Anthem Bronze Pathway Essentials HMO 6000 Plan Details for 2021- HealthPocket
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Anthem Bronze Pathway Essentials HMO 6000

$265.80/mo
View BrochureSummary of BenefitsProvider Directory

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Zip Code80219
Applicant5/28/1987 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAnthem Bronze Pathway Essentials HMO 6000
Plan IDhhs-76680CO0220058
Plan Year2021
Insurance ProviderAnthem BCBS
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,000
Out-of-Pocket Maximum$8,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$45 Copay with deductible, 30.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Specialist Visit30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$500 Copay after deductible, 30.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Deductible - Family$12000 per group
Out-of-Pocket Maximum - Family$17100 per group

Prescription drug coverage

Generic Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.anthem.com/health-insurance/provider-directory/searchcriteria?brand=abcbs
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?No - TRAD/PAR network
Does this plan cover services outside the country?No - Urgent/Emergency Coverage Only

Hospital services

Emergency Room Services$200 Copay after deductible, 30.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)$500 Copay per Stay after deductible, 40.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service30.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care30.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care$500 Copay after deductible, 40.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Mental Health

Mental/Behavioral Health Outpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services$500 Copay per Stay after deductible, 40.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Substance use disorder outpatient services30.00% Coinsurance after deductible
Substance use disorder inpatient services$500 Copay per Stay after deductible, 40.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management
Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaIncluded
Child Dental Coverage - Major Dental CareIncluded

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Bariatric Surgery
Hearing Aids
Infertility Treatment
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
Applied Behavior Analysis Based Therapies
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Prosthetics: Legs and Arms
Telehealth PCP
Telehealth Specialist
Intensive Outpatient for Substance Use Disorder
Mental/Behavioral Health Prenatal Care
Partial Hospitalization for Mental/Behavioral Health
Partial Hospitalization for Substance Use Disorder
Postpartum Mental/Behavioral Health
Postpartum Substance Use Disorder
Residential Day Treatment for Mental/Behavioral Health
Residential Day Treatment for Substance Use Disorder
Substance Use Disorder Prenatal Care
Telehealth Mental/Behavioral Health
Telehealth Substance Use Disorder
Autism Spectrum Disorders - Assessment and Evaluation Services
Intensive Outpatient for Mental/Behavioral Health
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Rehabilitative Occupational Therapy
Rehabilitative Physical Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $266Oscar Bronze Classic PCP Copay ($3 Prescription List + Free 24/$6,000.00Select
from $291Oscar Silver Saver 2 Off-Ex$6,200.00Select
from $302KP Select CO Silver 6000/45 X$6,000.00Select
from $306Anthem Bronze Pathway HMO 6000$6,000.00Select
from $312Anthem Bronze Mountain Enhanced HMO 6000$6,000.00Select
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  • Phone Number
    (303) 935-9142
  • Office Locations
    1930 S Federal Blvd
    Denver, CO 80219
1930 S Federal Blvd Denver CO, 80219

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HealthPocket.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.

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