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Rocky - Anthem Gold Pathway PPO 700
Nevada, 2017
Plan Type
PPO
Metal Tier
Gold
Out of Pocket Maximum
$7,150
Deductible
$700
Call (855) 782-0916 to speak with a licensed agent about a new health plan.
Emergency Room Care: $250 Copay after deductible + 15% 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) | $700 |
|---|---|
| Deductible (Family) | $2,100 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | 15% Coinsurance after deductible |
| Inpatient Facility | $350 Copay per stay after deductible + 40% Coinsurance after deductible |
| Inpatient Physician | 15% Coinsurance after deductible |
| Emergency Room Services | $250 Copay after deductible + 15% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | $500 Copay after deductible + 15% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 15% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 15% 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 | $350 Copay after deductible + 40% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 15% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 15% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 15% Coinsurance after deductible |
| Outpatient Facility | 15% Coinsurance after deductible |
| Outpatient Surgery | 15% 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 | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Anthem Catastrophic Pathway PPO 7150 | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Bronze Pathway PPO 5150 for HSA | Deductible $5,150 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Anthem Silver Pathway PPO 4000 | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway PPO 2750 | Deductible $2,750 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway PPO 2250 | Deductible $2,250 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Bronze Pathway PPO 6200 | Deductible $6,200 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Anthem Silver Pathway PPO 3500 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan Anthem Bronze Pathway PPO 4600 | Deductible $4,600 | Coinsurance Not applicable | Out of Pocket $7,150 |