Gym Access IND Silver HMO BC 0941

Plan Type: HMO
Plan Tier: Silver
Medical Deductible - Individual: $5600
Medical Deductible - Family: $3000
Drug Deductible - Individual: $5600
Drug Deductible - Family: $3000
Out of Pocket Max - Individual: $7150
Out of Pocket Max - Family: $7150
Primary Care Visit: $50
Specialist Visit: $100
Emergency Room: $400 Copay after deductible
Hospital - Physician: No Charge
Hospital - Facility: $600 Copay per Stay after deductible
Link to Full SBC: http://www.fhcp.com/documents/ISBC/2020/56503FL2550002-01.pdf
Plan Brochure: http://www.fhcp.com/documents/ISOB/2020/56503FL2550002-01.pdf

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $10
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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