Anthem - Anthem Gold Pathway Transition X HMO 1500

Kentucky, 2019

  • Plan Type

    HMO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $6,250

  • Deductible

    $1,500

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) $1,500
Deductible (Family) $3,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,250
Out of Pocket Maximum (Family) $12,500

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $500 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible + 50% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% 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 per stay after deductible + 50% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx $35 Copay after deductible
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Kentucky

Plan Anthem Silver Pathway Transition X HMO 3700 for HSA Deductible $3,700 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver Pathway X HMO 2700 for HSA Deductible $2,700 Coinsurance Not applicable Out of Pocket $6,350
Plan Anthem Bronze Pathway X HMO 6100 Deductible $6,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Transition HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X Transition HMO 6750 Deductible $6,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X HMO 6500 for HSA Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver Pathway X HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway Transition X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold Pathway X HMO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $6,250
Plan Anthem Silver Pathway HMO 3200 Deductible $3,200 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze Pathway Transition X HMO 6500 for HSA Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,700
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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) $1,500
Deductible (Family) $3,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,250
Out of Pocket Maximum (Family) $12,500

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $500 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible + 50% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% 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 per stay after deductible + 50% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx $35 Copay after deductible
Non Preferred Brand Rx 40% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Kentucky

Plan Anthem Silver Pathway Transition X HMO 3700 for HSA Deductible $3,700 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver Pathway X HMO 2700 for HSA Deductible $2,700 Coinsurance Not applicable Out of Pocket $6,350
Plan Anthem Bronze Pathway X HMO 6100 Deductible $6,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Transition HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X Transition HMO 6750 Deductible $6,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X HMO 6500 for HSA Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver Pathway X HMO 6700 Deductible $6,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway Transition X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold Pathway X HMO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $6,250
Plan Anthem Silver Pathway HMO 3200 Deductible $3,200 Coinsurance Not applicable Out of Pocket $6,550
Plan Anthem Bronze Pathway Transition X HMO 6500 for HSA Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,700