Anthem Silver Tiered 6000 CSR 73 – HMO

73% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: $20 copay
Specialist visit: $60 copay
Urgent care visit: $55 copay

SKU: 48396ME071007404 Category:

Description

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

Health Care Plan Details

Network type HMO
Deductible $3,500 per person $3,500 per person
Out-of-pocket max $6,900 per person $13,800 per family
Metal tier Silver

Visit Copay

Primary care visit $20 copay
Specialist visit $60 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care $55 copay
Emergency room 35% after deductible
Ambulance 35% after deductible
Hospital stay (facility) 35% after deductible
Hospital stay (physician) 35% after deductible
Outpatient procedure (facility) 35% after deductible
Outpatient procedure (physician) 35% after deductible
Physical rehabilitation 35% after deductible

Maternitowny and Pregnancy

Labor, delivery, hospital stay 35% after deductible

Pharmacy, Drugs, and Medication

Generic $20 copay
Brand $50 copay
Non-preferred Brand 40% after deductible
Specialty 40% after deductible

Lab Tests and Diagnostic Procedures

X-rays 35% after deductible
Imaging (CT/PET/MRI) 35% after deductible
Blood work $15 copay

Mental and Psychiatric Health Care

Mental Health outpatient services $20 copay
Psychiatric hospital stay 35% after deductible

Health Plan Provider Information

Health Plan Benefits https://d2ed110nmrd591.cloudfront.net/blobs/VtZm8rdi6ZGZH4ABozCkUrve.pdf