2018 IND Bronze Standardized HMO Plan Details - HealthPocket

IND Bronze Standardized HMO


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Zip Code33186
Applicant8/21/1983 Male
Coverage Start8/22/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameIND Bronze Standardized HMO
Plan IDqhp-56503FL2670001
Insurance ProviderFlorida Healthcare Plan
Metal LevelExpanded Bronze
Plan TypeHMO
Out-of-Pocket Maximum$7,350
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$35 Copay
Specialist Visit$75 Copay
Deductible - Family$13300
Out-of-Pocket Maximum - Family$14700

Prescription drug coverage

Generic Drugs$35 Copay
Preferred Brand Drugs35% Coinsurance after deductible
Non-Preferred Brand Drugs40% Coinsurance after deductible
Specialty Drugs45% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services40% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible
PremiumPlan NameDeductible
from $216
Ambetter Essential Care 7 (2018)
from $224
Ambetter Essential Care 1 (2018)
from $227
Ambetter Essential Care 1 (2018) + Vision
from $233
Ambetter Essential Care 1 (2018) + Vision + Adult Dental
from $257
Ambetter Essential Care 1 (2018)

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