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Gym Access IND Bronze HMO HSA 5000/6550
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Gym Access IND Bronze HMO HSA 5000/6550

Overview
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Gym Access IND Bronze HMO HSA 5000/6550 is an individual health health plan issued by Florida Health Care 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 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
Florida Health Care Plan, Inc.
Plan ID
56503FL2240001
Coverage area
Flagler County, Florida
Phone
Local Phone: 1-386-676-7110
Toll-Free: 1-800-232-0578
TTY: 1-800-955-8771
Plan type
HMO
Coverage type
Medical deductible
$5,000
Out-of-pocket maximum
$6,550
Generic drug co-pay
$3 Copay after deductible
Preferred brand drug co-pay
$30 Copay after deductible
Primary care physician visit cost
30% Coinsurance after deductible
Specialist doctor visit cost
30% Coinsurance after deductible
Doctor Visits
Primary Care Visit 30% Coinsurance after deductible
Specialist Visit 30% Coinsurance after deductible
Emergency Room Visit 30% Coinsurance after deductible
Inpatient Facility Visit 30% Coinsurance after deductible
Inpatient Physician Visit 30% Coinsurance after deductible
Prescription Drugs
Generic Drugs $3 Copay after deductible
Preferred Brand Drugs $30 Copay after deductible
Non-preferred Brand Drugs $55 Copay after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,000
Medical Maximum Out Of Pocket (Individual) $6,550
Medical Deductible (Family) $10,000
Medical Maximum Out Of Pocket (Family) $13,100
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 99.80%
Premium Child Age 0-14 212
Premium Child Age 18 253
Premium Adult Individual Age 21 277
Premium Adult Individual Age 27 290
Premium Adult Individual Age 30 314
Premium Adult Individual Age 40 354
Premium Adult Individual Age 50 495
Premium Adult Individual Age 60 752
Premium Couple 21 554
Premium Couple 30 629
Premium Couple 40 709
Premium Couple 50 991
Premium Couple 60 1,505
Couple+1 child, Age 21 767
Couple+1 child, Age 30 842
Couple+1 child, Age 40 921
Couple+1 child, Age 50 1,203
Couple+2 children, Age 21 979
Couple+2 children, Age 30 1,054
Couple+2 children, Age 40 1,133
Couple+2 children, Age 50 1,415
Couple+3 or more Children, Age 21 1,191
Couple+3 or more Children, Age 30 1,266
Couple+3 or more Children, Age 40 1,345
Couple+3 or more Children, Age 50 1,627
Individual+1 child, Age 21 489
Individual+1 child, Age 30 527
Individual+1 child, Age 40 566
Individual+1 child, Age 50 707
Individual+2 children, Age 21 701
Individual+2 children, Age 30 739
Individual+2 children, Age 40 779
Individual+2 children, Age 50 919
Individual+3 or more children, Age 21 914
Individual+3 or more children, Age 30 951
Individual+3 or more children, Age 40 991
Individual+3 or more children, Age 50 1,132
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