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Gym Access IND Platinum HMO BC 1941

Overview
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Gym Access IND Platinum HMO BC 1941 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
56503FL2630002
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
$10
Specialist doctor visit cost
$20
Doctor Visits
Primary Care Visit $10
Specialist Visit $20
Emergency Room Visit $125
Inpatient Facility Visit $350 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) 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 0-14 405.02
Premium Child Age 18 483.37
Premium Adult Individual Age 21 529.43
Premium Adult Individual Age 27 554.85
Premium Adult Individual Age 30 600.91
Premium Adult Individual Age 40 676.62
Premium Adult Individual Age 50 945.57
Premium Adult Individual Age 60 1,436.88
Premium Couple 21 1,058.86
Premium Couple 30 1,201.82
Premium Couple 40 1,353.24
Premium Couple 50 1,891.14
Premium Couple 60 2,873.76
Couple+1 child, Age 21 1,463.88
Couple+1 child, Age 30 1,606.84
Couple+1 child, Age 40 1,758.26
Couple+1 child, Age 50 2,296.16
Couple+2 children, Age 21 1,868.9
Couple+2 children, Age 30 2,011.86
Couple+2 children, Age 40 2,163.28
Couple+2 children, Age 50 2,701.18
Couple+3 or more Children, Age 21 2,273.92
Couple+3 or more Children, Age 30 2,416.88
Couple+3 or more Children, Age 40 2,568.3
Couple+3 or more Children, Age 50 3,106.2
Individual+1 child, Age 21 934.45
Individual+1 child, Age 30 1,005.93
Individual+1 child, Age 40 1,081.64
Individual+1 child, Age 50 1,350.59
Individual+2 children, Age 21 1,339.47
Individual+2 children, Age 30 1,410.95
Individual+2 children, Age 40 1,486.66
Individual+2 children, Age 50 1,755.61
Individual+3 or more children, Age 21 1,744.49
Individual+3 or more children, Age 30 1,815.97
Individual+3 or more children, Age 40 1,891.68
Individual+3 or more children, Age 50 2,160.63
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