Anthem Anthem HealthKeepers Silver DirectAccess - cbky (Virginia)

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Company Anthem Blue Cross and Blue Shield
Plan Year 2014
State Virginia
Metal Tier Silver
Plan Type HMO
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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) $1,500
Deductible (Family) $3,000
Coinsurance 30%
Out of Pocket Maximum (Individual) $5,500
Out of Pocket Maximum (Family) $11,000

Doctors Visits

Primary Care Visit $35 Copay and 30% Coinsurance af
Specialist Visit 30% Coinsurance after deductible
In Patient Hospital Services 30% Coinsurance after deductible
Emergency Room Services 40% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% coinsurance
Laboratory Outpatient and Professional Services 30% coinsurance
X-ray and Diagnostic Imaging 30% coinsurance

Other

Mental / Behavioral Health 30% coinsurance
Rehabilitative Speech Therapy 30% coinsurance
Rehabilitative Occupational & Physical Therapy 30% coinsurance
Outpatient Facility 30% coinsurance
Outpatient Surgery 30% coinsurance

Prescription Drugs

Generic Rx $15
Preferred Brand Rx $40
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% 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

Deductible (Individual) $1,500.00
Deductible (Family) $3,000.00
Out of Pocket Maximum (Individual) $4,250.00
Out of Pocket Maximum (Family) $8,500.00
Primary Care Physician $30 Copay and 30% Coinsurance af
Specialists 30% Coinsurance after deductible
Emergency Room 40% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $15.00
Preferred Brand Rx $40
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% 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) $725.00
Deductible (Family) $1,450.00
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 $20 Copay and 30% Coinsurance af
Specialists 30% Coinsurance after deductible
Emergency Room 40% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $35
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% 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) $175.00
Deductible (Family) $350.00
Out of Pocket Maximum (Individual) $650.00
Out of Pocket Maximum (Family) $1,300.00
Services In Network Out of Network
Primary Care Physician $10 Copay and 30% Coinsurance af
Specialists 30% Coinsurance after deductible
Emergency Room 40% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $30
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

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