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Gold Classic 2000
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Gold Classic 2000

Overview
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Gold Classic 2000 is an individual health health plan issued by QCA Health Plan, 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 White county, Arkansas.

What Type of Health Plan Is This?

This plan is a POS plan, or a Point of Service plan. This plan requires you get a referral from your primary care doctor in order to see a specialist doctor. You pay less if you use providers that are in-network and you pay more if you use those that are out-of-network.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
QCA Health Plan, Inc.
Plan ID
70525AR0070050
Coverage area
White County, Arkansas
Phone
Local Phone: 1-501-228-7111x7006
Toll-Free: 1-800-235-7111
TTY: 1-501-219-5188
Plan type
POS
Coverage type
Medical deductible
$2,000
Out-of-pocket maximum
$4,000
Generic drug co-pay
$10
Preferred brand drug co-pay
$35
Primary care physician visit cost
$25
Specialist doctor visit cost
$50
Doctor Visits
Primary Care Visit $25
Specialist Visit $50
Emergency Room Visit $100
Inpatient Facility Visit 30% Coinsurance after deductible
Inpatient Physician Visit 30% Coinsurance after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $35
Non-preferred Brand Drugs $65
Specialty Drugs $200
Medical Deductible
Medical Deductible (Individual) $2,000
Medical Maximum Out Of Pocket (Individual) $4,000
Medical Deductible (Family) $4,000
Medical Maximum Out Of Pocket (Family) $8,000
Drug Deductible
Drug Deductible (Individual) $0
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $0
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 283
Premium Child Age 18 337
Premium Adult Individual Age 21 369
Premium Adult Individual Age 27 387
Premium Adult Individual Age 30 419
Premium Adult Individual Age 40 472
Premium Adult Individual Age 50 660
Premium Adult Individual Age 60 1,004
Premium Couple 21 739
Premium Couple 30 839
Premium Couple 40 945
Premium Couple 50 1,321
Premium Couple 60 2,008
Couple+1 child, Age 21 1,022
Couple+1 child, Age 30 1,122
Couple+1 child, Age 40 1,228
Couple+1 child, Age 50 1,604
Couple+2 children, Age 21 1,305
Couple+2 children, Age 30 1,405
Couple+2 children, Age 40 1,511
Couple+2 children, Age 50 1,887
Couple+3 or more Children, Age 21 1,588
Couple+3 or more Children, Age 30 1,688
Couple+3 or more Children, Age 40 1,794
Couple+3 or more Children, Age 50 2,170
Individual+1 child, Age 21 652
Individual+1 child, Age 30 702
Individual+1 child, Age 40 755
Individual+1 child, Age 50 943
Individual+2 children, Age 21 935
Individual+2 children, Age 30 985
Individual+2 children, Age 40 1,038
Individual+2 children, Age 50 1,226
Individual+3 or more children, Age 21 1,218
Individual+3 or more children, Age 30 1,268
Individual+3 or more children, Age 40 1,321
Individual+3 or more children, Age 50 1,509
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