Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access)
Health First Commercial Plans, Inc. · 2026 plan year
Gold
- Ind. medical deductible
- $3,000
- Rx deductible (separate)
- $500
- Family deductible
- $6,000
- Ind. OOP max
- $8,250
- Family OOP max
- $16,500
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Other cost-sharing reduction variants for this plan:
More Health First Commercial Plans, Inc. plans in FL
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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 | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $90.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $250.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $1000.00 Copay per Stay |
| Outpatient Surgery Physician/Surgical Services | 30.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $80.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $15.00 |
| Non-Preferred Brand Drugs | $50.00 Copay after deductible |
| Preferred Brand Drugs | $30.00 Copay after deductible |
| Preferred Generic Drugs | $2.00 |
| Specialty Drugs | 30.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental Health Office Visit | $90.00 |
| Mental/Behavioral Health Inpatient Services | $1000.00 Copay per Stay |
| Mental/Behavioral Health Outpatient Services | 30.00% Coinsurance after deductible |
Other
| Benefit | In-network |
|---|---|
| Major Dental Care - Adult | Not covered |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 30.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | No charge |
| Anesthesia Services for Dental Care | 30.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | No charge |
| Cardiac and Pulmonary Rehabilitation | 30.00% Coinsurance after deductible |
| Chemotherapy | 30.00% Coinsurance after deductible |
| Chiropractic Care | $90.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $1,000.00 |
| Dental Check-Up for Children | No charge |
| Diabetes Education | No charge |
| Dialysis | 30.00% Coinsurance after deductible |
| Durable Medical Equipment | 30.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | $250.00 |
| Enteral/Parenteral and Oral Nutrition Therapy | 30.00% Coinsurance after deductible |
| Eye Glasses for Adult | Not covered |
| Eye Glasses for Children | No charge |
| Genetic Testing Lab Services | 30.00% Coinsurance after deductible |
| Habilitation Services | 30.00% Coinsurance after deductible |
| Hearing Aids | Not covered |
| Home Health Care Services | 30.00% Coinsurance after deductible |
| Hospice Services | 30.00% Coinsurance after deductible |
| Hyperbaric Oxygen Therapy | 30.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | No charge |
| Infertility Treatment | Not covered |
| Infusion Therapy | 30.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | No charge |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Child | No charge |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | No charge |
| Osteoporosis Treatment | $90.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 30.00% Coinsurance after deductible |
| Outpatient Observation | 30.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 30.00% Coinsurance after deductible |
| Partial Hospitalization | 30.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 30.00% Coinsurance after deductible |
| Radiation | 30.00% Coinsurance after deductible |
| Reconstructive Surgery | $1,000.00 |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 30.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 30.00% Coinsurance after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $90.00 |
| Skilled Nursing Facility | $1000.00 Copay per Stay |
| Substance Abuse Disorder Inpatient Services | $1000.00 Copay per Stay |
| Substance Abuse Disorder Outpatient Services | 30.00% Coinsurance after deductible |
| Substance Abuse Office Visit | $90.00 |
| Transplant | $1,000.00 |
| Treatment for Temporomandibular Joint Disorders | $1,000.00 |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $135.00 |
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