Florida health plan · 2026

Bronze 22 Health · 13887FL0010003

22 Health offers this marketplace health insurance plan (Plan ID 13887FL0010003) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Expanded Bronze Plan type: HMO CSR: Standard Bronze Off Exchange Plan Issuer: 22 Health
Telehealth Data pending HSA eligible Yes Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 64.12% (35.88% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$318 – $1247

Before subsidies

Estimate after subsidies

Deductible

$7,500

$15000 per group

See deductible details

Max out-of-pocket

$10,000

$20000 per group

Review MOOP rules

Office visits

Primary care $50.00
Specialist $100.00
HSA Eligible

Drug tiers

Generic $25.00
Preferred brand $50.00 Copay after deductible

View formulary tiers

$436 / mo before subsidies

≈ $5226 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1380 / mo before subsidies

≈ $16561 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1671 / mo before subsidies

≈ $20057 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1062 / mo before subsidies

≈ $12746 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

0.00%

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

50.00% Coinsurance after deductible

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Florida). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Standard Bronze Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

0.00%

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

50.00% Coinsurance after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 13887FL0010003
Coverage year 2026
State Florida
Issuer 22 Health
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 13887FL0010003-00
Available variants

Standard Off Exchange Plan · 13887FL0010003-00

Standard On Exchange Plan · 13887FL0010003-01

Open to Indians below 300% FPL · 13887FL0010003-02

Open to Indians above 300% FPL · 13887FL0010003-03
Last plan update Tue, 28 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Florida 2508
PCPs in Florida 771
Telehealth support Data pending
Nationwide providers 2513
2,508 doctors statewide 771 PCPs 44 OB/GYN

Provider network(s)

Providers Florida All US states
All 2508 2513
PCP 771 772
Allergy 4 4
OB/GYN 44 44
Dentists 9 9

Drug coverage overview

7,645 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERICS 6,265
SPECIALTY-DRUGS 1,380
Prior authorization Drugs
Required 1,616
Not Required 6,029
Step therapy Drugs
Required 864
Not Required 6,781
Quantity limits Drugs
Has Limit 2,441
No Limit 5,204

Customer highlights

What stands out for members

  • Issuer: 22 Health · Plan ID 13887FL0010003 · 2026 filing.
  • Disease management programs available: Asthma, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 13887FL0010003-00 (Standard Off Exchange Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Diabetes Education

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Home Health Care Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 20.0 Days per Benefit Period

To be eligible for benefits, you must essentially be confined to the home, as an alternative to a Hospital stay, and be physically unable to get needed medical services on an outpatient basis. Some limitations apply to Home Health Care Services, see EHB benchmark plan documents for additional details.

Exclusions: Homemaker or domestic maid services, sitter or companion services, Services rendered by an employee or operator of an adult congregate living facility, adult foster care, adult day care center, or a nursing home facility. Also excluded is Speech Therapy provided for a diagnosis of developmental delay. Custodial Care is excluded. Food, housing and home delivered meals and Services rendered in a Hospital, nursing home, or immediate care facilities are excluded. Part- time- services limited to less than 8 hours a da, less than 40 hours a week. Intermitten Services limit to each visit up to but not exceeding 2 hours a day

Laboratory Outpatient and Professional Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Medical self-administered drugs in the treatment of cancer, diabetes or conditions requiring immediate stabilization or administration of dialysis are covered.

Preventive Care/Screening/Immunization

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Preventive colonoscopy (age 50+) 1 every 10 years. High risk colonoscopy 1 every 2 years. In order for Preventive services to be covered, Services must be provided in accordance with prevailing medical standards consistent with the recommendations for Preventive Adult and Pediatric Health Care as indicated by the USPSTF.

Primary Care Visit to Treat an Injury or Illness

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Physician Administered Drugs. Medical selfadministered drugs in the treatment of cancer, diabetes or conditions requiring immediate stabilization or administration of dialysis are covered.

