Gym Access IND Bronze HMO 1041

Plan Type: HMO
Plan Tier: Expanded Bronze
Medical Deductible - Individual: $4700
Medical Deductible - Family: Included in Medical
Drug Deductible - Individual: $4700
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $8150
Out of Pocket Max - Family: $8150
Primary Care Visit: $50
Specialist Visit: $75
Emergency Room: 50% Coinsurance after deductible
Hospital - Physician: 50% Coinsurance after deductible
Hospital - Facility: 50% Coinsurance after deductible
Link to Full SBC: http://www.fhcp.com/documents/ISBC/2020/56503FL2780001-01.pdf
Plan Brochure: http://www.fhcp.com/documents/ISOB/2020/56503FL2780001-01.pdf

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $10 Copay after deductible
Non-Preferred Brand Drugs: $55 Copay after deductible
Preferred Brand Drugs: $30 Copay after deductible
Specialty Drugs: 50% 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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