Anthem Bronze Pathway X HMO 4800 Plan Details for 2020- HealthPocket

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Zip Code30044
Applicant10/24/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAnthem Bronze Pathway X HMO 4800
Plan IDqhp-49046GA0410114
Plan Year2020
Insurance ProviderBlue Cross Blue Shield of Georgia
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$4,800
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$40 Copay
Specialist Visit30% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Deductible - Family$9600
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs30% Coinsurance after deductible
Non-Preferred Brand Drugs40% Coinsurance after deductible
Specialty Drugs40% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.anthem.com/health-insurance/provider-directory/searchcriteria/?alphaprefix=1620

Hospital services

Emergency Room Services30% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30% Coinsurance after deductible
Inpatient Physician and Surgical Services50% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care30.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsHospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Cosmetic Surgery
Skilled Nursing Facility
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Weight Loss Programs
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Clinical Trials
Diabetes Care Management
Off Label Prescription Drugs
Well Child Care
Bone Marrow Transplant
Heart Transplant
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $302
Anthem Bronze Pathway X Guided Access HMO 4800
$4,800.00Select
from $337
KP GA Signature Bronze 5000/50
$5,000.00Select
from $365
Anthem Silver Pathway X Guided Access HMO 4950
$4,950.00Select
from $369
Anthem Bronze Pathway Guided Access HMO 4800
$4,800.00Select
from $370
KP GA Bronze 5000/50
$5,000.00Select
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  • Phone Number
    (678) 344-8700
  • Office Locations
    2878 Five Forks Trickum Rd
    Lawrenceville, GA 30044
2878 Five Forks Trickum Rd Lawrenceville GA, 30044

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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 Benefytt Technologies, Inc. family of companies.