Rehabilitative Occupational and Rehabilitative Physical Therapy

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Exclusions: If provided in an inpatient setting, member must be actively participating in 2 rehabillitative therapies and be able to tolerate at least 3 hours per day of skilled Rehab services for at least 5 days a week. Members condition must be likely to significantly improve. Inpatient rehab limit is 21 days.

Rehabilitative Speech Therapy

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Specialist Visit

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Physician Administered Drugs. Medical selfadministered drugs in the treatment of cancer, diabetes or conditions requiring immediate stabilization or administration of dialysis are covered.

Urgent Care Centers or Facilities

$75.00
Tier 1 in-network $75.00
Out-of-network 100.00%

X-rays and Diagnostic Imaging

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Chemo treatment for proven malignant disease

Delivery and All Inpatient Services for Maternity Care

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Care for the mother includes the postpartum assessment.

Exclusions: Maternity services rendered to a covered person who is acting as a gestational surrogate are excluded.

Dialysis

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Covered Services include dialysis treatments in an outpatient dialysis, or home dialysis and training for you and the person who will help you with home self-dialysis.

Durable Medical Equipment

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Exclusions: Durable Medical Equipment which is primarily for convenience and/or comfort; modifications to motor vehicles and/or homes, including but not limited to, wheelchair lifts or ramps; water therapy devices such as Jacuzzis, hot tubs, swimming pools or whirlpools; exercise and massage equipment, electric scooters, hearing aids, air conditioners and purifiers, humidifiers, water softeners and/or purifiers, pillows, mattresses or waterbeds, escalators, elevators, stair glides, emergency alert equipment, handrails and grab bars, heat appliances, dehumidifiers, and the replacement of DME solely because it is old or used are excluded.

Emergency Room Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Emergency Transportation/Ambulance

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Ground, air and water travel, combined per day maximum. Add'l limitations may exist for air and water transport; Covered when necessary to transport a newborn child to and from the nearest appropriate facility which is staffed and equipped to treat the newborn child condition. Covered services for transportation between facilities when medically necessary. Services covered from one location to other when patient is bedridden, wheelchair bound and cannot otherwise be transported. 5500 per day maximum.

Hospice Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Inpatient Hospital Services (e.g., Hospital Stay)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Inpatient Rehabilitation is covered; Partial Hospitalization is a Covered services include chemotherapy and radiation treatments for proven malignant disease, therapies and transplants.

Exclusions: Gowns, slippers, toiletries, telephone, TV, guest or gourmet meals, admission kits. All Inpatient Rehabilitation Services for Substance Dependency, drug and alcohol related diagnoses (except as otherwise covered in the Substance Dependency category), Pain Management, and respiratory ventilator management Services are excluded

Inpatient Physician and Surgical Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Surgical Assistant Services are covered when the assistant is necessary.

Mental/Behavioral Health Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Partial Hospitalization is a covered service in lieu of inpatient hospitalization and is combined with the inpatient hospital benefit. Two days of partial hospitalization will count as one day toward the\ninpatient mental and nervous disorder benefit

Exclusions: Services for psychological testing associated with the evaluation and diagnosis of learning disabilities; marriage counseling; pre-marital counseling; courtordered care or testing, or required as a condition of parole or probation; testing of aptitude, ability, intelligence or interest; evaluation for the purpose of maintaining employment, services for cognitive remediation, inpatient confinement that are primarily intended for a change in environment, or inpatient (overnight) mental health services received in a residential treatment facility

Mental/Behavioral Health Outpatient Services

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services may be subject to additional cost sharing. Please refer to the plan policy documents for detailed information.

