Anthem Silver Direct Access Standard CT

Plan Information
Company Anthem Blue Cross and Blue Shield of Connecticut
State CT
Metal Tier Silver
Plan Type PPO

Cost Sharing Benefits

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.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,000 Data Not Available
Deductible (Family) Data Not Available Data Not Available
Coinsurance Data Not Available Data Not Available
Out of Pocket Maximum (Individual) $6,250 Data Not Available
Out of Pocket Maximum (Family) Data Not Available Data Not Available
Services In Network Out of Network
Primary Care Visit $30 copay Data Not Available
Specialist Visit $45 copay Data Not Available
In Patient Hospital Services $500 copay Data Not Available
Emergency Room Services $150 copay $150 copay
Mental / Behavioral Health $30 copay Data Not Available
Imaging (CT/PET Scans, MRIs) $75 copay Data Not Available
Rehabilitative Speech Therapy $30 copay Data Not Available
Rehabilitative Occupational & Physical Therapy $30 copay Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services $30 copay Data Not Available
X-ray and Diagnostic Imaging $45 copay Data Not Available
Outpatient Facility $500 copay Data Not Available
Outpatient Surgery $500 copay Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $10 copay
Preferred Brand Rx $25 copay
Non Preferred Brand Rx $40 copay
Specialty Drugs 0.4

Other Plans

Other plans that are available in the state.

Plan Name
Anthem HMO Catastrophic Pathway X Enhanced 6600/0%
Anthem HMO Bronze Pathway X Enhanced 0% for HSA
Anthem HMO Bronze Pathway X Enhanced 5750/0%
Anthem HMO Gold Pathway X Enhanced 1500/0%
Anthem PPO Bronze Standard Pathway X 5000/40%
Anthem PPO Bronze Standard Pathway X 0% for HSA
Anthem PPO Silver Standard Pathway X 2600
Anthem PPO Silver Pathway X 3200/0%
Anthem PPO Gold Standard Pathway X 1000
Anthem Blue Cross Blue Shield HMO Multi State Plan
Anthem Blue Cross Blue Shield PPO Multi State Plan
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