2019 Health First GYM ACCESS Gold HMO 70 1742 Plan Details - HealthPocket

Health First GYM ACCESS Gold HMO 70 1742

$414.17/mo

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Zip Code33186
Applicant11/16/1983 Male
Coverage Start11/19/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameHealth First GYM ACCESS Gold HMO 70 1742
Plan IDqhp-36194FL0120013
Plan Year2019
Insurance ProviderHealth First Commercial Plans, Inc.
Metal LevelGold
Plan TypeHMO
Deductible$1,500
Out-of-Pocket Maximum$3,500
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$40 Copay
Specialist Visit$80 Copay
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$3000
Out-of-Pocket Maximum - Family$7000

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand Drugs$30 Copay
Non-Preferred Brand Drugs$50 Copay
Specialty Drugs30% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$250 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$700 Copay
Inpatient Physician and Surgical ServicesNo Charge

Maternity

Prenatal and Postnatal CareNot Applicable

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient ServicesNot Applicable

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsTreatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Infusion Therapy
Anesthesia Services for Dental Care
Enteral/Parenteral and Oral Nutrition Therapy
Osteoporosis Treatment
Cardiac and Pulmonary Rehabilitation
Preferred Generic Drugs
Genetic Testing Lab Services
Hyperbaric Oxygen Therapy
Outpatient Observation
Partial Hospitalization
Allergy Injections
Fitness Center Membership
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
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
Transplant
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
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  • 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.

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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.

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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.