2019 Gym Acccess IND Platinum HMO 92 Plan Details - HealthPocket

Gym Acccess IND Platinum HMO 92

$526.21/mo

Apply For This Plan

Zip Code33186
Applicant10/18/1984 Male
Coverage Start10/19/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameGym Acccess IND Platinum HMO 92
Plan IDqhp-56503FL2660002
Plan Year2019
Insurance ProviderFlorida Healthcare Plan
Metal LevelPlatinum
Plan TypeHMO
Deductible$500
Out-of-Pocket Maximum$3,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$15 Copay
Specialist Visit$30 Copay
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$1000
Out-of-Pocket Maximum - Family$6000

Prescription drug coverage

Generic Drugs$3 Copay
Preferred Brand Drugs$30 Copay
Non-Preferred Brand Drugs$55 Copay
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$100 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$300 Copay
Inpatient Physician and Surgical ServicesNo Charge

Maternity

Prenatal and Postnatal CareNot Applicable

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient ServicesNot Applicable

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsOff Label Prescription Drugs
Dental Anesthesia
Congenital Anomaly, including Cleft Lip/Palate
Bone Marrow Transplant
Nutrition/Formulas
Osteoporosis
Gym Access
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Diabetes Care Management
More Excluded BenefitsCosmetic Surgery
Weight Loss Programs
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $320
Ambetter Gold 2
$500.00Select
from $326
Ambetter Gold 2 + Vision
$500.00Select
from $337
Ambetter Gold 2 + Vision + Adult Dental
$500.00Select
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  • Phone Number
    (305) 380-6773
  • Office Locations
    9000 Sw 137th Ave
    Miami, FL 33186
9000 Sw 137th Ave Miami FL, 33186
  • What is the Platinum Plan?

    ObamaCare’s Platinum Plan is a type of Metal Plan on the Health Insurance Marketplace. Platinum Plans qualify for Tax Credits and have the highest premiums. A Platinum Plan is designed to incur the lowest out-of-pocket expenses for enrollees. A typical platinum plan enrollee pays approximately 10% of the costs of covered healthcare services with the plan paying the remainder. In comparison, a typical Bronze Plan enrollee pays 40% of covered medical expenses.

  • How are Platinum Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Platinum Plan pays 90% of covered medical costs for a typical enrollee while the other Obamacare health plans pay a lower percentage of these costs.

  • How much does a Platinum Plan cost?

    The monthly premium for a Platinum Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Platinum Plan premiums in your area.

  • When Can I Enroll in a Platinum Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).