Gym Access IND Bronze HMO BC 3841

Plan Type: HMO
Plan Tier: Expanded Bronze
Medical Deductible - Individual: $6400
Medical Deductible - Family: Included in Medical
Drug Deductible - Individual: $6400
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $8000
Out of Pocket Max - Family: $8000
Primary Care Visit: $35
Specialist Visit: $65
Emergency Room: 50% Coinsurance after deductible
Hospital - Physician: No Charge after Deductible
Hospital - Facility: $100 Copay per Stay after deductible
Link to Full SBC: http://www.fhcp.com/documents/ISBC/2020/56503FL2530002-01.pdf
Plan Brochure: http://www.fhcp.com/documents/ISOB/2020/56503FL2530002-01.pdf

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $35
Non-Preferred Brand Drugs: 40% Coinsurance after deductible
Preferred Brand Drugs: 35% Coinsurance after deductible
Specialty Drugs: 45% Coinsurance after deductible
Link to Full Policy Formulary: http://fm.formularynavigator.com/FBO/126/2020_QHP_Formulary_Member_Doc.pdf

This Carrier Offers:



About The Carrier

Florida Health Care Plan, Inc. (FHCP) provides health care services. The Company offers health insurance, medicare plans, and other related services. FHCP serves members in the State of Florida.

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