2019 Gold Plan HSA M1 Plan Details - HealthPocket

Gold Plan HSA M1

$393.22/mo

Apply For This Plan

Zip Code72209
Applicant1/22/1984 Male
Coverage Start1/24/2019
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameGold Plan HSA M1
Plan IDqhp-75293AR1210005
Plan Year2019
Insurance ProviderArkansas Blue Cross Blue Shield
Metal LevelGold
Plan TypePPO
Deductible$3,000
Out-of-Pocket Maximum$3,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional Services0.00% Coinsurance after deductible
X-rays and Diagnostic Imaging0.00% Coinsurance after deductible
Deductible - Family$6000
Out-of-Pocket Maximum - Family$6000

Prescription drug coverage

Generic DrugsNo Charge after Deductible
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal Care0.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services0.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services0.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNo Charge
Eye Glasses for Children0.00% Coinsurance after deductible

Exclusions and Limitations

More Included BenefitsWell Baby Visits and Care
Hearing Aids
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
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
Skilled Nursing Facility
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Nutritional Counseling
Reconstructive Surgery
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Off Label Prescription Drugs
Dental Anesthesia
Gastric Electrical Stimulation
Well Child Care
Applied Behavior Analysis Based Therapies
Cochlear Implants
Craniofacial Surgery
Specialty Drugs Tier 2
Preventive Drugs
More Excluded BenefitsAcupuncture
Weight Loss Programs
Dental Check-Up for Children
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $301
Ambetter Balanced Care 6 (2019)
$3,000.00Select
from $324
Ambetter Balanced Care 6 (2019) + Vision + Adult Dental
$3,000.00Select
/
Please select the correct zip
Abdelal, Ahmed
View All Details
Khan, Mahmood
View All Details
Badhwar, Anil
View All Details
Snyder, Stephen
View All Details
Crowell, Karen
View All Details
Burrall, Stacy
View All Details
Garrison, Deanna
View All Details
Kidz Palace Therapy Llc
View All Details
Elite Therapy Llc
View All Details
Cranfield, Thomas
View All Details
Elite Medical Care, Llc
View All Details
Jordan, Vernon
View All Details
Fowler, Tamara
View All Details
Baptist Health Behavioral Services Clinic
View All Details
Jackson, Kelly
View All Details
Digestive Wellness Clinic, Pllc
View All Details
Ray, Shawnessa
View All Details
White, Tammy
View All Details
Southwest Family Practice Pa
View All Details
Riley Sanford, Sarita
View All Details
Stokes, Erica
View All Details
Harmon, Meredith
View All Details
Jenson, Charles
View All Details
Jarvis, Sarah
View All Details
Ahmed Abdelal, M.D.
View All Details
  • Phone Number
    (501) 455-7021
  • Office Locations
    11321 Interstate 30
    Little Rock, AR 72209
11321 Interstate 30 Little Rock AR, 72209
  • 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.