Exclusions: Services for psychological testing associated with the evaluation and diagnosis of learning disabilities; marriage counseling; pre-marital counseling; courtordered care or testing, or required as a condition of parole or probation; testing of aptitude, ability, intelligence or interest; evaluation for the purpose of maintaining employment inpatient confinement or inpatient mental health services received in a residential treatment facility. Exclude services for psychological testing associated with the evaluation and diagnosis of learning disabilities or for mental retardation.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Breast reconstructive surgery. Surgery to reestablish symmetry between two breasts and implanted prostheses incident to Mastectomy is covered. Breast cancer treatment including treatment for physical complications related to a Mastectomy (including lymphedemas), and outpatient post-surgical follow up in accordance with prevailing medical standards as determined by the attending physician are covered.

Outpatient Rehabilitation Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic. Speech Therapy is covered for child cleft lip and cleft palate; Outpatient therapies include Cardiac, Occupational, Physical, Speech, Massage therapies in the Home Health Care, Hospital and Skilled Nursing Facility setting

Outpatient Surgery Physician/Surgical Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Specific surgical procedures performed by a physician. Covered services include Sterilization (tubal ligations and vasectomies) regardless of Medical Necessity. Surgery to correct deformity which was caused by disease, trauma, birth defects, growth defects or prior therapeutic processes. Oral surgical procedures for excision of tumors, cysts, abscesses, and lesions of the mouth. Surgical procedures involving bones or joints (e.g. TMJ) and facial region if, under accepted medical standards, such surgery is necessary to treat conditions caused by congenital or developmental deformity, disease, or injury. Services of a Physician for the purpose if rendering a second surgical opinion and related diagnostic. Services to help determine the need for surgery.

Radiation

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Skilled Nursing Facility

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 60.0 Days per Benefit Period

Covered services include intravenous solutions, transfusion supplies and equipment, chemotherapy treatment for proven malignant disease, Physical, Speech and Occupational Therapies

Exclusions: Confinement for custodial care; Room & Board; respiratory, pulmonary or inhalation therapy, blood products, dressings, casts, diagnostic services

Substance Abuse Disorder Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Covered Services include detoxification

Exclusions: Exclusion of "expenses for prolonged care and treatment of substance Dependency in a specialized inpatient or residential treatment facility"

Substance Abuse Disorder Outpatient Services

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services may be subject to additional cost sharing. Please refer to the plan policy documents for detailed information.

Transplant

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Transplant Services. Bone marrow transplant as defined in rule 59B-12.001 of the Florida Administrative code, corneal transplant, heart transplant, heart/lung combination transplant, liver transplant, kidney transplant, pancreas transplant, pancreas transplant performed simultaneously with a kidney transplant, whole single or whole bilateral lung transplant, donor costs and organ acquisition for transplants not covered whole or in part by any other insurance carrier, organization or person (excl bone marrow transplants)

Exclusions: Transplants considered to be experimental or investigational, involving non-human organ or tissue, donation or acquisition of organ or tissue for a recipient not covered, implant of an artificial organ, sold or donated organs, bone marrow transplants not specifically listed in rule 59B-12.001 of the Florida Administrative code, services in connection with identification of a donor from local, state or national listings except for bone marrow transplant, non-medical costs, device that replaces either the atrium or the ventricle.

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Routine Eye Exam for Children

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Benefit Period

Well Baby Visits and Care

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$25.00
Tier 1 in-network $25.00
Out-of-network 100.00%

Covers up to 30 day supply (retail prescription); 90 day supply (mail order Prescription. Responsible Rx Programs such as Prior Authorization, Responsible Steps or Responsible Quantity may apply.

Exclusions: Non-prescription medicines, vitamins, mineral supplements, over the counter drugs, drugs to treat sexual dysfunction

Non-Preferred Brand Drugs

$100.00 Copay after deductible
Tier 1 in-network $100.00 Copay after deductible
Out-of-network 100.00%

Covers up to 30 day supply (retail prescription); 90 day supply (mail order Prescription. Responsible Rx Programs such as Prior Authorization, Responsible Steps or Responsible Quantity may apply.

