2019 SmartHealth Gold 1500 Plan Details - HealthPocket

SmartHealth Gold 1500

$481.00/mo

Apply For This Plan

Zip Code59102
Applicant11/16/1983 Male
Coverage Start11/20/2018
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameSmartHealth Gold 1500
Plan IDqhp-23603MT0290003
Plan Year2019
Insurance ProviderPacificSource Health Plans
Metal LevelGold
Plan TypePPO
Deductible$1,500
Out-of-Pocket Maximum$5,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness10% Coinsurance after deductible
Specialist Visit10% Coinsurance after deductible
Laboratory Outpatient and Professional Services10.00% Coinsurance after deductible
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible
Deductible - Family$3000
Out-of-Pocket Maximum - Family$10000

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand Drugs$50 Copay
Non-Preferred Brand Drugs$75 Copay
Specialty Drugs$250 Copay

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services10% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)10% Coinsurance after deductible
Inpatient Physician and Surgical Services10% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care0.00%

Mental Health

Mental/Behavioral Health Outpatient Services0.00%
Mental/Behavioral Health Inpatient Services0.00%

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for Children10.00% Coinsurance after deductible

Exclusions and Limitations

More Included BenefitsAbortion for Which Public Funding is Prohibited
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Nutritional Counseling
Reconstructive Surgery
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Cosmetic Surgery
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
Acupuncture
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
More Excluded BenefitsTreatment for Temporomandibular Joint Disorders
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Hearing Aids
Weight Loss Programs
Dental Check-Up for Children
PremiumPlan NameDeductible
from $535
PSN Gold 1500
$1,500.00Select
from $587
SmartHealth Gold 1500
$1,500.00Select
from $654
PSN Gold 1500
$1,500.00Select
  • 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.

Close

Health Plans Found

 

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.