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Gym Access IND Essential Plus Platinum HMO 65
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Gym Access IND Essential Plus Platinum HMO 65

Overview
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Gym Access IND Essential Plus Platinum HMO 65 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
56503FL1400001
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
$0
Out-of-pocket maximum
$2,000
Generic drug co-pay
$3
Preferred brand drug co-pay
$30
Primary care physician visit cost
$20
Specialist doctor visit cost
$35
Doctor Visits
Primary Care Visit $20
Specialist Visit $35
Emergency Room Visit $100
Inpatient Facility Visit $250 Copay per Day
Inpatient Physician Visit No Charge
Prescription Drugs
Generic Drugs $3
Preferred Brand Drugs $30
Non-preferred Brand Drugs $55
Specialty Drugs 50%
Medical Deductible
Medical Deductible (Individual) $0
Medical Maximum Out Of Pocket (Individual) $2,000
Medical Deductible (Family) $0
Medical Maximum Out Of Pocket (Family) $4,000
Drug Deductible
Drug Deductible (Individual) $0
Drug Maximum Out Of Pocket (Individual) $2,000
Drug Deductible (Family) $0
Drug Maximum Out Of Pocket (Family) $4,000
Premium Rates
EHB Percent of Total Premium 99.80%
Premium Child Age 0-14 405
Premium Child Age 18 483
Premium Adult Individual Age 21 529
Premium Adult Individual Age 27 555
Premium Adult Individual Age 30 601
Premium Adult Individual Age 40 676
Premium Adult Individual Age 50 945
Premium Adult Individual Age 60 1,437
Premium Couple 21 1,059
Premium Couple 30 1,202
Premium Couple 40 1,353
Premium Couple 50 1,891
Premium Couple 60 2,874
Couple+1 child, Age 21 1,464
Couple+1 child, Age 30 1,607
Couple+1 child, Age 40 1,758
Couple+1 child, Age 50 2,296
Couple+2 children, Age 21 1,869
Couple+2 children, Age 30 2,012
Couple+2 children, Age 40 2,164
Couple+2 children, Age 50 2,702
Couple+3 or more Children, Age 21 2,274
Couple+3 or more Children, Age 30 2,417
Couple+3 or more Children, Age 40 2,569
Couple+3 or more Children, Age 50 3,107
Individual+1 child, Age 21 934
Individual+1 child, Age 30 1,006
Individual+1 child, Age 40 1,082
Individual+1 child, Age 50 1,351
Individual+2 children, Age 21 1,339
Individual+2 children, Age 30 1,411
Individual+2 children, Age 40 1,487
Individual+2 children, Age 50 1,756
Individual+3 or more children, Age 21 1,745
Individual+3 or more children, Age 30 1,816
Individual+3 or more children, Age 40 1,892
Individual+3 or more children, Age 50 2,161
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