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GoldPOS

Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits

HMO Louisiana

Starting at

$714

/month before subsidy

Key facts

Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits is a 2026 Gold POS health insurance plan from HMO Louisiana, sold on the ACA Marketplace in Louisiana under plan ID 19636LA0220005. The monthly premium starts at $714 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,000 ($3,000 for a family), and the individual out-of-pocket maximum is $9,700 ($19,400 for a family). After the deductible, coinsurance is 20% for covered in-network care. The plan is not HSA-eligible.

Plan ID
19636LA0220005
Plan year
2026
State
Louisiana
Metal level
Gold
Plan type
POS
HSA-eligible
No

Individual Deductible

$1,000

Family: $3,000

Out-of-Pocket Max

$9,700

Family: $19,400

Coinsurance

20%

You pay after deductible

Network Type

POS

LAN005

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$40.00
Specialist Visit$60.00
Urgent Care$60.00
Emergency Room20.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$7.00 Copay after deductible
Brand Name Drugs30.00% Coinsurance after deductible
Specialty Drugs20.00% Coinsurance after deductible
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
3.0overall
Medical care

How well doctors manage and coordinate care

Member experience
Not rated

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$2,640

your estimated cost

Deductible
$1,010
Copays
$60
Coinsurance
$1,510

Managing type 2 diabetes

A year of routine care

$1,780

your estimated cost

Deductible
$640
Copays
$400
Coinsurance
$680

A simple fracture

ER visit + follow-up

$1,460

your estimated cost

Deductible
$1,010
Copays
$240
Coinsurance
$210
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Official Plan Documents
Published by HMO Louisiana. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

This Gold POS plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.

Consider this plan if you:

  • Have ongoing health conditions requiring regular care
  • Take multiple prescription medications
  • Prefer lower costs at the time of service
  • Want peace of mind with comprehensive coverage

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,522/month

Annual Premium

$8,568

OOP Maximum

$9,700

💡 What this means:

With a $1,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 20% (coinsurance) until you hit $9,700 total. Then insurance covers everything else for the year.

More plans from HMO Louisiana in Louisiana

View all Marketplace plans in Louisiana

Frequently asked questions about Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits

How much does Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits cost per month?

Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits from HMO Louisiana starts at $714 per month before any subsidy in Louisiana. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits?

The individual medical deductible is $1,000, and the family deductible is $3,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits?

The most you would pay in a year for covered in-network care is $9,700 for an individual and $19,400 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits HSA-eligible?

No. Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits use?

Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits is a POS plan. POS plans blend HMO and PPO features: you pick a primary care provider and can go out of network at a higher cost.

Understand what you'd actually pay

Enroll at HealthCare.govBrowse Louisiana plans

Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.