Marketplace Gold Plans

Lowest Out-of-Pocket Costs

Are you are looking for a health plan with no or low deductibles and/or copays? Then our Marketplace Gold Plans are for you.

Call us today to learn more about enrollment timeframes and to find a plan that fits your needs.
1-855-572-7238.


Glance through the chart below for a comparison, or open up the linked PDFs for more details.

 
2017 Plan Benefits
HMO Gold
Coinsurance
HMO Gold
Copay
Medical Deductible (if any)
Single/Family
$1,200/$2,400 $0/$0
Medication Deductible (if any) 
Single/Family
$0/$0 $0/$0
Preventive Care Copay No Cost No Cost
Adult Primary Care Visit Copay $30 $30
Pediatric Primary Care Visit Copay
(Ages 0-19)
$0 $0
Specialty Care Visit Copay $50 $50
Inpatient Copay 20%1 $700 per day, not to exceed $3,500 per stay
Outpatient Copay 20%1 $600
Emergency Room Copay $5001 $500
Urgent Care Copay $50 $50
Routine Lab/X-Ray Copay No Cost No Cost
Imaging (MRI, CT, Scans) Copay $250 per test1 $250 per test1
Medication Copays:
Tier I
Tier II
Tier III
Tier IV
Tier V

$0
$10
$50
$100
30%

$0
$20
$50
$100
30%
Formulary link link
Compare Medication Costs link link
Maximum Out-Of-Pocket
Single/Family
$4,600/$9,200 $7,150/$14,300
Plan ID 26539TX0140001-01 26539TX0140002-00
Summary of Benefits & Coverage
(SBC)
Plan Documents
1After Medical Deductible  


Notify Me When I Can Enroll

Marketplace plan eligibility is based on both zip code and county.

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FirstCare is here for you.

We can help you find a plan that fits your needs. Contact us today!

Resources

FirstCare's Direct Enrollment Portal Service Area Map Find a Provider Get a Quote Pay Your Premium Rate Review Justification

Non-Discrimination Notice

FirstCare does not discriminate or exclude people based on race, color, national origin, age, disability, or sex. Read more here.

Ask the Pharmacist

Have a question about a specific drug, or a drug benefit in your plan? Email our Pharmacist for the answers you need!

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? Get the info you need today! FirstCare members can talk to a nurse 24/7 by calling 1.855.828.1013 to get answers 24 hours a day, 7 days a week! TTY users can call 7-1-1 or  1.800.955.8771. Voice communication is available at 1.800.955.8770.

Utilization Management

Ever wonder how we decide what services to authorize for our members? Our utilization management (UM) decisions are based on medical evidence and consensus of health care professionals. For more details, click here.

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