AdventHealthGYM ACCESS Bronze HMO 50 1797
| Plan Type: | HMO |
| Plan Tier: | Expanded Bronze |
| Medical Deductible - Individual: | $6900 |
| Medical Deductible - Family: | Included in Medical |
| Drug Deductible - Individual: | $6900 |
| Drug Deductible - Family: | Included in Medical |
| Out of Pocket Max - Individual: | $7700 |
| Out of Pocket Max - Family: | $7700 |
| Primary Care Visit: | $45 and 50% Coinsurance after deductible |
| Specialist Visit: | $60 and 50% Coinsurance after deductible |
| Emergency Room: | 50% Coinsurance after deductible |
| Hospital - Physician: | 50% Coinsurance after deductible |
| Hospital - Facility: | 50% Coinsurance after deductible |
| Link to Full SBC: | http://myAHplan.com/2020_sbc_1797 |
| Plan Brochure: |
Other Coverage:
| Child Dental: | Yes |
| 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://myAHplan.com/MP_formulary_2020 |
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