HMO - Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan

Nevada, 2017

  • Plan Type

    HMO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $6,000

  • Deductible

    $1,100

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) $1,100
Deductible (Family) $3,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services $200 Copay after deductible + 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $500 Copay after deductible + 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% 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 $500 Copay after deductible + 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Nevada

Plan Anthem Bronze Pathway HMO 6800 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,000
Plan Anthem Catastrophic Pathway HMO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze Pathway HMO 6300 for HSA Deductible $6,300 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver Pathway HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,850
Plan Anthem Silver Core Pathway HMO 5300 Deductible $5,300 Coinsurance Not applicable Out of Pocket $6,450
Plan Anthem Bronze Pathway HMO 4950 Deductible $4,950 Coinsurance Not applicable Out of Pocket $6,100
Plan Anthem Silver Pathway HMO 2500 Deductible $2,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Bronze Pathway HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze Pathway HMO 5000 Deductible $5,000 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) $1,100
Deductible (Family) $3,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services $200 Copay after deductible + 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $500 Copay after deductible + 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% 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 $500 Copay after deductible + 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Nevada

Plan Anthem Bronze Pathway HMO 6800 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Silver Pathway HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,000
Plan Anthem Catastrophic Pathway HMO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze Pathway HMO 6300 for HSA Deductible $6,300 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Silver Pathway HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $6,850
Plan Anthem Silver Core Pathway HMO 5300 Deductible $5,300 Coinsurance Not applicable Out of Pocket $6,450
Plan Anthem Bronze Pathway HMO 4950 Deductible $4,950 Coinsurance Not applicable Out of Pocket $6,100
Plan Anthem Silver Pathway HMO 2500 Deductible $2,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Anthem Bronze Pathway HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,150
Plan Anthem Bronze Pathway HMO 5000 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150