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Gym Access IND Gold HMO BC 5651
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Gym Access IND Gold HMO BC 5651

Overview
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Gym Access IND Gold HMO BC 5651 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
56503FL2590002
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
$5,000
Generic drug co-pay
$10
Preferred brand drug co-pay
$40
Primary care physician visit cost
$25
Specialist doctor visit cost
$60
Doctor Visits
Primary Care Visit $25
Specialist Visit $60
Emergency Room Visit $350
Inpatient Facility Visit $600 Copay per Day
Inpatient Physician Visit No Charge
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $40
Non-preferred Brand Drugs $75
Specialty Drugs 30%
Medical Deductible
Medical Deductible (Individual) $0
Medical Maximum Out Of Pocket (Individual) $5,000
Medical Deductible (Family) $0
Medical Maximum Out Of Pocket (Family) $10,000
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 0-14 325
Premium Child Age 18 388
Premium Adult Individual Age 21 425
Premium Adult Individual Age 27 446
Premium Adult Individual Age 30 483
Premium Adult Individual Age 40 543
Premium Adult Individual Age 50 760
Premium Adult Individual Age 60 1,155
Premium Couple 21 851
Premium Couple 30 966
Premium Couple 40 1,087
Premium Couple 50 1,520
Premium Couple 60 2,310
Couple+1 child, Age 21 1,176
Couple+1 child, Age 30 1,291
Couple+1 child, Age 40 1,413
Couple+1 child, Age 50 1,845
Couple+2 children, Age 21 1,502
Couple+2 children, Age 30 1,617
Couple+2 children, Age 40 1,739
Couple+2 children, Age 50 2,171
Couple+3 or more Children, Age 21 1,828
Couple+3 or more Children, Age 30 1,943
Couple+3 or more Children, Age 40 2,064
Couple+3 or more Children, Age 50 2,497
Individual+1 child, Age 21 751
Individual+1 child, Age 30 808
Individual+1 child, Age 40 869
Individual+1 child, Age 50 1,085
Individual+2 children, Age 21 1,076
Individual+2 children, Age 30 1,134
Individual+2 children, Age 40 1,195
Individual+2 children, Age 50 1,411
Individual+3 or more children, Age 21 1,402
Individual+3 or more children, Age 30 1,459
Individual+3 or more children, Age 40 1,520
Individual+3 or more children, Age 50 1,737
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