Anthem Silver Pathway Essentials HMO 2800 S04 $0 Select Drugs – HMO

73% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: 20% after deductible
Specialist visit: 20% after deductible
Urgent care visit: 20% after deductible

SKU: 76680CO022007104 Category:

Description

This plan has 73% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type HMO
Deductible $2,800 per person $2,800 per person
Out-of-pocket max $5,850 per person $11,700 per family
Metal tier Silver

Visit Copay

Primary care visit 20% after deductible
Specialist visit 20% after deductible
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care 20% after deductible
Emergency room $500 plus 20% after deductible copay, $500 plus 20% after deductible
Ambulance 20% after deductible
Hospital stay (facility) $500 plus 40% after deductible copay, $500 plus 40% after deductible
Hospital stay (physician) 20% after deductible
Outpatient procedure (facility) 20% after deductible
Outpatient procedure (physician) 20% after deductible
Physical rehabilitation 20% after deductible

Maternitowny and Pregnancy

Labor, delivery, hospital stay $500 plus 40% after deductible copay, $500 plus 40% after deductible

Pharmacy, Drugs, and Medication

Generic 20% after deductible
Brand 20% after deductible
Non-preferred Brand 30% after deductible
Specialty 30% after deductible

Lab Tests and Diagnostic Procedures

X-rays 20% after deductible
Imaging (CT/PET/MRI) $450 plus 40% after deductible copay, $450 plus 40% after deductible
Blood work 20% after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services 20% after deductible
Psychiatric hospital stay $500 plus 40% after deductible copay, $500 plus 40% after deductible

Health Plan Provider Information