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Zip Code	33186 (edit)
Applicant	2/22/1984 Male (edit)
Coverage Start	2/23/2019 (edit)

Insurance Type	ACA (Obamacare)
Plan Name	BlueOptions Platinum 1424
Plan ID	hhs-16842FL0070110
Plan Year	2019
Insurance Provider	Blue Cross Blue Shield of Florida
Metal Level	Platinum
Plan Type	EPO
Deductible	$0
Out-of-Pocket Maximum	$2,000
Personal Score
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$10 Copay
Specialist Visit	$20 Copay
Laboratory Outpatient and Professional Services	Not Applicable
X-rays and Diagnostic Imaging	$75 Copay
Diagnostic Imaging such as MRIs, CT, and PET scans	$150 Copay
Deductible - Family	$0 per group
Out-of-Pocket Maximum - Family	$4000 per group

Prescription drug coverage
Generic Drugs	$10 Copay
Preferred Brand Drugs	$40 Copay
Non-Preferred Brand Drugs	30.00% Coinsurance
Specialty Drugs	50.00% Coinsurance

Access to doctors and hospitals
Provider directory URL	https://providersearch.floridablue.com/providersearch/pub/index.htm
Does this plan have access to a national provider network?	Yes
Is a referral required to see a Specialist?	Not Covered
Does this plan cover services outside plan service area?	Yes - Covered services as outlined in the member contract.
Does this plan cover services outside the country?	Yes - Covered services as outlined in the member contract.

Hospital services
Emergency Room Services	$75 Copay
Inpatient Hospital Services (e.g., Hospital Stay)	$350 Copay per Day
Inpatient Physician and Surgical Services	Not Applicable
Emergency Transportation or Ambulance Service	$350 Copay

Maternity
Prenatal and Postnatal Care	$20 Copay
Delivery and all inpatient services for maternity care	$350 Copay

Mental Health
Mental/Behavioral Health Outpatient Services	$20 Copay
Mental/Behavioral Health Inpatient Services	$350 Copay per Day
Substance use disorder outpatient services	$20 Copay
Substance use disorder inpatient services	$350 Copay per Day

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy
Does this plan offer a wellness program?	Not Covered

Vision Coverage
Routine Eye Exam for Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Not Covered
Child Dental Coverage - Basic Dental Care	Not Covered
Child Dental Coverage - Orthodontia	Not Covered
Child Dental Coverage - Major Dental Care	Not Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Imaging (CT/PET Scans, MRIs) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Durable Medical Equipment Hospice Services Routine Foot Care Dental Anesthesia Diabetes Care Management Accidental Dental Allergy Testing Chemotherapy Diabetes Education Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Nutritional Counseling Prosthetic Devices Radiation Reconstructive Surgery Transplant Treatment for Temporomandibular Joint Disorders Well Baby Visits and Care Bone Marrow Testing Bone Marrow Transplant Congenital Anomaly, including Cleft Lip/Palate Nutrition/Formulas Off Label Prescription Drugs Osteoporosis
More Limited Benefits	Skilled Nursing Facility Home Health Care Services Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Bariatric Surgery Cosmetic Surgery Hearing Aids Infertility Treatment Long-Term/Custodial Nursing Home Care Private-Duty Nursing Weight Loss Programs Dental Check-Up for Children Abortion for Which Public Funding is Prohibited

+ See All Coverage Details

Premium

Plan Name

Deductible

from $425

Gym Access IND Gold HMO BC 5651

$0.00

from $462

BlueSelect Gold 1535

$0.00

from $468

Gym Access IND Gold POS BC 5651

$0.00

from $494

BlueCare Gold 1565

$0.00

from $518

Gym Access IND Platinum HMO 4000

$0.00

Last Name

Location/Distance

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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.

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.

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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.