Anthem - Anthem Bronze X HMO 5000 Online Plus

Maine, 2019

  • Plan Type

    HMO

  • Metal Tier

    Expanded Bronze

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $5,000

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) $5,000
Deductible (Family) $10,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 35% Coinsurance after deductible
Inpatient Physician 35% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 35% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 35% Coinsurance after deductible
Laboratory Outpatient and Professional Services 35% Coinsurance after deductible
X-Ray and Diagnostic Imaging 35% 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 35% Coinsurance after deductible
Mental / Behavioral Health Outpatient 35% Coinsurance after deductible
Rehabilitative Speech Therapy 35% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 35% Coinsurance after deductible
Outpatient Facility 35% Coinsurance after deductible
Outpatient Surgery 35% Coinsurance after deductible

Prescription Drugs

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

Other Plans in Maine

Plan Anthem Bronze X POS 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic X POS 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 Online Plus Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 Online Plus Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X HMO 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze X HMO 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver X POS 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X HMO 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Gold X POS 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold X POS 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Catastrophic X POS 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold X HMO 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900
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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) $5,000
Deductible (Family) $10,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 35% Coinsurance after deductible
Inpatient Physician 35% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 35% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 35% Coinsurance after deductible
Laboratory Outpatient and Professional Services 35% Coinsurance after deductible
X-Ray and Diagnostic Imaging 35% 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 35% Coinsurance after deductible
Mental / Behavioral Health Outpatient 35% Coinsurance after deductible
Rehabilitative Speech Therapy 35% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 35% Coinsurance after deductible
Outpatient Facility 35% Coinsurance after deductible
Outpatient Surgery 35% Coinsurance after deductible

Prescription Drugs

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

Other Plans in Maine

Plan Anthem Bronze X POS 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic X POS 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 Online Plus Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 Online Plus Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X HMO 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic X HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver X POS 3850 Deductible $3,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze X POS 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze X HMO 5000 for HSA Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Silver X POS 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X HMO 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Gold X POS 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold X POS 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X HMO 5800 Deductible $5,800 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze X POS 6250 for HSA Deductible $6,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Catastrophic X POS 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Gold X HMO 1350 Deductible $1,350 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver X POS 2250 Deductible $2,250 Coinsurance Not applicable Out of Pocket $7,900