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Gym Access IND Bronze Standardized HMO
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Gym Access IND Bronze Standardized HMO

Overview
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Gym Access IND Bronze Standardized HMO 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
56503FL2670001
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
$6,650
Out-of-pocket maximum
$7,350
Generic drug co-pay
$35
Preferred brand drug co-pay
35% Coinsurance after deductible
Primary care physician visit cost
$35
Specialist doctor visit cost
$75
Doctor Visits
Primary Care Visit $35
Specialist Visit $75
Emergency Room Visit 40% Coinsurance after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs $35
Preferred Brand Drugs 35% Coinsurance after deductible
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $6,650
Medical Maximum Out Of Pocket (Individual) $7,350
Medical Deductible (Family) $13,300
Medical Maximum Out Of Pocket (Family) $14,700
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 0-14 215
Premium Child Age 18 257
Premium Adult Individual Age 21 281
Premium Adult Individual Age 27 295
Premium Adult Individual Age 30 319
Premium Adult Individual Age 40 360
Premium Adult Individual Age 50 503
Premium Adult Individual Age 60 764
Premium Couple 21 563
Premium Couple 30 639
Premium Couple 40 720
Premium Couple 50 1,006
Premium Couple 60 1,529
Couple+1 child, Age 21 779
Couple+1 child, Age 30 855
Couple+1 child, Age 40 935
Couple+1 child, Age 50 1,221
Couple+2 children, Age 21 994
Couple+2 children, Age 30 1,070
Couple+2 children, Age 40 1,151
Couple+2 children, Age 50 1,437
Couple+3 or more Children, Age 21 1,210
Couple+3 or more Children, Age 30 1,286
Couple+3 or more Children, Age 40 1,366
Couple+3 or more Children, Age 50 1,652
Individual+1 child, Age 21 497
Individual+1 child, Age 30 535
Individual+1 child, Age 40 575
Individual+1 child, Age 50 718
Individual+2 children, Age 21 712
Individual+2 children, Age 30 750
Individual+2 children, Age 40 791
Individual+2 children, Age 50 934
Individual+3 or more children, Age 21 928
Individual+3 or more children, Age 30 966
Individual+3 or more children, Age 40 1,006
Individual+3 or more children, Age 50 1,149
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