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Gym Access IND Silver HMO BC 0941
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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
Premium Child Age 18 361
Premium Adult Individual Age 21 396
Premium Adult Individual Age 27 415
Premium Adult Individual Age 30 449
Premium Adult Individual Age 40 506
Premium Adult Individual Age 50 707
Premium Adult Individual Age 60 1,075
Premium Couple 21 792
Premium Couple 30 899
Premium Couple 40 1,013
Premium Couple 50 1,415
Premium Couple 60 2,151
Couple+1 child, Age 21 1,096
Couple+1 child, Age 30 1,203
Couple+1 child, Age 40 1,316
Couple+1 child, Age 50 1,719
Couple+2 children, Age 21 1,399
Couple+2 children, Age 30 1,506
Couple+2 children, Age 40 1,619
Couple+2 children, Age 50 2,022
Couple+3 or more Children, Age 21 1,702
Couple+3 or more Children, Age 30 1,809
Couple+3 or more Children, Age 40 1,922
Couple+3 or more Children, Age 50 2,325
Individual+1 child, Age 21 699
Individual+1 child, Age 30 753
Individual+1 child, Age 40 809
Individual+1 child, Age 50 1,011
Individual+2 children, Age 21 1,002
Individual+2 children, Age 30 1,056
Individual+2 children, Age 40 1,113
Individual+2 children, Age 50 1,314
Individual+3 or more children, Age 21 1,306
Individual+3 or more children, Age 30 1,359
Individual+3 or more children, Age 40 1,416
Individual+3 or more children, Age 50 1,617
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