Preferred Brand Drugs

$50.00 Copay after deductible
Tier 1 in-network $50.00 Copay after deductible
Out-of-network 100.00%

Covers up to 30 day supply (retail prescription); 90 day supply (mail order Prescription. Responsible Rx Programs such as Prior Authorization, Responsible Steps or Responsible Quantity may apply

Specialty Drugs

$500.00 Copay after deductible
Tier 1 in-network $500.00 Copay after deductible
Out-of-network 100.00%

Testing and desensitization therapy (e.g., injections) and the cost of desensitization serum are covered; Contraceptive medication by injection is covered when administered by a Physician for the purposes of contraception, limited to medication and administration.

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Coverage is limited to Care and stabilization treatment rendered within 62 days of an Accidental. Dental Injury provided such services are for the treatment of damage to Sound Natural Teeth.

Exclusions: Treatment must begin within 12 months of the injury.

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Limit: 2500.0 Dollars per Benefit Period

Diabetes coverage includes 'nutrition counseling'; home health services include 'nutritional guidance.'

Exclusions: Food or food products not covered under enteral formula; coverage to treat inherited diseases of amino acid and organic acids shall include coverage for food products modified to be low protein up to 25th birthday.

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Benefits include the purchase, fitting, adjustments, repairs and replacements.

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Covered lenses and frames each available at limit of one per year.

Habilitation Services

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Supplementing with the federal definition of habilitative services: Health care services that help a person keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who is not walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings.

Imaging (CT/PET Scans, MRIs)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Only for Breast reconstruction following a Mastectomy. Benefits include reconstructive surgery to correct significant deformities caused by congenital or developmental abnormalities, illness, injury or an earlier treatment in order to create a more normal appearance.

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Treatment for Temporomandibular Joint Disorders

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Limit: 2.0 Procedure(s) per Year

One splint in a six month period unless a more frequent replacement is determined to be medically necessary.

Exclusions: Services involving bones or joints of the jaw (eg, Services to treat temporomandibular join [TMJ] dysfunction or faicial region is, under accepted medical standards, such diagnostic services are necessary to treat conditions caused by congenital or developmental deformity, disease or injury. Payment for splints for the treatment of "TMJ" dysfunction is limited to one splint in a six-month period unlcess a more frequent replacement is determined by us to be medically necessary

Variant attributes

Bronze 22 Health · Variant 13887FL0010003-00

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Standard Bronze Off Exchange Plan

HIOS Product ID

13887FL001

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

13887FL0010003-00

Plan Marketing Name

Bronze 22 Health

Plan Variant Marketing Name

Bronze 22 Health

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

13887

Issuer Marketplace Marketing Name

22 Health

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

FLN001

Out of Country Coverage

No

Out of Service Area Coverage

No

Service Area ID

FLS001

State Code

FL

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.641164683

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$1,200

SBC Scenario, Having a Baby, Copayment

$200

SBC Scenario, Having a Baby, Deductible

$7,500

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$1,100

SBC Scenario, Having Diabetes, Deductible

$900

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$600

SBC Scenario, Treatment of a Simple Fracture, Deductible

$1,700

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$20000 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$10000 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$10,000

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

FLF003

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$0

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Design 1

Disease Management Programs Offered

Asthma, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

EHB Percent of Total Premium

1

First Tier Utilization

100%

Import Date

10/28/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

Yes

New/Existing Plan

New

Notice Required for Pregnancy

Yes

Is a Referral Required for Specialist?

No

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Plan ID

13887FL0010003

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$15000 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$7500 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$7,500

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Florida?

Bronze 22 Health (13887FL0010003) is a Expanded Bronze HMO from 22 Health in Florida for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Bronze 22 Health support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Bronze 22 Health HSA-eligible and does it include dental or vision coverage?

It is HSA-eligible, so you can pair it with a Health Savings Account to lower taxes.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does Bronze 22 Health support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Bronze 22 Health?

The issuer lists disease management resources for: Asthma, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy.

Is there out-of-country coverage for Bronze 22 Health?

No, out-of-country services are not covered for this plan.

Does Bronze 22 Health cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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