Anthem Catastrophic Pathway HMO 8550 Plan Details for 2021- HealthPocket

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Applicant Info
Applicant
Date of birth
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female
Income
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Zip Code	43228 (edit)
Applicant	1/20/1986 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	Anthem Catastrophic Pathway HMO 8550
Plan ID	hhs-29276OH0920425
Plan Year	2021
Insurance Provider	Anthem BCBS
Metal Level	Catastrophic
Plan Type	HMO
Deductible	$0
Out-of-Pocket Maximum	$0
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$40 Copay with deductible
Specialist Visit	Not Applicable
Laboratory Outpatient and Professional Services	Not Applicable
X-rays and Diagnostic Imaging	Not Applicable
Diagnostic Imaging such as MRIs, CT, and PET scans	Not Applicable

Prescription drug coverage
Generic Drugs	No Charge after deductible
Preferred Brand Drugs	No Charge after deductible
Non-Preferred Brand Drugs	No Charge after deductible
Specialty Drugs	No Charge after deductible

Access to doctors and hospitals
Provider directory URL	https://www.anthem.com/health-insurance/provider-directory/searchcriteria
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	Not Applicable
Inpatient Hospital Services (e.g., Hospital Stay)	Not Applicable
Inpatient Physician and Surgical Services	Not Applicable
Emergency Transportation or Ambulance Service	Not Applicable

Maternity
Prenatal and Postnatal Care	Not Applicable
Delivery and all inpatient services for maternity care	Not Applicable

Mental Health
Mental/Behavioral Health Outpatient Services	Not Applicable
Mental/Behavioral Health Inpatient Services	Not Applicable
Substance use disorder outpatient services	Not Applicable
Substance use disorder inpatient services	Not 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 Infertility Treatment 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 Habilitation Services Durable Medical Equipment Hospice Services 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)
More Limited Benefits	Skilled Nursing Facility Private-Duty Nursing Home Health Care Services Outpatient Rehabilitation Services Dental Check-Up for Children Chiropractic Care Accidental Dental Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Bariatric Surgery Cosmetic Surgery Hearing Aids Long Term Care Weight Loss Programs Routine Foot Care Dental Care - Adult Abortion for Which Public Funding is Prohibited Long-Term/Custodial Nursing Home Care

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Last Name

Location/Distance

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Mark, Barnhart

Patrick, Callender

Steven, Miller

Douglas, Finnie

Thomas, Baker

Kevin, Klauer

Andrea, Caito

Caitlin, Brown

Christopher, Smith

Comprehensive Wound Care Consultants Llc

Muhammad, Baig

Paige, Houghtaling

Hayleigh, Tomek

Emma, Folk

Cassondra, Righter

Kirstan, Law

Megan, Sugden

Tiffany, Pfeil

Nina, Henry

Fabian, Soto

Abigail, Wills

Adam, Dennison

Mark Barnhart, DPM

Phone Number
(614) 870-0000
Office Locations
5212 W Broad St
Columbus, OH 43228

What is the Catastrophic Plan?
Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."
How are Catastrophic Plans different than other Obamacare health plans?
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.
How much does a Catastrophic Plan cost?
The monthly premium for a Catastrophic Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Catastrophic Plan premiums in your area.

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.

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

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Anthem Catastrophic Pathway HMO 8550

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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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