ElevateHealth Gold 1000

Individual Health Insurance (Obamacare)

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ElevateHealth Gold 1000

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Monthly Cost

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Benefits & Coverage

Plan Name
ElevateHealth Gold 1000
Plan Year
2018
Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
Metal Level
Gold
Out-of-Pocket Maximum
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness
$20 Copay
Specialist Visit
$40 Copay
Laboratory Outpatient and Professional Services
No Charge after deductible
X-rays and Diagnostic Imaging
Not Applicable
Diagnostic Imaging such as MRIs, CT, and PET scans
$50 Copay after deductible
Deductible - Family
$2000 per group
Out-of-Pocket Maximum - Family
$8000 per group

Prescription drug coverage

Generic Drugs
$20 Copay
Preferred Brand Drugs
$50 Copay
Non-Preferred Brand Drugs
$100 Copay
Specialty Drugs
$250 Copay

Access to doctors and hospitals

Provider directory URL
http://www.providerlookuponline.com/Harvardpilgrim/po7/Search.aspx
Does this plan have access to a national provider network?
No
Is a referral required to see a Specialist?
Yes - A referral is needed for all specialists except for OB/GYN, Chiropractic Care, Routine Eye Exams, and Mental Health Providers
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
$100 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)
$250 Copay per Stay after deductible
Inpatient Physician and Surgical Services
No Charge after deductible
Emergency Transportation or Ambulance Service
No Charge after deductible

Maternity

Prenatal and Postnatal Care
No Charge
Delivery and all inpatient services for maternity care
$250 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services
$20 Copay
Mental/Behavioral Health Inpatient Services
$250 Copay per Stay after deductible
Substance use disorder outpatient services
$20 Copay
Substance use disorder inpatient services
$250 Copay per Stay after deductible

Medical Management Programs

Does this plan offer disease managment programs?
Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
Does this plan offer a wellness program?
Included

Vision Coverage

Routine Eye Exam for Children
Included
Eye Glasses for Children
Included
Routine Eye Exam for Adults
Included

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
Bariatric Surgery
Hearing Aids
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
Home Health Care Services
Durable Medical Equipment
Hospice Services
Routine Foot Care
Applied Behavior Analysis Based Therapies
Dental Anesthesia
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Abortion for Which Public Funding is Prohibited
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Well Baby Visits and Care
Bone Marrow Transplant
Off Label Prescription Drugs
Wigs
Low Protein Foods
Convenience Care Clinic
More Limited Benefits
Skilled Nursing Facility
Acupuncture
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Inpatient Rehabilitation Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Treatment for Temporomandibular Joint Disorders
Early Intervention Services
More Excluded Benefits
Cosmetic Surgery
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children

What To Know

  • This is an ACA (Obamacare) compliant health plan.

Physician Directory

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Gold plan frequently asked questions (FAQ)

  • 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 Affordable Care Act health plans runs from November 1, 2015 to January 31, 2016. See our Open Enrollment article for more information.

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