2019 HMO 2000 Elite Gold Plan Details - HealthPocket

HMO 2000 Elite Gold

$494.77/mo

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Zip Code60629
Applicant11/15/1983 Male
Coverage Start11/16/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameHMO 2000 Elite Gold
Plan IDqhp-20129IL0330017
Plan Year2019
Insurance ProviderHealth Alliance
Metal LevelGold
Plan TypeHMO
Deductible$2,000
Out-of-Pocket Maximum$6,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$20 Copay
Specialist Visit$45 Copay
Laboratory Outpatient and Professional Services10.00% Coinsurance after deductible
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible
Deductible - Family$4000
Out-of-Pocket Maximum - Family$12000

Prescription drug coverage

Generic Drugs$10 Copay
Preferred Brand Drugs$40 Copay
Non-Preferred Brand Drugs$80 Copay
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)$200 Copay
Inpatient Physician and Surgical Services10% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care10.00% Coinsurance after deductible

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 BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
More Excluded BenefitsCosmetic Surgery
Long-Term/Custodial Nursing Home Care
Abortion for Which Public Funding is Prohibited
Acupuncture
Weight Loss Programs
PremiumPlan NameDeductible
from $407
Blue Choice Preferred Silver PPO 203
$2,200.00Select
from $427
Performance Gold 2000 - Copay $30/$70
$2,000.00Select
from $435
Blue Choice Preferred Silver PPO 303
$2,200.00Select
from $447
Performance Gold HSA 2000
$2,000.00Select
from $471
HMO 2000 Methodist Gold
$2,000.00Select
  • 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.

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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.