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myBlue Silver 1603
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myBlue Silver 1603

Overview
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myBlue Silver 1603 is an individual health health plan issued by Health Options, 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 Osceola 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
Health Options, Inc.
Plan ID
30252FL0070005
Coverage area
Osceola County, Florida
Phone
Local Phone: 1-800-352-2583
Toll-Free: 1-800-352-2583
TTY: 1-800-955-8771
Plan type
HMO
Coverage type
Medical deductible
$5,950
Out-of-pocket maximum
$7,150
Generic drug co-pay
$15
Preferred brand drug co-pay
$67 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 $350 Copay after deductible
Inpatient Facility Visit $600 Copay per Stay after deductible
Inpatient Physician Visit No Charge
Prescription Drugs
Generic Drugs $15
Preferred Brand Drugs $67 Copay after deductible
Non-preferred Brand Drugs 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,950
Medical Maximum Out Of Pocket (Individual) $7,150
Medical Deductible (Family) $11,900
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) See Plan Brochure
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 314
Premium Child Age 18 375
Premium Adult Individual Age 21 411
Premium Adult Individual Age 27 430
Premium Adult Individual Age 30 466
Premium Adult Individual Age 40 525
Premium Adult Individual Age 50 734
Premium Adult Individual Age 60 1,115
Premium Couple 21 822
Premium Couple 30 933
Premium Couple 40 1,050
Premium Couple 50 1,468
Premium Couple 60 2,231
Couple+1 child, Age 21 1,136
Couple+1 child, Age 30 1,247
Couple+1 child, Age 40 1,365
Couple+1 child, Age 50 1,783
Couple+2 children, Age 21 1,451
Couple+2 children, Age 30 1,562
Couple+2 children, Age 40 1,679
Couple+2 children, Age 50 2,097
Couple+3 or more Children, Age 21 1,765
Couple+3 or more Children, Age 30 1,876
Couple+3 or more Children, Age 40 1,994
Couple+3 or more Children, Age 50 2,412
Individual+1 child, Age 21 725
Individual+1 child, Age 30 781
Individual+1 child, Age 40 839
Individual+1 child, Age 50 1,048
Individual+2 children, Age 21 1,040
Individual+2 children, Age 30 1,095
Individual+2 children, Age 40 1,154
Individual+2 children, Age 50 1,363
Individual+3 or more children, Age 21 1,354
Individual+3 or more children, Age 30 1,410
Individual+3 or more children, Age 40 1,468
Individual+3 or more children, Age 50 1,677
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