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

/
HERNANDEZ, OSCAR
14221 SW 120TH ST
MIAMI, FL 33186
VAZQUEZ, NELSON
13500 SW 88 ST
KENDALL, FL 33186
KADE, KAREN
12600 SW 120TH ST
MIAMI, FL 33186
FEITO, PATRICIA
12314 SW 127TH AVE
MIAMI, FL 33186
OTERO, FELIPE
11028 SW 132ND PL
MIAMI, FL 33186
PEREZ, CARLOS
12002 SW 128TH CT
MIAMI, FL 33186
JARRETT, WENTWORTH
12955 SW 132ND ST
MIAMI, FL 33186
PONS, FRANCISCO
13500 SW 88TH ST
MIAMI, FL 33186
SHAH, CHANDRAKANT
13033 SW 112TH ST
MIAMI, FL 33186
CINTAS, MAURA
9000 SW 137TH AVE
MIAMI, FL 33186
RODICIO, ILEANA
9000 SW 137TH AVE
MIAMI, FL 33186
MAYORGA, RENE
14261 SW 120TH ST STE 110
MIAMI, FL 33186
APOLLON, KATIA
8900 SW 117TH AVE
MIAMI, FL 33186
KARSENTI, REBECCA
8900 SW 117TH AVE
MIAMI, FL 33186
GUPTA, PADMA
13500 SW 88TH ST
MIAMI, FL 33186
PELAEZ, ANNETTE
8900 SW 117TH AVE
MIAMI, FL 33186
PERLYN, CHAD
13400 SW 120TH ST
MIAMI, FL 33186
BARCENAS, JORGE
14687 SW 104TH ST
MIAMI, FL 33186
LEVIN, SANFORD
12485 SW 137TH AVE
MIAMI, FL 33186
SWARTZ, ALAN
13550 N KENDALL DR
MIAMI, FL 33186
GUZMAN, FELIX
12600 SW 120TH ST
MIAMI, FL 33186
KRAINSON, JAMES
12600 SW 120TH ST
MIAMI, FL 33186
PINERA-LLANO, AYLEEN
8501 SW 124TH AVE
MIAMI, FL 33183
GARCIA, NELSON
8200 SW 117TH AVE STE 110
MIAMI, FL 33183
MARTEL, JERRY
8200 SW 117TH AVE
MIAMI, FL 33183
Details
OSCAR HERNANDEZ, MD
Phone Number
(305) 279-1515
Office Locations
14221 SW 120TH ST
MIAMI, FL 33186
14221 SW 120TH ST MIAMI FL, 33186

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