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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
Premium Child Age 18 275
Premium Adult Individual Age 21 301
Premium Adult Individual Age 27 316
Premium Adult Individual Age 30 342
Premium Adult Individual Age 40 385
Premium Adult Individual Age 50 538
Premium Adult Individual Age 60 818
Premium Couple 21 603
Premium Couple 30 684
Premium Couple 40 770
Premium Couple 50 1,077
Premium Couple 60 1,636
Couple+1 child, Age 21 833
Couple+1 child, Age 30 915
Couple+1 child, Age 40 1,001
Couple+1 child, Age 50 1,307
Couple+2 children, Age 21 1,064
Couple+2 children, Age 30 1,145
Couple+2 children, Age 40 1,232
Couple+2 children, Age 50 1,538
Couple+3 or more Children, Age 21 1,295
Couple+3 or more Children, Age 30 1,376
Couple+3 or more Children, Age 40 1,462
Couple+3 or more Children, Age 50 1,769
Individual+1 child, Age 21 532
Individual+1 child, Age 30 572
Individual+1 child, Age 40 616
Individual+1 child, Age 50 769
Individual+2 children, Age 21 762
Individual+2 children, Age 30 803
Individual+2 children, Age 40 846
Individual+2 children, Age 50 999
Individual+3 or more children, Age 21 993
Individual+3 or more children, Age 30 1,034
Individual+3 or more children, Age 40 1,077
Individual+3 or more children, Age 50 1,230
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