CeltiCare Preferred Select PPO 80/20 2500 Deductible

Individual Health Insurance (Obamacare)

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Benefits & Coverage

Plan Name
CeltiCare Preferred Select PPO 80/20 2500 Deductible
Plan ID
21663FL0040016
Plan Year
2013
Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
Plan Type
PPO
Deductible
$2,500
Out-of-Pocket Maximum
$4,500
Plan Highlights

Cost & Coverage

Estimated Monthly Base Rate
Estimated monthly premium starts at $116.99
How many applications are denied?
27% of the applicants were denied
How accurate is this estimate?
1% of the applicants ended up paying a higher amount than the quoted price
Deductible
Individual: $2500
Family: $7500
In-Network Out-of-Pocket Limit
Individual: $4500
Family: $13500
What is included in the in-network out-of-pocket limit?
Deductible + Coinsurance
Is this plan Health Savings Account (HSA) eligible?
No
Plan Type
PPO

Health Services Options

Service
In Network
Out of Network
Primary care physician office visit
$15 Copay
40% Coinsurance after deductible
Specialist
$15 Copay
40% Coinsurance after deductible
Diagnostic Test (X-ray, blood work)
20% Coinsurance after deductible
40% Coinsurance after deductible
Outpatient Facility Fee
20% Coinsurance after deductible
40% Coinsurance after deductible
Outpatient Physician/Surgeon Fee
20% Coinsurance after deductible
40% Coinsurance after deductible
Hospital facility fee
20% Coinsurance after deductible
40% Coinsurance after deductible
Hospital physician/surgeon fee
20% Coinsurance after deductible
40% Coinsurance after deductible
Emergency Room
20% Coinsurance after deductible
20% Coinsurance after deductible

Drug Services

Generic Drugs
Coverage: $10 Copay
Preferred Brand Drugs
Coverage: $40 Copay
Specialty Drugs
Coverage: 30% Coinsurance after deductible

Mental Health or Substance Abuse Services

Service
In Network
Out of Network
Mental/behavioral health outpatient services
20% Coinsurance after deductible
40% Coinsurance after deductible
Mental/behavioral health inpatient services
20% Coinsurance after deductible
40% Coinsurance after deductible
Substance use disorder inpatient services
Not Covered
Not Covered
Substance use disorder outpatient services
Not Covered
Not Covered

Maternity Services

Service
In Network
Out of Network
Prenatal/postnatal care
Not Covered
Not Covered
Delivery and all inpatient services for maternity care
Not Covered
Not Covered

Coverage Options Summary

Included Benefits
  • Durable medical equipment
  • Emergency Transportation
  • Eye glasses children
  • Home health care
  • Hospice
  • Imaging (CT/PET scans, MRIs)
  • Inpatient rehabilitation
  • Non-preferred brand drugs
  • Skilled nursing care
  • Other practitioner office visit
  • Outpatient rehabilitation
  • Preventive care, screening, immunization
  • Routine eye exam children
  • Urgent Care
Excluded Benefits
  • Acupuncture
  • Bariatric surgery
  • Chiropractic
  • Cosmetic surgery
  • Dental care adult
  • Dental check up children
  • Eye exam adult
  • Habilitation
  • Hearing Aid
  • Infertility treatment
  • Long Term Care
  • Non-emergency care outside U.S.
  • Private duty nursing
  • Routine foot care
  • Routine hearing tests
  • Weight loss program

What To Know

  • 27%of the applicants were denied
  • 1%of the applicants ended up paying a higher amount than the quoted price

Physician Directory

List of doctors that accepts CeltiCare Preferred Select PPO 80/20 2500 Deductible Plan in Florida

/
OTERO, FELIPE
11028 SW 132ND PL
MIAMI, FL 33186
MCANDLESS, MEGAN
8900 N KENDALL DR
MIAMI, FL 33176
LAFOSSE-MARIN, STEPHANE
8900 N KENDALL DR
MIAMI, FL 33176
WHITLEY, AMY
8900 N KENDALL DR
MIAMI, FL 33176
LLANES, HUGO
12771 SW 104TH AVE
MIAMI, FL 33176
CONVERS, ALBERTO
8900 N KENDALL DR
MIAMI, FL 33176
ELGARRESTA, LAWRENCE
8900 N KENDALL DR
MIAMI, FL 33176
HALL, ANDREW
1210 S OLD DIXIE HWY
JUPITER, FL 33458
EUSTACE, JOHN
9000 SW 87TH CT
MIAMI, FL 33176
VILLALBA, BENJAMIN
14875 NW 77TH AVENUE
MIAMI LAKES, FL 33014
RUIZ, ALDO
7400 SW 87TH AVE
MIAMI, FL 33173
CARDENAS, OFELIA
14708 SW 56TH ST
MIAMI, FL 33185
MCCARTHY, MARTIN
9370 SUNSET DR
MIAMI, FL 33173
SHARMA, JATINDER
9370 SUNSET DR
MIAMI, FL 33173
OCHOA, JENNIFER
2450 SW 137TH AVE STE 221
MIAMI, FL 33175
MOSES, MICHAEL
6801 SW 144TH TER
VILLAGE OF PALMETTO BAY, FL 33158
BAEZ, ROSAURA
621 TAMIAMI TRL N
NOKOMIS, FL 34275
TORRES, JONATHAN
10739 W FLAGLER ST
MIAMI, FL 33174
BLOCK, JEFFREY
6200 SW 73RD ST
SOUTH MIAMI, FL 33143
ROBU, CRISTINA
7000 SW 62ND AVE
SOUTH MIAMI, FL 33143
PEREZ, OSVALDO
5995 SW 71 STREET
MIAMI, FL 33143
PALERMO, NICK
6200 SW 73RD ST
SOUTH MIAMI, FL 33143
FARKAS, JEREMY
6200 SW 73RD ST
SOUTH MIAMI, FL 33143
EISERMANN-ROGERS, KATHRYN
6705 SW 57TH AVE
CORAL GABLES, FL 33143
SCHRIER, HARRY
6200 SW 73RD ST
SOUTH MIAMI, FL 33143
Details
FELIPE OTERO, MSPT
Phone Number
(786) 355-2187
Office Locations
11028 SW 132ND PL
MIAMI, FL 33186
11028 SW 132ND PL MIAMI FL, 33186

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