Capital Health Plan HMO Gold 3000
Capital Health Plan · 2026 plan year
Gold
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $8,500
- Family OOP max
- $17,000
Compare with other Gold plans in FL
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Capital Health Plan plans in FL
Monthly premiums by age
Rating Area 36 — the lowest-priced of the 9 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $404 | $404 |
| 21 | $529 | $571 |
| 30 | $600 | $675 |
| 40 | $676 | $794 |
| 50 | $944 | $1,133 |
| 60 | $1,435 | $1,722 |
| 64 and over | $1,586 | $1,903 |
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 | $25.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $350.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $750.00 Copay per Day |
| Outpatient Surgery Physician/Surgical Services | $100.00 |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $15.00 |
| Non-Preferred Brand Drugs | $60.00 |
| Preferred Brand Drugs | $30.00 |
| Specialty Drugs | $250.00 |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $750.00 |
| Mental/Behavioral Health Outpatient Services | $50.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | $750.00 |
| Acupuncture | Not covered |
| Allergy Testing | $50.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | $750.00 |
| Chiropractic Care | $50.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $750.00 |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | No charge |
| Dialysis | No charge |
| Durable Medical Equipment | No charge |
| Emergency Transportation/Ambulance | $200.00 |
| Eye Glasses for Children | No charge |
| Habilitation Services | $50.00 |
| Hearing Aids | Not covered |
| Home Health Care Services | $35.00 |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $250.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | Not covered |
| 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 - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | $50.00 |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $350.00 |
| Outpatient Rehabilitation Services | $50.00 |
| Prenatal and Postnatal Care | $50.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | No charge |
| Radiation | $750.00 |
| Reconstructive Surgery | $750.00 |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50.00 |
| Rehabilitative Speech Therapy | $50.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | $50.00 |
| Routine Eye Exam for Children | $50.00 |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | No charge |
| Substance Abuse Disorder Inpatient Services | $750.00 |
| Substance Abuse Disorder Outpatient Services | $50.00 |
| Transplant | $750.00 |
| Treatment for Temporomandibular Joint Disorders | $750.00 |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | No charge |
Plan rules
Service area
This plan covers 9 geographic areas.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.