Florida health plan · 2025

myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) · 30252FL0070056

Health Options, Inc. offers this marketplace health insurance plan (Plan ID 30252FL0070056) 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: Gold Plan type: HMO CSR: Standard Gold Off Exchange Plan Issuer: Health Options, Inc.
Telehealth Data pending HSA eligible No Dental Not listed Vision Child

CMS AV Calculator output: 78.06% (21.94% member share on average). Learn about AV methodology.

2025 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

$387 – $1874

Before subsidies

Estimate after subsidies

Deductible

$1,500

$3000 per group

See deductible details

Max out-of-pocket

$7,800

$15600 per group

Review MOOP rules

Office visits

Primary care $30.00
Specialist $60.00
HSA Not eligible

Drug tiers

Generic $15.00
Preferred brand $30.00

View formulary tiers

$589 / mo before subsidies

≈ $7063 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.

$1970 / mo before subsidies

≈ $23644 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.

$2386 / mo before subsidies

≈ $28635 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.

$1516 / mo before subsidies

≈ $18197 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

25.00% Coinsurance after deductible

Durable Medical Equipment

No Charge

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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 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 Gold 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

25.00% Coinsurance after deductible

Durable Medical Equipment

No Charge

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 30252FL0070056
Coverage year 2025
State Florida
Issuer Health Options, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 30252FL0070056-00
Available variants

Standard Off Exchange Plan · 30252FL0070056-00

Standard On Exchange Plan · 30252FL0070056-01

Open to Indians below 300% FPL · 30252FL0070056-02

Open to Indians above 300% FPL · 30252FL0070056-03

Last plan update Thu, 19 Sep 2024 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 232
PCPs in Florida 39
Telehealth support Data pending
Nationwide providers 246
232 doctors statewide 39 PCPs 1 OB/GYN
Providers Florida All US states
All 232 246
PCP 39 41
Allergy N/A N/A
OB/GYN 1 1
Dentists 1 1

Drug coverage overview

4,361 drugs tracked

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

Tier Covered drugs
ZERO-COST-SHARE-PREVENTIVE-DRUGS 2,573
BRAND 1,029
GENERIC 627
PREFERRED-GENERIC 131
UNKNOWN 1
Prior authorization Drugs
Required 1,206
Not Required 3,155
Step therapy Drugs
Required 0
Not Required 4,361
Quantity limits Drugs
Has Limit 1,704
No Limit 2,657

Customer highlights

What stands out for members

  • Issuer: Health Options, Inc. · Plan ID 30252FL0070056 · 2025 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 30252FL0070056-00 (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

$60.00

Diabetes Care Management

$60.00

Diabetes Education

No Charge

Home Health Care Services

No Charge

Laboratory Outpatient and Professional Services

25.00% Coinsurance after deductible

Other Practitioner Office Visit (Nurse, Physician Assistant)

