Anthem - Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan

Maine, 2017

  • Plan Type

    POS

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,950

  • Deductible

    $2,800

Enroll Now
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Call (855) 866-5590 to speak with a licensed agent about a new health plan.

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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) $2,800
Deductible (Family) $5,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,950
Out of Pocket Maximum (Family) $13,900

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 25% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 25% Coinsurance after deductible
Laboratory Outpatient and Professional Services 25% Coinsurance after deductible
X-Ray and Diagnostic Imaging 25% 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 25% Coinsurance after deductible
Mental / Behavioral Health Outpatient 25% Coinsurance after deductible
Rehabilitative Speech Therapy 25% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 25% Coinsurance after deductible
Outpatient Facility 25% Coinsurance after deductible
Outpatient Surgery 25% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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) $2,400
Deductible (Family) $4,800
Out of Pocket Maximum (Individual) $5,250
Out of Pocket Maximum (Family) $10,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $200 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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

Deductible (Individual) $700
Deductible (Family) $1,400
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $100 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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

Deductible (Individual) $150
Deductible (Family) $300
Out of Pocket Maximum (Individual) $650
Out of Pocket Maximum (Family) $1,300

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $75 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Maine

Plan Anthem Catastrophic X POS 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X HMO 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Bronze X HMO 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver X HMO 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Bronze X POS 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Catastrophic X POS 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X HMO 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X HMO 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X POS 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Silver X HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,950
Plan Anthem Silver Core X POS 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X HMO 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X POS 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Silver X POS 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,950
Plan Anthem Catastrophic X HMO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Silver Core X HMO 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Silver Core X POS 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550
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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) $2,800
Deductible (Family) $5,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,950
Out of Pocket Maximum (Family) $13,900

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 25% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 25% Coinsurance after deductible
Laboratory Outpatient and Professional Services 25% Coinsurance after deductible
X-Ray and Diagnostic Imaging 25% 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 25% Coinsurance after deductible
Mental / Behavioral Health Outpatient 25% Coinsurance after deductible
Rehabilitative Speech Therapy 25% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 25% Coinsurance after deductible
Outpatient Facility 25% Coinsurance after deductible
Outpatient Surgery 25% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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) $2,400
Deductible (Family) $4,800
Out of Pocket Maximum (Individual) $5,250
Out of Pocket Maximum (Family) $10,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $200 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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

Deductible (Individual) $700
Deductible (Family) $1,400
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $100 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% 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

Deductible (Individual) $150
Deductible (Family) $300
Out of Pocket Maximum (Individual) $650
Out of Pocket Maximum (Family) $1,300

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $75 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Maine

Plan Anthem Catastrophic X POS 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X HMO 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Bronze X HMO 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver X HMO 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Bronze X POS 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Catastrophic X POS 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X HMO 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X HMO 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X POS 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Silver X HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,500
Plan Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,950
Plan Anthem Silver Core X POS 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze X HMO 6250 Deductible $6,250 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze X POS 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Silver X POS 2900 for HSA Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,950
Plan Anthem Catastrophic X HMO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,000
Plan Anthem Silver Core X HMO 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,050
Plan Anthem Silver Core X POS 4650 Deductible $4,650 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,550