Gym Access IND Silver POS BC 0941
Florida Health Care Plans · 2026 plan year
Silver
- Ind. medical deductible
- $5,000
- Rx deductible (separate)
- $2,100
- Family deductible
- $10,000
- Ind. OOP max
- $8,350
- Family OOP max
- $16,700
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Compare with other Silver plans in FL
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
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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.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $440 | $440 |
| 21 | $575 | $690 |
| 30 | $653 | $784 |
| 40 | $735 | $882 |
| 50 | $1,028 | $1,233 |
| 60 | $1,562 | $1,874 |
| 64 and over | $1,726 | $2,071 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | No charge |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $100.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 40.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | $600.00 Copay per Stay after deductible |
| Outpatient Surgery Physician/Surgical Services | No Charge after deductible |
| Urgent Care Centers or Facilities | $100.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | $55.00 Copay after deductible |
| Preferred Brand Drugs | $30.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $600.00 Copay per Stay after deductible |
| Mental/Behavioral Health Outpatient Services | $80.00 |
Other
| Benefit | In-network |
|---|---|
| Delivery and All Inpatient Services for Maternity Care | $600.00 Copay after deductible |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | $100.00 |
| Acupuncture | Not covered |
| Allergy Testing | $10.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Bone Marrow Transplant | $600.00 Copay after deductible |
| Chemotherapy | 50.00% Coinsurance after deductible |
| Chiropractic Care | $50.00 |
| Congenital Anomaly, including Cleft Lip/Palate | $100.00 |
| Cosmetic Surgery | Not covered |
| Dental Anesthesia | 40.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Care Management | $10.00 |
| Diabetes Education | No charge |
| Dialysis | 50.00% Coinsurance after deductible |
| Durable Medical Equipment | No charge |
| Emergency Transportation/Ambulance | $400.00 |
| Eye Glasses for Children | $25.00 |
| Gender Affirming Care | Not covered |
| Habilitation Services | $50.00 |
| Hearing Aids | Not covered |
| Home Health Care Services | No charge |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $500.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | 50.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | $35.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | $10.00 |
| Routine Foot Care | Not covered |
| Nutrition/Formulas | No charge |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Osteoporosis | $100.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | No charge |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $350.00 Copay after deductible |
| Outpatient Rehabilitation Services | $50.00 |
| Prenatal and Postnatal Care | $100.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | No charge |
| Radiation | 50.00% Coinsurance after deductible |
| Reconstructive Surgery | $600.00 Copay after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50.00 |
| Rehabilitative Speech Therapy | $50.00 |
| Skilled Nursing Facility | $15.00 Copay per Day |
| Substance Abuse Disorder Inpatient Services | $600.00 Copay per Stay after deductible |
| Substance Abuse Disorder Outpatient Services | $80.00 |
| Telehealth | No charge |
| Transplant | $600.00 Copay after deductible |
| Treatment for Temporomandibular Joint Disorders | $100.00 |
| Weight Loss Programs | No charge |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $60.00 |
Plan rules
Service area
This plan covers 5 geographic areas.
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