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Anthem - Anthem Bronze Pathway X 4950
Indiana, 2017
Plan Type
HMO
Metal Tier
Bronze
Out of Pocket Maximum
$7,150
Deductible
$4,950
Emergency Room Care: $500 Copay after deductible + 50% Coinsurance after deductible
Cost Sharing Benefits (In Network)
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) | $4,950 |
|---|---|
| Deductible (Family) | $9,900 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | 50% Coinsurance after deductible |
|---|---|
| Specialist Visit | 50% Coinsurance after deductible |
| Inpatient Facility | $1500 Copay per stay after deductible + 50% Coinsurance after deductible |
| Inpatient Physician | 50% Coinsurance after deductible |
| Emergency Room Services | $500 Copay after deductible + 50% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | $300 Copay after deductible + 50% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 50% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 50% Coinsurance after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Available |
| Pain Management | Available |
| Pregnancy | Not available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | $1500 Copay after deductible + 50% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 50% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 50% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 50% Coinsurance after deductible |
| Outpatient Facility | 50% Coinsurance after deductible |
| Outpatient Surgery | 50% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | 40% Coinsurance after deductible |
|---|---|
| Preferred Brand Rx | 50% Coinsurance after deductible |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
Other Plans in Indiana
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Anthem Bronze Pathway X 5300 | Deductible $5,300 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Bronze Pathway X POS 5000 | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway X 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan | Deductible $1,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Bronze Pathway X 5850 | Deductible $5,850 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway X 3500 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $6,150 |
| Plan Anthem Bronze Pathway X 0 for HSA | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Anthem Silver Pathway X for HSA | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $4,500 |
| Plan Anthem Bronze Pathway X 7150 | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Core Pathway X 5300 | Deductible $5,300 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State Plan | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway X 4350 | Deductible $4,350 | Coinsurance Not applicable | Out of Pocket $5,700 |
| Plan Anthem Catastrophic Pathway X 7150 | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Bronze Pathway X 20 for HSA | Deductible $5,200 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Anthem Bronze Pathway X 6500 | Deductible $6,500 | Coinsurance Not applicable | Out of Pocket $7,150 |