|Applicant||10/15/1983 Male |
|Insurance Type||ACA (Obamacare)|
|Plan Name||Sparrow PHP Gold 2000 Exclusive|
|Insurance Provider||Physicians Plus Insurance|
Costs for Medical Care
|Primary Care Visit to Treat an Injury or Illness||$30 Copay|
|Specialist Visit||$60 Copay|
|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 URL||Coming Soon|
|Emergency Room Services||$350 Copay|
|Inpatient Hospital Services (e.g., Hospital Stay)||30% Coinsurance after deductible|
|Inpatient Physician and Surgical Services||30% Coinsurance after deductible|
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.
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.
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.
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.