Anthem Silver Direct Access - EPO Tiered (California)

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Company Anthem Blue Cross of California
Plan Year 2014
State California
Metal Tier Silver
Plan Type EPO
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Cost Sharing Benefits (In Network)

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $2,000
Deductible (Family) $4,000
Coinsurance 20%
Out of Pocket Maximum (Individual) $6,350
Out of Pocket Maximum (Family) $12,700

Doctors Visits

Primary Care Visit $45 copay
Specialist Visit $65 copay
In Patient Hospital Services 20% coinsurance
Emergency Room Services $250 copay

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% coinsurance
Laboratory Outpatient and Professional Services $45 copay
X-ray and Diagnostic Imaging $65 copay

Other

Mental / Behavioral Health 20% coinsurance
Rehabilitative Speech Therapy 20% coinsurance
Rehabilitative Occupational & Physical Therapy 20% coinsurance
Outpatient Facility 20% coinsurance
Outpatient Surgery 20% coinsurance

Prescription Drugs

Generic Rx $25 copay
Preferred Brand Rx $50 copay
Non Preferred Brand Rx $70 copay
Specialty Drugs 0.2

Other Plans

Other plans that are available in the state.

Plan Name
Anthem Minimum Coverage PPO
Anthem Bronze 60 PPO
Anthem Platinum 90 PPO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Silver 70 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Gold 80 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Platinum 90 HMO
Anthem Minimum Coverage EPO
Anthem Minimum Coverage EPO
Anthem Minimum Coverage EPO
Anthem Minimum Coverage EPO
Anthem Minimum Coverage EPO
Anthem Bronze 60 EPO
Anthem Bronze 60 EPO
Anthem Bronze 60 EPO
Anthem Bronze 60 EPO
Anthem Bronze 60 EPO
Anthem Platinum 90 EPO
Anthem Platinum 90 EPO
Anthem Platinum 90 EPO
Anthem Platinum 90 EPO
Anthem Platinum 90 EPO
Anthem Bronze 60 Health Savings Account PPO
Anthem Bronze 60 Health Savings Account EPO
Anthem Bronze 60 Health Savings Account EPO
Anthem Bronze 60 Health Savings Account EPO
Anthem Bronze 60 Health Savings Account EPO
Anthem Bronze 60 Health Savings Account EPO
Anthem Silver 70 PPO - A Multi State Plan
Anthem God 80 PPO - A Multi State Plan
Anthem Silver 70 EPO - A Multi State Plan
Anthem Silver 70 EPO - A Multi State Plan
Anthem Silver 70 EPO - A Multi State Plan
Anthem Silver 70 EPO - A Multi State Plan
Anthem Silver 70 EPO - A Multi State Plan
Anthem Gold 80 EPO - A Multi State Plan
Anthem Gold 80 EPO - A Multi State Plan
Anthem Gold 80 EPO - A Multi State Plan
Anthem Gold 80 EPO - A Multi State Plan
Anthem Gold 80 EPO - A Multi State Plan

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