Anthem Colorado Option Bronze Mountain Enhanced Std – HMO

Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: first 3 visit(s) $50 then $50 copay after deductible
Specialist visit: 50% after deductible
Urgent care visit: 50% after deductible

Description

Health Care Plan Details

Network type HMO
Deductible $7,500 per person $7,500 per person
Out-of-pocket max $9,450 per person $18,900 per family
Metal tier Expanded Bronze

Visit Copay

Primary care visit first 3 visit(s) $50 then $50 copay after deductible
Specialist visit 50% after deductible
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care 50% after deductible
Emergency room 50% after deductible
Ambulance 50% after deductible
Hospital stay (facility) 50% after deductible
Hospital stay (physician) 50% after deductible
Outpatient procedure (facility) 50% after deductible
Outpatient procedure (physician) 50% after deductible
Physical rehabilitation 50% after deductible

Maternitowny and Pregnancy

Labor, delivery, hospital stay 50% after deductible

Pharmacy, Drugs, and Medication

Generic $30 copay
Brand $200 copay
Non-preferred Brand $350 copay
Specialty $700 copay

Lab Tests and Diagnostic Procedures

X-rays 50% after deductible
Imaging (CT/PET/MRI) 50% after deductible
Blood work 50% after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services 50% after deductible
Psychiatric hospital stay 50% after deductible

Health Plan Provider Information