Anthem Blue Cross Bronze 60 HMO Plan Details for 2020- HealthPocket

Anthem Blue Cross Bronze 60 HMO

$0.00/mo

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Zip Code90011
Applicant12/13/1984 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAnthem Blue Cross Bronze 60 HMO
Plan IDexch-CA2020AnthemBlueCrossBronze60HMO
Plan Year2020
Insurance ProviderAnthem Blue Cross
Metal LevelBronze HMO
Plan TypeHMO
Deductible$6,300
Out-of-Pocket Maximum$7,800
Plan Highlights

Yearly Deductible & Out-of-Pocket

Yearly Deductible - Individual$6300
Yearly Deductible - Family$12600
Separate Drug Deductible - Individual$500
Separate Drug Deductible - Family$1000
Out-of-Pocket Max - Individual$7800
Out-of-Pocket Max - Family$15600
Maximum Cost per Prescription$500

Doctor Visit

Primary Care VisitFirst 3 visits at $65 Copay before deductible
Specialist Visit$95 Copay after deductible
Other Practitioner Office Visit$65 Copay after deductible
Preventive Care/Screening/ImmunizationNo Charge

Tests

Laboratory Tests$40 Copay
X-rays and Diagnostic Imaging40% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40% Coinsurance after deductible

Drugs

Tier 1 (Most Generic Drugs)$18 Copay after deductible
Tier 2 (Preferred Brand Drugs)40% Coinsurance after deductible
Tier 3 (Non-Preferred Brand Drugs)40% Coinsurance after deductible
Tier 4 (Specialty Drugs)40% Coinsurance after deductible

Outpatient Services

Outpatient Facility Fee40% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40% Coinsurance after deductible
Outpatient Services Office Visits40% Coinsurance after deductible

ER & Urgent Care

Emergency Room Facility Fee40% Coinsurance after deductible
Emergency Transportation40% Coinsurance after deductible
Urgent Care$65 Copay after deductible
Emergency Room Professional FeeNo Charge

Hospital

Inpatient Hospital Services40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible

Mental/Behavioral Health

Mental/Behavioral Health Outpatient Services$65 Copay before deductible
Mental/Behavioral Health Inpatient Facility Fee40% Coinsurance after deductible
Mental/Behavioral Health Inpatient Professional Fee40% Coinsurance after deductible
Substance Use Disorder Outpatient Services$65 Copay before deductible
Substance Use Disorder Inpatient Facility Fee40% Coinsurance after deductible
Substance Use Disorder Inpatient Professional Fee40% Coinsurance after deductible

Pregnancy

Prenatal CareNo Charge
Delivery and Maternity Care Inpatient Facility Fee40% Coinsurance after deductible
Delivery and Maternity Care Inpatient Professional Fee40% Coinsurance after deductible

Other Special Needs

Home Health Care Services40% Coinsurance after deductible
Outpatient Rehabilitation Services$65 Copay
Habilitation Services$65 Copay
Skilled Nursing Facility40% Coinsurance after deductible
Durable Medical Equipment40% Coinsurance after deductible
Hospice ServicesNo Charge
Acupuncture$65 Copay after deductible
Rehabilitative Speech Therapy$65 Copay
Rehabilitative Occupational and Rehabilitative Physical Therapy$65 Copay
Well Baby Visits and CareNo Charge
Allergy Testing$95 Copay after deductible
Diabetes EducationNo Charge
Nutritional CounselingNot covered

Children's Vision

Eye Exam for ChildrenNo Charge
Eyeglasses for ChildrenNo Charge

Children's Dental

Child Filling - One Surface20% Coinsurance
Child Dental CheckupNo Charge
Child Root Canal - Molar50% Coinsurance
Child Medically Necessary Orthodontia50% Coinsurance
PremiumPlan NameDeductible
from $0
Anthem Blue Cross Bronze 60 EPO
$6,300.00Select
from $0
Blue Shield Bronze 60 PPO
$6,300.00Select
from $0
Chinese Community Bronze 60 HMO
$6,300.00Select
from $0
Health Net Bronze 60 PureCare HSP
$6,300.00Select
from $0
Health Net Bronze 60 EnhancedCare PPO
$6,300.00Select
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  • Phone Number
    (323) 233-0425
  • Office Locations
    4211 Avalon Blvd
    Los Angeles, CA 90011
4211 Avalon Blvd Los Angeles CA, 90011

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).