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Gym Access IND Gold POS 5500

Overview
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Gym Access IND Gold POS 5500 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 a POS plan, or a Point of Service plan. This plan requires you get a referral from your primary care doctor in order to see a specialist doctor. You pay less if you use providers that are in-network and you pay more if you use those that are out-of-network.

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
56503FL2010001
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
POS
Coverage type
Medical deductible
$2,500
Out-of-pocket maximum
$5,500
Generic drug co-pay
$10
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 $200
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $30
Non-preferred Brand Drugs $55
Specialty Drugs 50%
Medical Deductible
Medical Deductible (Individual) $2,500
Medical Maximum Out Of Pocket (Individual) $5,500
Medical Deductible (Family) $5,000
Medical Maximum Out Of Pocket (Family) $11,000
Drug Deductible
Drug Deductible (Individual) $0
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $0
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 99.80%
Premium Child Age 0-14 340.31
Premium Child Age 18 406.14
Premium Adult Individual Age 21 444.85
Premium Adult Individual Age 27 466.2
Premium Adult Individual Age 30 504.9
Premium Adult Individual Age 40 568.51
Premium Adult Individual Age 50 794.5
Premium Adult Individual Age 60 1,207.31
Premium Couple 21 889.7
Premium Couple 30 1,009.8
Premium Couple 40 1,137.02
Premium Couple 50 1589
Premium Couple 60 2,414.62
Couple+1 child, Age 21 1,230.01
Couple+1 child, Age 30 1,350.11
Couple+1 child, Age 40 1,477.33
Couple+1 child, Age 50 1,929.31
Couple+2 children, Age 21 1,570.32
Couple+2 children, Age 30 1,690.42
Couple+2 children, Age 40 1,817.64
Couple+2 children, Age 50 2,269.62
Couple+3 or more Children, Age 21 1,910.63
Couple+3 or more Children, Age 30 2,030.73
Couple+3 or more Children, Age 40 2,157.95
Couple+3 or more Children, Age 50 2,609.93
Individual+1 child, Age 21 785.16
Individual+1 child, Age 30 845.21
Individual+1 child, Age 40 908.82
Individual+1 child, Age 50 1,134.81
Individual+2 children, Age 21 1,125.47
Individual+2 children, Age 30 1,185.52
Individual+2 children, Age 40 1,249.13
Individual+2 children, Age 50 1,475.12
Individual+3 or more children, Age 21 1,465.78
Individual+3 or more children, Age 30 1,525.83
Individual+3 or more children, Age 40 1,589.44
Individual+3 or more children, Age 50 1,815.43
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