Anthem Bronze Pathway X Enhanced 6000/30% ($0 Preferred Virtual Care + $0 Select Drugs) – HMO

Description

Health Care Plan Details

Network type	HMO
Deductible	$6,000 per person $6,000 per person
Out-of-pocket max	$9,400 per person $18,800 per family
Metal tier	Expanded Bronze

Visit Copay

Primary care visit	$40 copay
Specialist visit	$100 copay
Preventive care visit	No charge

Urgent, Emergency Care, and Hospital Care

Urgent care	$60 copay
Emergency room	30% coinsurance after deductible
Ambulance	30% coinsurance after deductible
Hospital stay (facility)	30% coinsurance after deductible
Hospital stay (physician)	30% coinsurance after deductible
Outpatient procedure (facility)	30% coinsurance after deductible
Outpatient procedure (physician)	30% coinsurance after deductible
Physical rehabilitation	30% coinsurance after deductible

Maternitowny and Pregnancy

Well baby care	No charge
Labor, delivery, hospital stay	30% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic	30% coinsurance after deductible
Brand	30% coinsurance after deductible
Non-preferred Brand	40% coinsurance after deductible
Specialty	40% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays	30% coinsurance after deductible
Imaging (CT/PET/MRI)	30% coinsurance after deductible
Blood work	30% coinsurance after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services	$40 copay
Psychiatric hospital stay	30% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits	https://sbc.anthem.com/dpsdeeplink/deepLink/AnthemBronzePathwayXEnhanced6000300PreferredVirtualCare0SelectDrugs/English/DG166700596595.pdf
Drug and medication plan formulary	https://www.anthem.com/NHSelectdrugtier4
Search doctor list	https://www.anthem.com/find-care/?alphaprefix=YGQ