Anthem Anthem Bronze DirectAccess - cabu OH

Plan Information
Company Anthem Blue Cross and Blue Shield
State OH
Metal Tier Bronze
Plan Type PPO

Cost Sharing Benefits

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) $5,000 $10,000
Deductible (Family) $10,000 $20,000
Coinsurance 30% $15,000
Out of Pocket Maximum (Individual) $6,350 $30,000
Out of Pocket Maximum (Family) $12,700
Services In Network Out of Network
Primary Care Visit $45 Copay before deductible and $15,000 copay
Specialist Visit 30% Coinsurance after deductible $15,000 copay
In Patient Hospital Services $500 Copay per Stay and 30% Coin $15,000 copay
Emergency Room Services $200 Copay before deductible and $200 copay
Mental / Behavioral Health 30% coinsurance $15,000 copay
Imaging (CT/PET Scans, MRIs) 30% coinsurance $15,000 copay
Rehabilitative Speech Therapy 30% coinsurance $15,000 copay
Rehabilitative Occupational & Physical Therapy 30% coinsurance $15,000 copay
Preventative Care $0 $15,000 copay
Laboratory Outpatient and Professional Services 30% coinsurance $15,000 copay
X-ray and Diagnostic Imaging 30% coinsurance $15,000 copay
Outpatient Facility 30% coinsurance $15,000 copay
Outpatient Surgery 30% coinsurance $15,000 copay
Prescription Drugs In Network Out of Network
Generic Rx 30% Coinsurance after deductible
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Anthem Bronze DirectAccess - caah
Anthem Bronze DirectAccess - caaz
Anthem Bronze DirectAccess - cabt
Anthem Bronze DirectAccess - cabu
Anthem Bronze DirectAccess - cafd
Anthem Bronze DirectAccess w/Child Dental - cdbu
Anthem Bronze DirectAccess w/HSA - caas
Anthem Catastrophic DirectAccess
Anthem Gold DirectAccess - ccac
Anthem Gold DirectAccess w/Child Dental - cdcq
Anthem Silver DirectAccess - cbai
Anthem Silver DirectAccess - cbce
Anthem Silver DirectAccess - cbpa
Anthem Silver DirectAccess - cbwl
Anthem Silver DirectAccess w/HSA - cbey
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