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Gym Access IND Essential Plus Catastrophic HMO 36
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Gym Access IND Essential Plus Catastrophic HMO 36

Overview
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Gym Access IND Essential Plus Catastrophic HMO 36 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
56503FL1300001
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
$7,900
Out-of-pocket maximum
$7,900
Generic drug co-pay
No Charge after Deductible
Preferred brand drug co-pay
No Charge after Deductible
Primary care physician visit cost
No Charge after Deductible
Specialist doctor visit cost
No Charge after Deductible
Doctor Visits
Primary Care Visit No Charge after Deductible
Specialist Visit No Charge after Deductible
Emergency Room Visit No Charge after Deductible
Inpatient Facility Visit No Charge after Deductible
Inpatient Physician Visit No Charge after Deductible
Prescription Drugs
Generic Drugs No Charge after Deductible
Preferred Brand Drugs No Charge after Deductible
Non-preferred Brand Drugs No Charge after Deductible
Specialty Drugs No Charge after Deductible
Medical Deductible
Medical Deductible (Individual) $7,900
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $15,800
Medical Maximum Out Of Pocket (Family) $15,800
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 0-14 184
Premium Child Age 18 220
Premium Adult Individual Age 21 241
Premium Adult Individual Age 27 253
Premium Adult Individual Age 30 274
Premium Adult Individual Age 40 308
Premium Adult Individual Age 50 431
Premium Adult Individual Age 60 655
Premium Couple 21 483
Premium Couple 30 548
Premium Couple 40 617
Premium Couple 50 863
Premium Couple 60 1,311
Couple+1 child, Age 21 668
Couple+1 child, Age 30 733
Couple+1 child, Age 40 802
Couple+1 child, Age 50 1,047
Couple+2 children, Age 21 852
Couple+2 children, Age 30 918
Couple+2 children, Age 40 987
Couple+2 children, Age 50 1,232
Couple+3 or more Children, Age 21 1,037
Couple+3 or more Children, Age 30 1103
Couple+3 or more Children, Age 40 1,172
Couple+3 or more Children, Age 50 1,417
Individual+1 child, Age 21 426
Individual+1 child, Age 30 459
Individual+1 child, Age 40 493
Individual+1 child, Age 50 616
Individual+2 children, Age 21 611
Individual+2 children, Age 30 643
Individual+2 children, Age 40 678
Individual+2 children, Age 50 801
Individual+3 or more children, Age 21 796
Individual+3 or more children, Age 30 828
Individual+3 or more children, Age 40 863
Individual+3 or more children, Age 50 986
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