Anthem Silver Direct Access Standard (Connecticut)

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Company Anthem Blue Cross and Blue Shield of Connecticut
Plan Year 2014
State Connecticut
Metal Tier Silver
Plan Type PPO
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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) $3,000
Deductible (Family) Data Not Available
Coinsurance Data Not Available
Out of Pocket Maximum (Individual) $6,250
Out of Pocket Maximum (Family) Data Not Available

Doctors Visits

Primary Care Visit $30 copay
Specialist Visit $45 copay
In Patient Hospital Services $500 copay
Emergency Room Services $150 copay

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $75 copay
Laboratory Outpatient and Professional Services $30 copay
X-ray and Diagnostic Imaging $45 copay


Mental / Behavioral Health $30 copay
Rehabilitative Speech Therapy $30 copay
Rehabilitative Occupational & Physical Therapy $30 copay
Outpatient Facility $500 copay
Outpatient Surgery $500 copay

Prescription Drugs

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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