Matthew - Anthem Silver Pathway X Enhanced HMO 3800 0

New Hampshire, 2018

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $5,800

  • Deductible

    $3,800

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) $3,800
Deductible (Family) $7,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,800
Out of Pocket Maximum (Family) $11,600

Doctor Visits

Primary Care Visit $40 Copay after deductible
Specialist Visit $60 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 $40 Copay after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility $250 Copay after deductible
Outpatient Surgery No charge 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 40% 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) $2,800
Deductible (Family) $5,600
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Physician $30 Copay after deductible
Specialists $50 Copay after deductible
Emergency Room $500 Copay after deductible
Inpatient Facility $500 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% 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) $1,900
Out of Pocket Maximum (Family) $3,800

Doctor Visits

Primary Care Physician $20 Copay after deductible
Specialists $40 Copay after deductible
Emergency Room $250 Copay after deductible
Inpatient Facility $250 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% 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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician $10 Copay after deductible
Specialists $30 Copay after deductible
Emergency Room $75 Copay after deductible
Inpatient Facility $100 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

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

Other Plans in New Hampshire

Plan Anthem Silver Pathway X Enhanced HMO 3500 0 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Catastrophic Pathway X Enhanced HMO 7350 0 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 6300 30 Deductible $6,300 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,650
Plan Anthem Bronze Pathway X Enhanced HMO 6350 40 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,350
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 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,650
Plan Anthem Gold Pathway X Enhanced HMO 1500 10 Deductible $1,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 2500 30 Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
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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) $3,800
Deductible (Family) $7,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,800
Out of Pocket Maximum (Family) $11,600

Doctor Visits

Primary Care Visit $40 Copay after deductible
Specialist Visit $60 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 $40 Copay after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility $250 Copay after deductible
Outpatient Surgery No charge 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 40% 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) $2,800
Deductible (Family) $5,600
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Physician $30 Copay after deductible
Specialists $50 Copay after deductible
Emergency Room $500 Copay after deductible
Inpatient Facility $500 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% 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) $1,900
Out of Pocket Maximum (Family) $3,800

Doctor Visits

Primary Care Physician $20 Copay after deductible
Specialists $40 Copay after deductible
Emergency Room $250 Copay after deductible
Inpatient Facility $250 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% 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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician $10 Copay after deductible
Specialists $30 Copay after deductible
Emergency Room $75 Copay after deductible
Inpatient Facility $100 Copay per stay after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

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

Other Plans in New Hampshire

Plan Anthem Silver Pathway X Enhanced HMO 3500 0 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Catastrophic Pathway X Enhanced HMO 7350 0 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 6300 30 Deductible $6,300 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,650
Plan Anthem Bronze Pathway X Enhanced HMO 6350 40 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,350
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 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,650
Plan Anthem Gold Pathway X Enhanced HMO 1500 10 Deductible $1,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Anthem Silver Pathway X Enhanced HMO 2500 30 Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350