Anthem - Anthem Silver X HMO 4500

Maine, 2019

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $4,500

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) $4,500
Deductible (Family) $9,000
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 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 25% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 25% Coinsurance after deductible
Laboratory Outpatient and Professional Services 25% Coinsurance after deductible
X-Ray and Diagnostic Imaging 25% 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 25% Coinsurance after deductible
Mental / Behavioral Health Outpatient 25% Coinsurance after deductible
Rehabilitative Speech Therapy 25% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 25% Coinsurance after deductible
Outpatient Facility 25% Coinsurance after deductible
Outpatient Surgery 25% Coinsurance 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) $3,300
Deductible (Family) $6,600
Out of Pocket Maximum (Individual) $5,150
Out of Pocket Maximum (Family) $10,300

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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 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 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 Bronze X HMO 5000 Online Plus Deductible $5,000 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) $4,500
Deductible (Family) $9,000
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 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 25% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 25% Coinsurance after deductible
Laboratory Outpatient and Professional Services 25% Coinsurance after deductible
X-Ray and Diagnostic Imaging 25% 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 25% Coinsurance after deductible
Mental / Behavioral Health Outpatient 25% Coinsurance after deductible
Rehabilitative Speech Therapy 25% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 25% Coinsurance after deductible
Outpatient Facility 25% Coinsurance after deductible
Outpatient Surgery 25% Coinsurance 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) $3,300
Deductible (Family) $6,600
Out of Pocket Maximum (Individual) $5,150
Out of Pocket Maximum (Family) $10,300

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $750
Out of Pocket Maximum (Family) $1,500

Doctor Visits

Primary Care Physician
Specialists 25% Coinsurance after deductible
Emergency Room $250 Copay after deductible + 25% Coinsurance after deductible
Inpatient Facility 25% Coinsurance after deductible
Inpatient Physician 25% Coinsurance 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 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 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 Bronze X HMO 5000 Online Plus Deductible $5,000 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