$60.00

Preventive Care/Screening/Immunization

0.00%

Primary Care Visit to Treat an Injury or Illness

$30.00

Rehabilitative Occupational and Rehabilitative Physical Therapy

$30.00

Rehabilitative Speech Therapy

$30.00

Specialist Visit

$60.00

Urgent Care Centers or Facilities

$45.00

X-rays and Diagnostic Imaging

25.00% Coinsurance after deductible

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Bone Marrow Transplant

25.00% Coinsurance after deductible

Chemotherapy

25.00% Coinsurance after deductible

Delivery and All Inpatient Services for Maternity Care

25.00% Coinsurance after deductible

Dialysis

25.00% Coinsurance after deductible

Durable Medical Equipment

No Charge

Emergency Room Services

25.00% Coinsurance after deductible

Emergency Transportation/Ambulance

25.00% Coinsurance after deductible

Hospice Services

No Charge

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

25.00% Coinsurance after deductible

Inpatient Physician and Surgical Services

25.00% Coinsurance after deductible

Mental/Behavioral Health Inpatient Services

25.00% Coinsurance after deductible

Mental/Behavioral Health Outpatient Services

$30.00

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

25.00% Coinsurance after deductible

Outpatient Rehabilitation Services

$30.00

Outpatient Surgery Physician/Surgical Services

25.00% Coinsurance after deductible

Radiation

25.00% Coinsurance after deductible

Skilled Nursing Facility

25.00% Coinsurance after deductible

Substance Abuse Disorder Inpatient Services

25.00% Coinsurance after deductible

Substance Abuse Disorder Outpatient Services

$30.00

Transplant

25.00% Coinsurance after deductible

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Hearing Aids

Coverage details pending

Major Dental Care - Child

Coverage details pending

Prenatal and Postnatal Care

$60.00

Routine Eye Exam for Children

No Charge

Well Baby Visits and Care

No Charge

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$15.00

Non-Preferred Brand Drugs

$60.00

Off Label Prescription Drugs

$60.00

Preferred Brand Drugs

$30.00

Specialty Drugs

$250.00

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$60.00

Basic Dental Care - Adult

Coverage details pending

Dental Anesthesia

$60.00

Dental Check-Up for Children

Coverage details pending

Infusion Therapy

25.00% Coinsurance after deductible

Major Dental Care - Adult

Coverage details pending

Nutritional Counseling

$60.00

Nutrition/Formulas

25.00% Coinsurance after deductible

Orthodontia - Adult

Coverage details pending

Orthodontia - Child

Coverage details pending

Prosthetic Devices

No Charge

Routine Dental Services (Adult)

Coverage details pending

Weight Loss Programs

Coverage details pending

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Acupuncture

Coverage details pending

Allergy Testing

$60.00

Bariatric Surgery

Coverage details pending

Congenital Anomaly, including Cleft Lip/Palate

25.00% Coinsurance after deductible

Cosmetic Surgery

Coverage details pending

Eye Glasses for Children

No Charge

Gender Affirming Care

25.00% Coinsurance after deductible

Habilitation Services

$30.00

Imaging (CT/PET Scans, MRIs)

25.00% Coinsurance after deductible

Infertility Treatment

Coverage details pending

Long-Term/Custodial Nursing Home Care

Coverage details pending

Osteoporosis

$60.00

Private-Duty Nursing

Coverage details pending

Reconstructive Surgery

25.00% Coinsurance after deductible

Routine Eye Exam (Adult)

Coverage details pending

Routine Foot Care

$60.00

Treatment for Temporomandibular Joint Disorders

$60.00

Variant attributes

myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) · Variant 30252FL0070056-00

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Standard Gold Off Exchange Plan

HIOS Product ID

30252FL007

Metal Level

Gold

Plan ID (Standard Component ID with Variant)

30252FL0070056-00

Plan Marketing Name

myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards)

Plan Variant Marketing Name

myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards)

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

30252

Issuer Marketplace Marketing Name

Florida Blue HMO (a BlueCross BlueShield FL company)

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

FLN002

Out of Country Coverage

Yes

Out of Country Coverage Description

Accident and emergency services.

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Accident and emergency services.

Service Area ID

FLS004

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

0.780612576352931

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

$2,000

SBC Scenario, Having a Baby, Copayment

$70

SBC Scenario, Having a Baby, Deductible

$1,500

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$1,400

SBC Scenario, Having Diabetes, Deductible

$100

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$100

SBC Scenario, Treatment of a Simple Fracture, Copayment

$200

SBC Scenario, Treatment of a Simple Fracture, Deductible

$1,500

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

25.00%

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

$15600 per group

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

$7800 per person

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

$7,800

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

FLF036

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

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, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy

EHB Percent of Total Premium

1.0

First Tier Utilization

100%

Import Date

2024-09-19 01:01:32

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

Yes

Plan Effective Date

2025-01-01

Plan Expiration Date

2025-12-31

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Specialist Requiring a Referral

All Specialists require a referral with the exception of Chiropractors, Podiatrists, Dermatologists, Obstetric/Gynecologists, Behavioral Health Services, Physical Therapy, Occupational Therapy, and Speech Therapy.

Plan ID

30252FL0070056

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

$3000 per group

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

$1500 per person

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

$1,500

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?

myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) (30252FL0070056) is a Gold HMO from Health Options, Inc. in Florida for the 2025 coverage year.

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

Does myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) 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 myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) 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 myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards)?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy.

Is there out-of-country coverage for myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards)?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Accident and emergency services.

Does myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Accident and emergency services.

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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