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Florida Hospital GYM ACCESS Gold HMO 70 1743
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Florida Hospital GYM ACCESS Gold HMO 70 1743

Overview
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Florida Hospital GYM ACCESS Gold HMO 70 1743 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
36194FL0140013
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
$1,500
Out-of-pocket maximum
$3,500
Generic drug co-pay
$15
Preferred brand drug co-pay
$30 Copay after deductible
Primary care physician visit cost
$40
Specialist doctor visit cost
$80
Doctor Visits
Primary Care Visit $40
Specialist Visit $80
Emergency Room Visit $250
Inpatient Facility Visit $700 Copay per Stay
Inpatient Physician Visit No Charge
Prescription Drugs
Generic Drugs $15
Preferred Brand Drugs $30 Copay after deductible
Non-preferred Brand Drugs $50 Copay after deductible
Specialty Drugs 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $1,500
Medical Maximum Out Of Pocket (Individual) $3,500
Medical Deductible (Family) $3,000
Medical Maximum Out Of Pocket (Family) $7,000
Drug Deductible
Drug Deductible (Individual) $200
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $400
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 99.18%
Premium Child Age 0-14 320
Premium Child Age 18 381
Premium Adult Individual Age 21 418
Premium Adult Individual Age 27 438
Premium Adult Individual Age 30 474
Premium Adult Individual Age 40 534
Premium Adult Individual Age 50 747
Premium Adult Individual Age 60 1,135
Premium Couple 21 836
Premium Couple 30 949
Premium Couple 40 1,069
Premium Couple 50 1,494
Premium Couple 60 2,270
Couple+1 child, Age 21 1,156
Couple+1 child, Age 30 1,269
Couple+1 child, Age 40 1,389
Couple+1 child, Age 50 1,814
Couple+2 children, Age 21 1,476
Couple+2 children, Age 30 1,589
Couple+2 children, Age 40 1,709
Couple+2 children, Age 50 2,134
Couple+3 or more Children, Age 21 1,796
Couple+3 or more Children, Age 30 1,909
Couple+3 or more Children, Age 40 2,029
Couple+3 or more Children, Age 50 2,454
Individual+1 child, Age 21 738
Individual+1 child, Age 30 794
Individual+1 child, Age 40 854
Individual+1 child, Age 50 1,067
Individual+2 children, Age 21 1,058
Individual+2 children, Age 30 1,114
Individual+2 children, Age 40 1,174
Individual+2 children, Age 50 1,387
Individual+3 or more children, Age 21 1,378
Individual+3 or more children, Age 30 1,434
Individual+3 or more children, Age 40 1,494
Individual+3 or more children, Age 50 1,707
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