Gold 1D $0 Deductible $0 PCP $0 Specialty Visit with PCP Referral + PCP Referral may unlock $0 Lab $0 Imaging & $0 Outpatient Procedures
by Harbor Health
This is the insurance company offering this plan. Another name for insurance company is carrier or issuer.
2027 health insurance plan
Monthly Premium
Monthly premium is the monthly cost of this plan. The monthly premium does not include additional out-of-pocket costs you must pay when receiving medical care (deductibles, copays, coinsurance).
Add your household and income to see your personalized premium and any subsidy.
Price this plan →Gold
This plan is classified as a Gold plan. Gold plans usually have medium – high monthly premium costs, but low – medium out-of-pocket costs when you need medical care.
HMOHealth Maintenance Organization (HMO) is a type of plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
SubsidyThis plan is eligible for a Subsidy to reduce the monthly premium.
Deductible · ind / family
You usually have to pay the full cost for medical care until you reach the deductible amount. After reaching the deductible you then start paying for medical care based on the out-of-pocket cost details of the plan (copays, coinsurance). For plans covering a family, there are typically separate deductible amounts for individuals and the whole family. The deductible resets each year and the monthly premium does not count towards it.
$0 / $0Max out-of-pocket · ind / family
Max Out-of-Pocket is the maximum amount you will have to pay for out-of-pocket medical costs (deductible, copays, coinsurance) when you need medical care. For plans covering a family, there are typically separate max out-of-pocket amounts for individuals and the whole family. Once you reach the max out-of-pocket amount you will not have to pay another dollar for medical care. The monthly premium does not count towards the max out-of-pocket.
$9,950 / $19,900Support Our Enrollment Help Partner
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Estimated yearly cost
See your estimated yearly cost
These totals depend on your premium. Add your household to unlock them.
Price this plan →Coverage details
Deductible · individual
You usually have to pay the full cost for medical care until you reach the deductible amount. After reaching the deductible you then start paying for medical care based on the out-of-pocket cost details of the plan (copays, coinsurance). For plans covering a family, there are typically separate deductible amounts for individuals and the whole family. The deductible resets each year and the monthly premium does not count towards it.
$0 /yrDeductible · family
You usually have to pay the full cost for medical care until you reach the deductible amount. After reaching the deductible you then start paying for medical care based on the out-of-pocket cost details of the plan (copays, coinsurance). For plans covering a family, there are typically separate deductible amounts for individuals and the whole family. The deductible resets each year and the monthly premium does not count towards it.
$0 /yrMax out-of-pocket · individual
Max Out-of-Pocket is the maximum amount you will have to pay for out-of-pocket medical costs (deductible, copays, coinsurance) when you need medical care. For plans covering a family, there are typically separate max out-of-pocket amounts for individuals and the whole family. Once you reach the max out-of-pocket amount you will not have to pay another dollar for medical care. The monthly premium does not count towards the max out-of-pocket.
$9,950 /yrMax out-of-pocket · family
Max Out-of-Pocket is the maximum amount you will have to pay for out-of-pocket medical costs (deductible, copays, coinsurance) when you need medical care. For plans covering a family, there are typically separate max out-of-pocket amounts for individuals and the whole family. Once you reach the max out-of-pocket amount you will not have to pay another dollar for medical care. The monthly premium does not count towards the max out-of-pocket.
$19,900 /yrIncludes child dental
Some plans include dental coverage for certain adult or child dental expenses.
NoIncludes adult dental
Some plans include dental coverage for certain adult or child dental expenses.
NoBenefit details and out-of-pocket costsYou usually have to pay the full cost for medical care until you reach the deductible amount. After reaching the deductible you then start paying for medical care based on the out-of-pocket cost details of the plan (copays, coinsurance). Out-of-pocket costs are also called cost sharing.
Doctor visits
Preventive care & screenings
All health insurance plans are required to provide preventive care services at no cost. Examples of preventive care services are doctor checkups and certain lab tests.
No chargePrimary care visit
A primary care visit is a visit with a primary care physician, nurse, or other provider for services which are not considered preventive care.
No ChargeSpecialist visit
A specialist visit is a visit with a physician who specializes in a specific area of medicine or group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions.
No ChargeHospital & emergency
Emergency room
Emergency room is a visit to the emergency room to receive an evaluation of an emergency medical condition and treatment.
50% CoinsuranceInpatient facility
Inpatient facility is the facility cost for medical care you receive when admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility.
50% CoinsuranceInpatient physician
Inpatient physician is the provider cost for medical care you receive when admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility.
50% CoinsurancePrescription drugs
Tier 1 · Generic
Generic drugs are classified as Tier 1 drugs — your lowest-cost option.
$10 CopayTier 2 · Preferred brand
Preferred brand drugs are classified as Tier 2 drugs — your midrange-cost option.
50% CoinsuranceTier 3 · Non-preferred brand
Non-preferred brand drugs are classified as Tier 3 drugs — your highest-cost option.
50% CoinsuranceTier 4 · Specialty
Specialty drugs are classified as Tier 4 drugs — additional high-cost options.
50% CoinsuranceDrug deductible · ind / family
You usually have to pay the full cost for prescription drugs until you reach the drug deductible amount. After reaching it you then start paying for prescription drugs based on the out-of-pocket cost details of the plan (copays, coinsurance). The drug deductible can be included in the medical deductible, in which case there are no separate deductible amounts.
Included in MedicalDrug max out-of-pocket · ind / family
Drug Max Out-of-Pocket is the maximum amount you will have to pay out-of-pocket for prescription drug costs (deductible, copays, coinsurance) for this plan. Once you reach it you will not have to pay another dollar for prescription drugs. The drug max out-of-pocket can be included within the medical max out-of-pocket, in which case there are no separate amounts.
Included in MedicalPlan documents & tools
* Figures shown are only for in-network medical costs.
** Please check with the insurance company if copay and coinsurance rates are before or after the deductible.
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