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Florida Hospital GYM ACCESS Gold HMO 80 1741
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Florida Hospital GYM ACCESS Gold HMO 80 1741

Overview
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Florida Hospital GYM ACCESS Gold HMO 80 1741 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
36194FL0140012
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
$3,450
Out-of-pocket maximum
$7,900
Generic drug co-pay
$15
Preferred brand drug co-pay
$30 Copay after deductible
Primary care physician visit cost
$15
Specialist doctor visit cost
$30
Doctor Visits
Primary Care Visit $15
Specialist Visit $30
Emergency Room Visit 20% Coinsurance after deductible
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $15
Preferred Brand Drugs $30 Copay after deductible
Non-preferred Brand Drugs $50 Copay after deductible
Specialty Drugs 20% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $3,450
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $6,900
Medical Maximum Out Of Pocket (Family) $15,800
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 99.09%
Premium Child Age 0-14 287
Premium Child Age 18 343
Premium Adult Individual Age 21 375
Premium Adult Individual Age 27 393
Premium Adult Individual Age 30 426
Premium Adult Individual Age 40 480
Premium Adult Individual Age 50 671
Premium Adult Individual Age 60 1,020
Premium Couple 21 751
Premium Couple 30 853
Premium Couple 40 960
Premium Couple 50 1,342
Premium Couple 60 2,040
Couple+1 child, Age 21 1,039
Couple+1 child, Age 30 1,140
Couple+1 child, Age 40 1,248
Couple+1 child, Age 50 1,630
Couple+2 children, Age 21 1,327
Couple+2 children, Age 30 1,428
Couple+2 children, Age 40 1,536
Couple+2 children, Age 50 1918
Couple+3 or more Children, Age 21 1,614
Couple+3 or more Children, Age 30 1,716
Couple+3 or more Children, Age 40 1,823
Couple+3 or more Children, Age 50 2,205
Individual+1 child, Age 21 663
Individual+1 child, Age 30 714
Individual+1 child, Age 40 768
Individual+1 child, Age 50 959
Individual+2 children, Age 21 951
Individual+2 children, Age 30 1,001
Individual+2 children, Age 40 1,055
Individual+2 children, Age 50 1,246
Individual+3 or more children, Age 21 1,238
Individual+3 or more children, Age 30 1,289
Individual+3 or more children, Age 40 1,343
Individual+3 or more children, Age 50 1,534
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