Anthem Silver DirectAccess - cbpa

Individual Health Insurance (Obamacare)

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Benefits & Coverage

Plan Name
Anthem Essential DirectAccess - cbpa
Plan ID
29276OH0770010
Plan Year
2014
Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
Metal Level
Silver
Plan Type
PPO
Deductible
$2,500
Out-of-Pocket Maximum
$6,000
Plan Highlights

Cost & Coverage

Estimated Monthly Base Rate
Estimated monthly premium starts at $1329.56
Deductible
Individual: $2500
Family: $5000
In-Network Out-of-Pocket Limit
Individual: $6000
Family: $12000
What is included in the in-network out-of-pocket limit?
Deductible + Coinsurance + Co-pay
Is this plan Health Savings Account (HSA) eligible?
No
How can I find a doctor in this plan's network?
Plan Type
PPO

Health Services Options

Service
In Network
Out of Network
Primary care physician office visit
$30 Copay
40% Coinsurance after deductible
Specialist
10% Coinsurance after deductible
40% Coinsurance after deductible
Diagnostic Test (X-ray, blood work)
10% Coinsurance after deductible
40% Coinsurance after deductible
Outpatient Facility Fee
10% Coinsurance after deductible
40% Coinsurance after deductible
Outpatient Physician/Surgeon Fee
10% Coinsurance after deductible
40% Coinsurance after deductible
Hospital facility fee
10% Coinsurance after deductible
40% Coinsurance after deductible
Hospital physician/surgeon fee
10% Coinsurance after deductible
40% Coinsurance after deductible
Emergency Room
10% Coinsurance after deductible
10% Coinsurance after deductible

Drug Services

Generic Drugs
Coverage: $15 Copay
Preferred Brand Drugs
Coverage: $40 Copay
Specialty Drugs
Coverage: 10% Coinsurance after deductible
What drugs are covered in the formulary?

Mental Health or Substance Abuse Services

Service
In Network
Out of Network
Mental/behavioral health outpatient services
10% Coinsurance after deductible
40% Coinsurance after deductible
Mental/behavioral health inpatient services
10% Coinsurance after deductible
40% Coinsurance after deductible
Substance use disorder inpatient services
10% Coinsurance after deductible
40% Coinsurance after deductible
Substance use disorder outpatient services
10% Coinsurance after deductible
40% Coinsurance after deductible

Maternity Services

Service
In Network
Out of Network
Prenatal/postnatal care
10% Coinsurance after deductible
40% Coinsurance after deductible
Delivery and all inpatient services for maternity care
10% Coinsurance after deductible
40% Coinsurance after deductible

Coverage Options Summary

Included Benefits
  • Durable medical equipment
  • Emergency Transportation
  • Eye glasses children
  • Habilitation
  • Home health care
  • Hospice
  • Imaging (CT/PET scans, MRIs)
  • Inpatient rehabilitation
  • Non-preferred brand drugs
  • Skilled nursing care
  • Other practitioner office visit
  • Outpatient rehabilitation
  • Preventive care, screening, immunization
  • Routine eye exam children
  • Urgent Care
Excluded Benefits
  • Acupuncture
  • Bariatric surgery
  • Cosmetic surgery
  • Dental care adult
  • Dental check up children
  • Eye exam adult
  • Hearing Aid
  • Infertility treatment
  • Long Term Care
  • Routine foot care
  • Weight loss program
Limited Benefits
  • Chiropractic
  • Non-emergency care outside U.S.
  • Private duty nursing
  • Routine hearing tests

What To Know

  • This is an ACA (Obamacare) compliant health plan.
  • This plan is eligible for a tax credit subsidy

Physician Directory

List of doctors that accepts Anthem Silver DirectAccess - cbpa Obamacare Plan in Ohio

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HEILMAN, ROBERT
4300 CLIME RD
COLUMBUS, OH 43228
KING, GRETZEL
104 N MURRAY HILL RD
COLUMBUS, OH 43228
LUKEN, THERESA
4300 CLIME RD
COLUMBUS, OH 43228
LAMPL, BROOKE
5100 W BROAD ST
COLUMBUS, OH 43228
HINCKLEY, JOHN
5100 W BROAD ST
COLUMBUS, OH 43228
VINCENT, KAREN
5100 W BROAD ST
COLUMBUS, OH 43228
LEVIN, SETH
5131 BEACON HILL RD
COLUMBUS, OH 43228
CUNAGIN, KIMBERLY
5100 W BROAD ST
COLUMBUS, OH 43228
JORDAN, KEVIN
5100 W BROAD ST
COLUMBUS, OH 43228
FRASER, WILLIAM
5100 W BROAD ST
COLUMBUS, OH 43228
RYBALTOWSKI, MARIUSZ
5100 W BROAD ST
COLUMBUS, OH 43228
PARKER, SARAH
5100 W BROAD ST
COLUMBUS, OH 43228
JONES, PAULA
5100 W BROAD ST
COLUMBUS, OH 43228
HARRIS, PAUL
5193 W BROAD ST
COLUMBUS, OH 43228
JONES, BRUCE
5100 W BROAD ST
COLUMBUS, OH 43228
JOHNSEN, RONALD
5100 W BROAD ST
COLUMBUS, OH 43228
HAMILTON, DANA
111 INAH AVE
COLUMBUS, OH 43228
SCOTT, MARY
4488 WEST BROAD STREET
COLUMBUS, OH 43228
BELL, PETER
5100 W BROAD ST
COLUMBUS, OH 43228
BIEDERMAN, BERNARD
17 NORTON RD
COLUMBUS, OH 43228
LOWE, ROBERT
5100 W BROAD ST
COLUMBUS, OH 43228
MCELDOWNEY, THOMAS
5100 W BROAD ST
COLUMBUS, OH 43228
FOSS, PETER
5131 BEACON HILL RD
COLUMBUS, OH 43228
KAUFMAN, JEFFREY
104 N MURRAY HILL RD
COLUMBUS, OH 43228
MILLER, STEVEN
5193 W BROAD ST
COLUMBUS, OH 43228
Details
ROBERT HEILMAN, M.D.
Phone Number
(614) 308-9066
Office Locations
4300 CLIME RD
COLUMBUS, OH 43228
4300 CLIME RD COLUMBUS OH, 43228

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