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Gym Access IND Silver HMO BC 0941

Overview
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Gym Access IND Silver HMO BC 0941 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
56503FL2550002
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
$5,600
Out-of-pocket maximum
$7,150
Generic drug co-pay
$10
Preferred brand drug co-pay
$30 Copay after deductible
Primary care physician visit cost
$50
Specialist doctor visit cost
$100
Doctor Visits
Primary Care Visit $50
Specialist Visit $100
Emergency Room Visit $400 Copay after deductible
Inpatient Facility Visit $600 Copay per Stay after deductible
Inpatient Physician Visit No Charge
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $30 Copay after deductible
Non-preferred Brand Drugs $55 Copay after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,600
Medical Maximum Out Of Pocket (Individual) $7,150
Medical Deductible (Family) $11,200
Medical Maximum Out Of Pocket (Family) $14,300
Drug Deductible
Drug Deductible (Individual) $3,000
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $3,000
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 99.80%
Premium Child Age 0-14 303.24
Premium Child Age 18 361.91
Premium Adult Individual Age 21 396.39
Premium Adult Individual Age 27 415.42
Premium Adult Individual Age 30 449.91
Premium Adult Individual Age 40 506.59
Premium Adult Individual Age 50 707.96
Premium Adult Individual Age 60 1,075.81
Premium Couple 21 792.78
Premium Couple 30 899.82
Premium Couple 40 1,013.18
Premium Couple 50 1,415.92
Premium Couple 60 2,151.62
Couple+1 child, Age 21 1,096.02
Couple+1 child, Age 30 1,203.06
Couple+1 child, Age 40 1,316.42
Couple+1 child, Age 50 1,719.16
Couple+2 children, Age 21 1,399.26
Couple+2 children, Age 30 1,506.3
Couple+2 children, Age 40 1,619.66
Couple+2 children, Age 50 2,022.4
Couple+3 or more Children, Age 21 1,702.5
Couple+3 or more Children, Age 30 1,809.54
Couple+3 or more Children, Age 40 1,922.9
Couple+3 or more Children, Age 50 2,325.64
Individual+1 child, Age 21 699.63
Individual+1 child, Age 30 753.15
Individual+1 child, Age 40 809.83
Individual+1 child, Age 50 1,011.2
Individual+2 children, Age 21 1,002.87
Individual+2 children, Age 30 1,056.39
Individual+2 children, Age 40 1,113.07
Individual+2 children, Age 50 1,314.44
Individual+3 or more children, Age 21 1,306.11
Individual+3 or more children, Age 30 1,359.63
Individual+3 or more children, Age 40 1,416.31
Individual+3 or more children, Age 50 1,617.68
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