50 | 30 visits a year |
| Rehabilitative Speech Therapy | $50 | 30 visits a year |
| Routine Dental Services (Adult) | Free | $1,000 a year |
| Routine Eye Exam (Adult) | Free | 1 exam a year |
| Routine Eye Exam for Children | Free | 1 exam a year |
| Routine Foot Care | $70 | |
| Skilled Nursing Facility | 30% | 60 days a year |
| Specialist Visit | $70 | |
| Specialty Drugs | 50% | |
| Substance Abuse Disorder Inpatient Services | 30% | |
| Substance Abuse Disorder Outpatient Services | $25 | |
| Substance Use Disorder Emergency Room | 30% | |
| Substance Use Disorder Emergency Transportation/Ambulance | 30% | |
| Substance Use Disorder ER Physician Fee | 30% | |
| Substance Use Disorder Outpatient Other Services | $200 | |
| Substance Use Disorder Urgent Care | $25 | |
| Tier 1b Generic Drugs | $15 | |
| Transplant | 30% | |
| Treatment for Temporomandibular Joint Disorders | $200 | |
| Urgent Care Centers or Facilities | $35 | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| Well Child Care | Free | |
| X-rays and Diagnostic Imaging | $75 |
How this plan works
POS: You pay less in the network. Some care outside it is covered at a higher cost, and specialists usually need a referral.
- Referral for specialists
- Not required
- Coinsurance
- 30% after the deductible
- Works with an HSA
- No
- Network
- Premier (ARN001)
- Sold in
- Every Arkansas county
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other Ambetter Health plans on the same network
The same doctors and hospitals, with different costs.
| Plan | Metal | Deductible | Out-of-pocket max |
|---|---|---|---|
| Elite Bronze (QualChoice) POS | Expanded Bronze | $0 | $11,800 |
| Elite Bronze (QualChoice) + Vision + Adult Dental POS | Expanded Bronze | $0 | $11,800 |
| Elite Gold (QualChoice) POS | Gold | $0 | $8,150 |
| Clear Gold (QualChoice) POS | Gold | $1,200 | $9,150 |
| Clear Gold (QualChoice) + Vision + Adult Dental POS | Gold | $1,200 | $9,150 |
| Signature Gold (QualChoice) POS | Gold | $2,500 | $8,600 |
| Signature Gold (QualChoice) + Vision + Adult Dental POS | Gold | $2,500 | $8,600 |
| Streamlined Silver (QualChoice) POS | Silver | $4,700 | $11,300 |
| Signature Silver (QualChoice) POS | Silver | $6,400 | $10,300 |
| Signature Silver (QualChoice) + Vision + Adult Dental POS | Silver | $6,400 | $10,300 |
| Signature Expanded Bronze (QualChoice) POS | Expanded Bronze | $7,500 | $12,000 |
| Signature Expanded Bronze (QualChoice) + Vision + Adult Dental POS | Expanded Bronze | $7,500 | $12,000 |
| Choice Bronze HSA (QualChoice) POS | Expanded Bronze | $7,950 | $7,950 |
| Choice Bronze HSA (QualChoice) + Vision + Adult Dental POS | Expanded Bronze | $7,950 | $7,950 |
Questions about Elite Gold (QualChoice) + Vision + Adult Dental
Does Elite Gold (QualChoice) + Vision + Adult Dental cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers Ambetter Health lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is Elite Gold (QualChoice) + Vision + Adult Dental?
It is a POS plan: you pay less in the network. Some care outside it is covered at a higher cost, and specialists usually need a referral. It is a Gold plan.
How much is a doctor visit with Elite Gold (QualChoice) + Vision + Adult Dental?
A primary care visit costs $25. A specialist visit costs $70. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $0 deductible.
Where is Elite Gold (QualChoice) + Vision + Adult Dental sold?
It is sold to people who live in every Arkansas county, through HealthCare.gov.
Why is there no monthly premium on this page?
Premiums depend on your age, county, household size and income, and most people get a subsidy, so a single price would mislead. HealthCare.gov shows the price for your household.
About this data
- Plan, costs and counties: the CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Service Area), plan year 2027. Costs are for the standard version of the plan; people who qualify for cost-sharing reductions pay less.
- Doctors: Ambetter Health's machine-readable provider directory, matched to the NPPES NPI registry. Only providers with an address in Arkansas are counted. Updated November 8, 2026.
- Accuracy: confirm costs in the plan documents and with the insurer. NPI Profile is not affiliated with CMS, HealthCare.gov or Ambetter Health.
