Anthem Bronze Pathway X 6350 Plan Details for 2020- HealthPocket

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Zip Code63129
Applicant12/5/1984 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAnthem Bronze Pathway X 6350
Plan IDqhp-32753MO0950003
Plan Year2020
Insurance ProviderAnthem BCBS
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$6,350
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness20% Coinsurance after deductible
Specialist Visit20% Coinsurance after deductible
Laboratory Outpatient and Professional Services20.00% Coinsurance after deductible
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible
Deductible - Family$12700
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs$50 Copay
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=JXK

Hospital services

Emergency Room Services20% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20% Coinsurance after deductible
Inpatient Physician and Surgical Services20% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care20.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services20.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services20.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsDental Anesthesia
Bone Marrow Testing
Newborn Hearing Screening
Applied Behavior Analysis Based Therapies
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Clinical Trials
Inherited Metabolic Disorder - PKU
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
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
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Bariatric Surgery
Cosmetic Surgery
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $327
Select by Medica Bronze H S A
$6,400.00Select
from $388
Oscar Classic Silver
$6,500.00Select
from $399
Select by Medica Bronze H S A
$6,400.00Select
from $475
Classic Silver (Free 24/7 Telemedicine + Free Preventive Care)
$6,500.00Select
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  • Phone Number
    (314) 487-8724
  • Office Locations
    4530 Lemay Ferry Rd
    Saint Louis, MO 63129
4530 Lemay Ferry Rd Saint Louis MO, 63129

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).

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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).