Anthem Anthem HealthKeepers Silver DirectAccess - cbau VA

Plan Information
Company Anthem Blue Cross and Blue Shield
State VA
Metal Tier Silver
Plan Type HMO

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) $3,350 $0
Deductible (Family) $6,700 $0
Coinsurance 15% $0
Out of Pocket Maximum (Individual) $5,500 $0
Out of Pocket Maximum (Family) $11,000 $0
Services In Network Out of Network
Primary Care Visit $45 $0
Specialist Visit 15% Coinsurance after deductible $0
In Patient Hospital Services 15% Coinsurance after deductible $0
Emergency Room Services 25% Coinsurance after deductible 25% coinsurance
Mental / Behavioral Health 15% coinsurance $0
Imaging (CT/PET Scans, MRIs) 15% coinsurance $0
Rehabilitative Speech Therapy 15% coinsurance $0
Rehabilitative Occupational & Physical Therapy 15% coinsurance $0
Preventative Care $0 $0
Laboratory Outpatient and Professional Services 15% coinsurance $0
X-ray and Diagnostic Imaging 15% coinsurance $0
Outpatient Facility 15% coinsurance $0
Outpatient Surgery 15% coinsurance $0
Prescription Drugs In Network Out of Network
Generic Rx $15
Preferred Brand Rx $40
Non Preferred Brand Rx 15% Coinsurance after deductible
Specialty Drugs 15% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $2,350.00
Deductible (Family) $4,700.00
Out of Pocket Maximum (Individual) $4,500.00
Out of Pocket Maximum (Family) $9,000.00
Services In Network Out of Network
Primary Care Physician $40
Specialists 15% Coinsurance after deductible
Emergency Room 25% Coinsurance after deductible
Inpatient Facility 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $15.00
Preferred Brand Rx $40
Non Preferred Brand Rx 15% Coinsurance after deductible
Specialty Drugs 15% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $750.00
Deductible (Family) $1,500.00
Out of Pocket Maximum (Individual) $1,500.00
Out of Pocket Maximum (Family) $3,000.00
Services In Network Out of Network
Primary Care Physician $30
Specialists 15% Coinsurance after deductible
Emergency Room 25% Coinsurance after deductible
Inpatient Facility 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $35
Non Preferred Brand Rx 15% Coinsurance after deductible
Specialty Drugs 15% Coinsurance after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $200.00
Deductible (Family) $400.00
Out of Pocket Maximum (Individual) $650.00
Out of Pocket Maximum (Family) $1,300.00
Services In Network Out of Network
Primary Care Physician $15
Specialists 15% Coinsurance after deductible
Emergency Room 25% Coinsurance after deductible
Inpatient Facility 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $30
Non Preferred Brand Rx 15% Coinsurance after deductible
Specialty Drugs 15% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
comments powered by Disqus