2019 Personal Choice PPO Gold Plan Details - HealthPocket

Personal Choice PPO Gold

$531.12/mo

Apply For This Plan

Zip Code19120
Applicant7/17/1984 Male
Coverage Start7/18/2019
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NamePersonal Choice PPO Gold
Plan IDqhp-31609PA0070002
Plan Year2019
Insurance ProviderIndependence Blue Cross
Metal LevelGold
Plan TypePPO
Deductible$0
Out-of-Pocket Maximum$6,500
Personal Score

Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$30 Copay
Specialist Visit$65 Copay
Laboratory Outpatient and Professional ServicesNo Charge
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$0
Out-of-Pocket Maximum - Family$13000

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand Drugs40% Coinsurance after deductible
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$350 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$750 Copay
Inpatient Physician and Surgical Services20% Coinsurance after deductible

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 ChildrenNo Charge
Eye Glasses for ChildrenNo Charge

Exclusions and Limitations

More Included BenefitsProsthetic Devices
Infusion Therapy
Nutritional Counseling
Reconstructive Surgery
Dental Anesthesia
Inherited Metabolic Disorder - PKU
Telemedicine
Diabetes Care Management
Allergy Testing
Hospice Services
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Infertility Treatment
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Dialysis
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Chemotherapy
Radiation
Diabetes Education
More Excluded BenefitsTreatment for Temporomandibular Joint Disorders
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $204
Marketplace Extra 1
$0.00Select
from $230
Marketplace Solutions 1
$0.00Select
from $238
Marketplace Direct 1
$0.00Select
from $245
Healthy Benefits Value HMO 0.50
$0.00Select
from $245
BlueCross Value 0.50, a Multi-State Plan
$0.00Select
/
Please select the correct zip
Kenneth, Nguyen
View All Details
Ronald, Small
View All Details
Daniel, Casto
View All Details
Glenn, Shopper
View All Details
Boris, Itskov
View All Details
Holy Redeemer Family Health Center
View All Details
Alan, Duong
View All Details
Complete Wellness Rehabilitation, Llc
View All Details
David, Ross
View All Details
Dedicated Pennsylvania Holding, Llc
View All Details
Einstein Pediatrics Associates Specialists
View All Details
Einstein Community Health Associates, Inc
View All Details
Einstein Community Health Associates, Inc
View All Details
Einstein Community Health Associates, Inc.
View All Details
Vip Healthcare Group
View All Details
Syed, Zahid
View All Details
Chanelle, Rice
View All Details
Diane, Clauss
View All Details
Lilla, Abdal-haqq
View All Details
Mauricio, Jalife Bucay
View All Details
Kenneth Nguyen, M.D.
View All Details
  • Phone Number
    (215) 324-2180
  • Office Locations
    448 E Wyoming Ave
    Philadelphia, PA 19120
448 E Wyoming Ave Philadelphia PA, 19120
  • What is the Gold Plan?

    ObamaCare’s Gold Plan is a type of Metal Plan on the Health Insurance Marketplace. Gold Plans qualify for Tax Credits, have high premiums, and good cost sharing. Gold plans mean higher premiums, less Tax Credits, but much better cost sharing on average than Silver or Bronze.

  • How are Gold 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 Gold Plan typically pays 80% of covered medical costs.

  • How much does a Gold Plan cost?

    The monthly premium for a Gold 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 your geographic region. You can use HealthPocket’s comparison tool to compare Gold Plan premiums in your area.

  • When Can I Enroll in a Gold 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.

Read More

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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 a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)

Close

Health Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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 a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)