Matthew - Anthem Gold Pathway X Enhanced HMO 1500 15

New Hampshire, 2019

  • Plan Type

    HMO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $7,900

  • 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) $4,500
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 15% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 15% 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 per stay after deductible + 15% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 15% Coinsurance after deductible
Preferred Brand Rx 15% Coinsurance after deductible
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in New Hampshire

Plan Anthem Bronze Pathway X Enhanced HMO 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X Enhanced HMO 3750 10 Deductible $3,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze Pathway X Enhanced HMO 6500 40 Deductible $6,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway X Enhanced HMO 7900 0 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 3800 0 Deductible $3,800 Coinsurance Not applicable Out of Pocket $5,800
Plan Anthem Silver Pathway X Enhanced HMO 6300 30 Deductible $6,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 3500 0 Deductible $3,500 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) $1,500
Deductible (Family) $4,500
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 15% Coinsurance after deductible
Inpatient Facility $500 Copay per stay after deductible + 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 15% 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 per stay after deductible + 15% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 15% Coinsurance after deductible
Preferred Brand Rx 15% Coinsurance after deductible
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in New Hampshire

Plan Anthem Bronze Pathway X Enhanced HMO 25 for HSA Deductible $5,150 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze Pathway X Enhanced HMO 5750 10 Deductible $5,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Bronze Pathway X Enhanced HMO 3750 10 Deductible $3,750 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 10 for HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Anthem Bronze Pathway X Enhanced HMO 6500 40 Deductible $6,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Catastrophic Pathway X Enhanced HMO 7900 0 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 3800 0 Deductible $3,800 Coinsurance Not applicable Out of Pocket $5,800
Plan Anthem Silver Pathway X Enhanced HMO 6300 30 Deductible $6,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Anthem Silver Pathway X Enhanced HMO 3500 0 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900