Insurance Type | ACA (Obamacare) |
Plan Name | Health First GYM ACCESS Silver HMO 80 HSA 1728 |
Plan ID | qhp-36194FL0120010 |
Plan Year | 2019 |
Insurance Provider | Health First Commercial Plans, Inc. |
Metal Level | Silver |
Plan Type | HMO |
Deductible | $2,500 |
Out-of-Pocket Maximum | $6,500 |
Personal Score | |
Plan Highlights |
Costs for Medical Care | |
---|---|
Primary Care Visit to Treat an Injury or Illness | 20% Coinsurance after deductible |
Specialist Visit | 20% Coinsurance after deductible |
Laboratory Outpatient and Professional Services | 20.00% Coinsurance after deductible |
X-rays and Diagnostic Imaging | 20.00% Coinsurance after deductible |
Deductible - Family | $5000 |
Out-of-Pocket Maximum - Family | $13000 |
Prescription drug coverage | |
---|---|
Generic Drugs | 10% Coinsurance after deductible |
Preferred Brand Drugs | 10% Coinsurance after deductible |
Non-Preferred Brand Drugs | 10% Coinsurance after deductible |
Specialty Drugs | 10% Coinsurance after deductible |
Access to doctors and hospitals | |
---|---|
Provider directory URL | Coming Soon |
Hospital services | |
---|---|
Emergency Room Services | 20% Coinsurance after deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | 20% Coinsurance after deductible |
Inpatient Physician and Surgical Services | 20% Coinsurance after deductible |
Maternity | |
---|---|
Prenatal and Postnatal Care | Not Applicable |
Mental Health | |
---|---|
Mental/Behavioral Health Outpatient Services | 20.00% Coinsurance after deductible |
Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
Vision Coverage | |
---|---|
Routine Eye Exam for Children | Not Applicable |
Eye Glasses for Children | Not Applicable |
Exclusions and Limitations | |
---|---|
More Included Benefits | 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 Urgent Care Centers or Facilities Other Practitioner Office Visit (Nurse, Physician Assistant) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Hospice Services Home Health Care Services Inpatient Physician and Surgical Services Dental Check-Up for Children Rehabilitative Speech Therapy Rehabilitative Occupational and Rehabilitative Physical Therapy Well Baby Visits and Care Transplant Accidental Dental Dialysis Allergy Testing Chemotherapy Radiation Diabetes Education Prosthetic Devices Infusion Therapy Treatment for Temporomandibular Joint Disorders Nutritional Counseling Reconstructive Surgery 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 |
More Excluded Benefits | Hearing Aids Acupuncture Weight Loss Programs Infertility Treatment Long-Term/Custodial Nursing Home Care Private-Duty Nursing Bariatric Surgery Cosmetic Surgery Abortion for Which Public Funding is Prohibited |
Premium | Plan Name | Deductible | |||
---|---|---|---|---|---|
from $399 |
| $2,500.00 | Select | ||
from $403 |
| $2,500.00 | Select | ||
from $404 |
| $2,500.00 | Select | ||
from $411 |
| $2,500.00 | Select | ||
from $425 |
| $2,650.00 | Select |
ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.
The monthly premium for a Silver 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 Silver Plan premiums in your area.
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.
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.