Matthew - Anthem Bronze Pathway X Enhanced HMO 0 for HSA

New Hampshire, 2017

  • Plan Type

    HMO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $6,550

  • Deductible

    $6,050

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) $6,050
Deductible (Family) $12,100
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,550
Out of Pocket Maximum (Family) $13,100

Doctor Visits

Primary Care Visit $30 Copay after deductible
Specialist Visit $40 Copay after deductible
Inpatient Facility $500 Copay per stay after deductible
Inpatient Physician No charge after deductible
Emergency Room Services $500 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge 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 $500 Copay per stay after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in New Hampshire

Plan Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Silver Pathway X Enhanced HMO 4000 0 Deductible $4,000 Coinsurance Not applicable Out of Pocket $5,700
Plan Anthem Catastrophic Pathway X Enhanced HMO 7150 0 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway X Enhanced HMO 4200 0 Deductible $4,200 Coinsurance Not applicable Out of Pocket $5,900
Plan Anthem Bronze Pathway X Enhanced HMO 5400 30 Deductible $5,400 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Gold Pathway X Enhanced HMO 1000 10 Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Bronze Pathway X Enhanced HMO 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,550
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 Enhanced HMO 5300 25 Deductible $5,300 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze Pathway X Enhanced HMO 6350 40 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,150
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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) $6,050
Deductible (Family) $12,100
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,550
Out of Pocket Maximum (Family) $13,100

Doctor Visits

Primary Care Visit $30 Copay after deductible
Specialist Visit $40 Copay after deductible
Inpatient Facility $500 Copay per stay after deductible
Inpatient Physician No charge after deductible
Emergency Room Services $500 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge 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 $500 Copay per stay after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in New Hampshire

Plan Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Silver Pathway X Enhanced HMO 4000 0 Deductible $4,000 Coinsurance Not applicable Out of Pocket $5,700
Plan Anthem Catastrophic Pathway X Enhanced HMO 7150 0 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway X Enhanced HMO 4200 0 Deductible $4,200 Coinsurance Not applicable Out of Pocket $5,900
Plan Anthem Bronze Pathway X Enhanced HMO 5400 30 Deductible $5,400 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Gold Pathway X Enhanced HMO 1000 10 Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Bronze Pathway X Enhanced HMO 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,550
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 Enhanced HMO 5300 25 Deductible $5,300 Coinsurance Not applicable Out of Pocket $6,750
Plan Anthem Bronze Pathway X Enhanced HMO 6350 40 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,150