Simple Secure (Free 24/7 Telemedicine + Free Preventive Care) Plan Details for 2020- HealthPocket

Simple Secure (Free 24/7 Telemedicine + Free Preventive Care)

$260.37/mo

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Zip Code33186
Applicant2/18/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameSimple Secure (Free 24/7 Telemedicine + Free Preventive Care)
Plan IDhhs-40572FL0070011
Plan Year2020
Insurance ProviderOscar
Metal LevelCatastrophic
Plan TypeEPO
Deductible$8,150
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$0 Copay after deductible
Specialist Visit$0 Copay after deductible
Laboratory Outpatient and Professional Services$0 Copay after deductible
X-rays and Diagnostic Imaging$0 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$0 Copay after deductible
Deductible - Family$16300 per group
Out-of-Pocket Maximum - Family$16300 per group

Prescription drug coverage

Generic Drugs$0 Copay after deductible
Preferred Brand Drugs$0 Copay after deductible
Non-Preferred Brand Drugs$0 Copay after deductible
Specialty Drugs$0 Copay after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.hioscar.com/search
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?Not Covered
Does this plan cover services outside the country?Not Covered

Hospital services

Emergency Room Services$0 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after deductible
Inpatient Physician and Surgical Services$0 Copay after deductible
Emergency Transportation or Ambulance Service$0 Copay after deductible

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care$0 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$0 Copay after deductible
Mental/Behavioral Health Inpatient Services$0 Copay after deductible
Substance use disorder outpatient services$0 Copay after deductible
Substance use disorder inpatient services$0 Copay after deductible

Medical Management Programs

Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaIncluded
Child Dental Coverage - Major Dental CareIncluded

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Dental Check-Up for Children
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Infusion Therapy
PremiumPlan NameDeductible
from $154
AdventHealth GYM ACCESS Catastrophic HMO 1748
$8,150.00Select
from $156
Health First GYM ACCESS Catastrophic HMO 1746
$8,150.00Select
from $189
AdventHealth GYM ACCESS Catastrophic HMO 1748
$8,150.00Select
from $190
Health First GYM ACCESS Catastrophic HMO 1746
$8,150.00Select
from $208
Catastrophic
$8,150.00Select
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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 Catastrophic Plan?

    Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."

  • How are Catastrophic 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. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.

  • How much does a Catastrophic Plan cost?

    The monthly premium for a Catastrophic 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 Catastrophic Plan premiums in your area.

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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).