Anthem Bronze Pathway HMO 6000 Plan Details for 2021- HealthPocket

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Gender
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Zip Code	80219 (edit)
Applicant	6/13/1986 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	Anthem Bronze Pathway HMO 6000
Plan ID	hhs-76680CO0220021
Plan Year	2021
Insurance Provider	Anthem BCBS
Metal Level	Expanded Bronze
Plan Type	HMO
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 Visit	30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging	30.00% 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 Drugs	30.00% Coinsurance after deductible
Preferred Brand Drugs	30.00% Coinsurance after deductible
Non-Preferred Brand Drugs	30.00% Coinsurance after deductible
Specialty Drugs	30.00% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	https://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 Services	30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service	30.00% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	30.00% 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 Services	30.00% 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 services	30.00% 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 Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Included
Child Dental Coverage - Basic Dental Care	Included
Child Dental Coverage - Orthodontia	Included
Child Dental Coverage - Major Dental Care	Included

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other 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 Facility Fee (e.g., Ambulatory Surgery Center) 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 Dental Anesthesia Diabetes Care Management Inherited Metabolic Disorder - PKU 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 Autism Spectrum Disorders Clinical Trials Congenital Anomaly, including Cleft Lip/Palate Off Label Prescription Drugs Prescription Drugs Other Non-Preferred Generic Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Intensive Outpatient for Mental Health/ Substance Abuse Partial Hospitalization for Mental Health/ Substance Abuse Prosthetics: Legs and Arms Residential Day Treatment for Mental Health/ Substance Abuse Telehealth PCP Telehealth Specialist Partial Hospitalization for Mental Health/Substance Abuse Intensive Outpatient for Mental Health/Substance Abuse Residential Day Treatment for Mental Health/Substance Abuse 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 Benefits	Skilled 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 Early Intervention Services Rehabilitative Occupational Therapy Rehabilitative Physical Therapy
More Excluded Benefits	Acupuncture Cosmetic Surgery Long Term Care Weight Loss Programs Routine Foot Care Non-Emergency Care When Traveling Outside the U.S. Dental Care - Adult Abortion for Which Public Funding is Prohibited Accidental Dental Spinal Manipulations Long-Term/Custodial Nursing Home Care

+ See All Coverage Details

Premium	Plan Name	Deductible
from $265	Anthem Bronze Pathway Essentials HMO 6000	$6,000.00	Select
from $266	Oscar Bronze Classic PCP Copay ($3 Prescription List + Free 24/	$6,000.00	Select
from $291	Oscar Silver Saver 2 Off-Ex	$6,200.00	Select
from $312	Anthem Bronze Mountain Enhanced HMO 6000	$6,000.00	Select
from $337	Oscar Silver Saver 2 ($3 Prescription List + Free 24/7 Virtual	$6,200.00	Select

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Larry Fisher, MD

Phone Number
(303) 935-9142
Office Locations
1930 S Federal Blvd
Denver, CO 80219

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ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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Anthem Bronze Pathway HMO 6000

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Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

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Anthem Bronze Pathway HMO 6000

Apply For This Plan

Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

Similar Plans

Physician Finder

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