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Florida Hospital GYM ACCESS Bronze HMO 50 1797
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Florida Hospital GYM ACCESS Bronze HMO 50 1797

Overview
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Florida Hospital GYM ACCESS Bronze HMO 50 1797 is an individual health health plan issued by Health First Commercial Plans, Inc. and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Flagler county, Florida.

What Type of Health Plan Is This?

This plan is an HMO plan, which is also known as a "Health Maintenance Organization." An HMO is a type of insurance plan that generally limits coverage to care from doctors who contract with the HMO. Out-of-network doctors are usually not covered.

You may be required to live or work in a particular service area in order to be eligible for the HMO's coverage. In an HMO, you will usually need to have a primary care doctor (PCP) and you need referrals in order to see specialists.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Health First Commercial Plans, Inc.
Plan ID
36194FL0140016
Coverage area
Flagler County, Florida
Phone
Local Phone: 1-855-443-4735
Toll-Free: 1-855-443-4735
TTY: 1-800-955-8771
Plan type
HMO
Coverage type
Medical deductible
$6,900
Out-of-pocket maximum
$7,700
Generic drug co-pay
$35
Preferred brand drug co-pay
35% Coinsurance after deductible
Primary care physician visit cost
$45 and 50% Coinsurance after deductible
Specialist doctor visit cost
50% Coinsurance after deductible
Doctor Visits
Primary Care Visit $45 and 50% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Emergency Room Visit 50% Coinsurance after deductible
Inpatient Facility Visit 50% Coinsurance after deductible
Inpatient Physician Visit 50% Coinsurance after deductible
Prescription Drugs
Generic Drugs $35
Preferred Brand Drugs 35% Coinsurance after deductible
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $6,900
Medical Maximum Out Of Pocket (Individual) $7,700
Medical Deductible (Family) $13,800
Medical Maximum Out Of Pocket (Family) $15,400
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 98.87%
Premium Child Age 0-14 230.69
Premium Child Age 18 275.32
Premium Adult Individual Age 21 301.56
Premium Adult Individual Age 27 316.03
Premium Adult Individual Age 30 342.27
Premium Adult Individual Age 40 385.39
Premium Adult Individual Age 50 538.58
Premium Adult Individual Age 60 818.42
Premium Couple 21 603.12
Premium Couple 30 684.54
Premium Couple 40 770.78
Premium Couple 50 1,077.16
Premium Couple 60 1,636.84
Couple+1 child, Age 21 833.81
Couple+1 child, Age 30 915.23
Couple+1 child, Age 40 1,001.47
Couple+1 child, Age 50 1,307.85
Couple+2 children, Age 21 1,064.5
Couple+2 children, Age 30 1,145.92
Couple+2 children, Age 40 1,232.16
Couple+2 children, Age 50 1,538.54
Couple+3 or more Children, Age 21 1,295.19
Couple+3 or more Children, Age 30 1,376.61
Couple+3 or more Children, Age 40 1,462.85
Couple+3 or more Children, Age 50 1,769.23
Individual+1 child, Age 21 532.25
Individual+1 child, Age 30 572.96
Individual+1 child, Age 40 616.08
Individual+1 child, Age 50 769.27
Individual+2 children, Age 21 762.94
Individual+2 children, Age 30 803.65
Individual+2 children, Age 40 846.77
Individual+2 children, Age 50 999.96
Individual+3 or more children, Age 21 993.63
Individual+3 or more children, Age 30 1,034.34
Individual+3 or more children, Age 40 1,077.46
Individual+3 or more children, Age 50 1,230.65
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types