Anthem - Anthem Silver Pathway Transition X HMO 3700 for HSA

Kentucky, 2019

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,700

  • Deductible

    $3,700

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) $3,700
Deductible (Family) $7,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,700
Out of Pocket Maximum (Family) $13,400

Doctor Visits

Primary Care Visit 15% Coinsurance after deductible
Specialist Visit 15% Coinsurance after deductible
Inpatient Facility $500 Copay per day after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible + 50% 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 $500 Copay after deductible + 50% 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 $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $2,000
Deductible (Family) $4,000
Out of Pocket Maximum (Individual) $5,500
Out of Pocket Maximum (Family) $11,000

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $300 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $200 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $150 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 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 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
Plan Anthem Gold Pathway Transition X HMO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $6,250
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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) $3,700
Deductible (Family) $7,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,700
Out of Pocket Maximum (Family) $13,400

Doctor Visits

Primary Care Visit 15% Coinsurance after deductible
Specialist Visit 15% Coinsurance after deductible
Inpatient Facility $500 Copay per day after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible + 50% 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 $500 Copay after deductible + 50% 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 $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $2,000
Deductible (Family) $4,000
Out of Pocket Maximum (Individual) $5,500
Out of Pocket Maximum (Family) $11,000

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $300 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician 15% Coinsurance after deductible
Specialists 15% Coinsurance after deductible
Emergency Room $200 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility $150 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 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 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
Plan Anthem Gold Pathway Transition X HMO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $6,250