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Florida Hospital Silver HMO 80 1786
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Florida Hospital Silver HMO 80 1786

Overview
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Florida Hospital Silver HMO 80 1786 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
36194FL0180005
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
$2,900
Out-of-pocket maximum
$7,150
Generic drug co-pay
$15
Preferred brand drug co-pay
$30 Copay after deductible
Primary care physician visit cost
20% Coinsurance after deductible
Specialist doctor visit cost
20% Coinsurance after deductible
Doctor Visits
Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
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 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $2,900
Medical Maximum Out Of Pocket (Individual) $7,150
Medical Deductible (Family) $5,800
Medical Maximum Out Of Pocket (Family) $14,300
Drug Deductible
Drug Deductible (Individual) $500
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $1,000
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 344
Premium Child Age 18 411
Premium Adult Individual Age 21 450
Premium Adult Individual Age 27 472
Premium Adult Individual Age 30 511
Premium Adult Individual Age 40 575
Premium Adult Individual Age 50 804
Premium Adult Individual Age 60 1,223
Premium Couple 21 901
Premium Couple 30 1,022
Premium Couple 40 1,151
Premium Couple 50 1,609
Premium Couple 60 2,446
Couple+1 child, Age 21 1,245
Couple+1 child, Age 30 1,367
Couple+1 child, Age 40 1,496
Couple+1 child, Age 50 1,954
Couple+2 children, Age 21 1,590
Couple+2 children, Age 30 1,712
Couple+2 children, Age 40 1,841
Couple+2 children, Age 50 2,299
Couple+3 or more Children, Age 21 1,935
Couple+3 or more Children, Age 30 2,057
Couple+3 or more Children, Age 40 2,186
Couple+3 or more Children, Age 50 2,643
Individual+1 child, Age 21 795
Individual+1 child, Age 30 856
Individual+1 child, Age 40 920
Individual+1 child, Age 50 1,149
Individual+2 children, Age 21 1,140
Individual+2 children, Age 30 1,200
Individual+2 children, Age 40 1,265
Individual+2 children, Age 50 1,494
Individual+3 or more children, Age 21 1,484
Individual+3 or more children, Age 30 1,545
Individual+3 or more children, Age 40 1,610
Individual+3 or more children, Age 50 1,839
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