Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

Gym Access IND Gold HMO 4500

Florida Health Care Plans · 2026 plan year

Gold
Ind. deductible
$2,550
Family deductible
$5,100
Ind. OOP max
$5,600
Family OOP max
$11,200

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Monthly premiums by age

Rating Area 5 — the lowest-priced of the 5 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$411$411
21$537$644
30$609$731
40$686$823
50$959$1,151
60$1,457$1,749
64 and over$1,611$1,933

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or IllnessNo charge

Specialist

BenefitIn-network
Specialist Visit$35.00

Hospital

BenefitIn-network
Emergency Room Services10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$250.00 Copay per Day
Outpatient Surgery Physician/Surgical Services10.00% Coinsurance after deductible
Urgent Care Centers or Facilities$75.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Non-Preferred Brand Drugs$55.00
Preferred Brand Drugs$30.00
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$250.00 Copay per Day
Mental/Behavioral Health Outpatient Services$35.00

Other

BenefitIn-network
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Inpatient Physician and Surgical ServicesNo charge
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$35.00
AcupunctureNot covered
Allergy TestingNo charge
Bariatric SurgeryNot covered
Bone Marrow Transplant$250.00
Chemotherapy50.00%
Chiropractic Care$35.00
Congenital Anomaly, including Cleft Lip/Palate$35.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$250.00
Dental Anesthesia10.00%
Dental Check-Up for ChildrenNot covered
Diabetes Care Management$10.00
Diabetes EducationNo charge
Dialysis50.00%
Durable Medical Equipment10.00%
Emergency Transportation/Ambulance10.00% Coinsurance after deductible
Eye Glasses for Children$25.00
Gender Affirming CareNot covered
Habilitation Services$35.00
Hearing AidsNot covered
Home Health Care Services10.00%
Hospice Services10.00%
Imaging (CT/PET Scans, MRIs)10.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy50.00%
Laboratory Outpatient and Professional Services$25.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutrition/Formulas10.00%
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Osteoporosis$35.00
Other Practitioner Office Visit (Nurse, Physician Assistant)No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)10.00% Coinsurance after deductible
Outpatient Rehabilitation Services$35.00
Prenatal and Postnatal Care$35.00
Private-Duty NursingNot covered
Prosthetic Devices10.00%
Radiation50.00%
Reconstructive Surgery$250.00
Rehabilitative Occupational and Rehabilitative Physical Therapy$35.00
Rehabilitative Speech Therapy$35.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for Children$10.00
Routine Foot CareNot covered
Skilled Nursing Facility$50.00 Copay per Day
Substance Abuse Disorder Inpatient Services$250.00 Copay per Day
Substance Abuse Disorder Outpatient Services$35.00
TelehealthNo charge
Transplant$250.00
Treatment for Temporomandibular Joint Disorders$35.00
Weight Loss ProgramsNo charge
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible

Service area

This plan covers 5 geographic areas.

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