Sharp Gold 80 HMO

Sharp Gold 80 HMO plan is ACA compliant.

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Sharp Gold 80 HMO - Available 2016

The Sharp Gold 80 HMO plan in CaliforniaSharp Gold 80 Health Insurance has no deductibles. All covered services contribute to the out-of-pocket maximum. Preventive care services, such as routine physical exams and mammogram screenings, are at no charge. Primary care visits are $30. This is one of the most comprehensive Sharp plans in California and will satisfy your mandated individual health insurance requirement also known as "minimum essential health coverage".

Plan Name Gold 80 HMO
Medical Deductible Individual:$2,000 Family:$4,000
Drug Benefits Deductible Individual $250 - Family $500
Annual Out-of-Pocket  
Out of Pocket Max for Med and Drug EHB Benefits (Total) Individual:$6,250 Family:$12,500
Emergency Health  
Urgent Care Centers or Facilities $60
Emergency Room Services $250
Emergency Transportation/Ambulance $250
Home Health Care  
Home Health Care Services $30
Hospitalization Services  
Inpatient Physician and Surgical Services No Charge
Habilitation Services $30
Inpatient Hospital Services (e.g., Hospital Stay) $600 Copay per day
Skilled Nursing Facility $300 Copay per day
Substance Abuse Disorder Outpatient Services $30
Substance Abuse Disorder Inpatient Services $600
Maternity Care  
Delivery and All Inpatient Services for Maternity Care $600
Prenatal and Postnatal Care No Charge
Other Services
Mental/Behavioral Health Inpatient Services $600
Durable Medical Equipment 20%
Hospice Services No Charge
Mental/Behavioral Health Outpatient Services $30
Rehabilitative Occupational and Rehabilitative Physical Therapy $30
Outpatient Services  
Outpatient Surgery Physician/Surgical Services No Charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center) 20%
Outpatient Rehabilitaion Svcs $30
Prescription Drug Coverage  
Generic Drugs $15
Non-Preferred Brand Drugs $70
Preferred Brand Drugs $50
Specialty Drugs 20%
Preventative Care  
Well Baby Visits and Care No Charge
Preventive Care/Screening/Immunization No Charge
Professional Services  
X-rays and Diagnostic Imaging $50
Specialist Visit $50
Imaging (CT/Pet Scans, MRI) $250
Laboratory Outpatient and Professional Services $30
Primary Care Visit to Treat an Injury or Illness $30

When receiving medical attention, you must only use a Sharp medical facility unless it is a medical emergency. Click here for Sharp physician and location information.

Information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage.

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