2019 Sparrow PHP Gold 2000 Exclusive Plan Details - HealthPocket

Sparrow PHP Gold 2000 Exclusive

$280.96/mo

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Zip Code48228
Applicant1/24/1984 Male
Coverage Start1/25/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameSparrow PHP Gold 2000 Exclusive
Plan IDqhp-60829MI0190016
Plan Year2019
Insurance ProviderPhysicians Plus Insurance
Metal LevelGold
Plan TypeHMO
Deductible$2,000
Out-of-Pocket Maximum$6,800
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$30 Copay
Specialist Visit$60 Copay
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Deductible - Family$4000
Out-of-Pocket Maximum - Family$13600

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs$50 Copay
Non-Preferred Brand Drugs$80 Copay
Specialty Drugs$150 Copay

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$350 Copay
Inpatient Hospital Services (e.g., Hospital Stay)30% Coinsurance after deductible
Inpatient Physician and Surgical Services30% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care30.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for Children30.00% Coinsurance after deductible

Exclusions and Limitations

More Included BenefitsInpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Weight Loss Programs
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
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
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Autism Spectrum Disorders
Clinical Trials
Dental Anesthesia
Telemedicine Services
Mental Health - Intermediate
Substance Use Disorders - Intermediate
Gender Reassignment Treatment
More Excluded BenefitsCosmetic Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Dental Check-Up for Children
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $308
Sparrow PHP Silver 2000 Exclusive
$2,000.00Select
from $343
Sparrow PHP Gold 2000 Exclusive
$2,000.00Select
from $376
Sparrow PHP Silver 2000 Exclusive
$2,000.00Select
from $441
Blue Cross® Premier PPO Silver
$2,000.00Select
from $484
Blue Cross Premier PPO Silver Off Marketplace
$2,000.00Select
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  • Phone Number
    (313) 584-3624
  • Office Locations
    16551 W Warren Ave
    Detroit, MI 48228
16551 W Warren Ave Detroit MI, 48228
  • 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.