Anthem Catastrophic Pathway 7350

Individual Health Insurance (Obamacare)

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Anthem Catastrophic Pathway 7350

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Monthly Cost

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Benefits & Coverage

Plan Name
Anthem Catastrophic Pathway 7350
Plan Year
2018
Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
Metal Level
Catastrophic
Out-of-Pocket Maximum
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness
$40 Copay with deductible
Specialist Visit
No Charge after deductible
Laboratory Outpatient and Professional Services
No Charge after deductible
X-rays and Diagnostic Imaging
No Charge after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans
No Charge after deductible
Deductible - Family
$14700 per group
Out-of-Pocket Maximum - Family
$14700 per group

Prescription drug coverage

Generic Drugs
0.00% Coinsurance after deductible
Preferred Brand Drugs
0.00% Coinsurance after deductible
Non-Preferred Brand Drugs
0.00% Coinsurance after deductible
Specialty Drugs
0.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URL
http://www.anthem.com/health-insurance/provider-directory/searchcriteria?branding=ABCBS&state=IN
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 - Urgent/Emergency Coverage Only
Does this plan cover services outside the country?
No - Urgent/Emergency Coverage Only

Hospital services

Emergency Room Services
No Charge after deductible
Inpatient Hospital Services (e.g., Hospital Stay)
No Charge after deductible
Inpatient Physician and Surgical Services
No Charge after deductible
Emergency Transportation or Ambulance Service
No Charge after deductible

Maternity

Prenatal and Postnatal Care
No Charge after deductible
Delivery and all inpatient services for maternity care
No Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient Services
No Charge after deductible
Mental/Behavioral Health Inpatient Services
No Charge after deductible
Substance use disorder outpatient services
No Charge after deductible
Substance use disorder inpatient services
No Charge after deductible

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
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
Dental Anesthesia
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
More Limited Benefits
Skilled Nursing Facility
Private-Duty Nursing
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation 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
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited

What To Know

  • This is an ACA (Obamacare) compliant health plan.
  • This plan is not eligible for a tax credit subsidy

Physician Directory

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Catastrophic plan frequently asked questions (FAQ)

  • 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.

  • When Can I Enroll in a Catastrophic Plan?

    The first Open Enrollment period for the new Affordable Care Act health plans began October 1, 2013 and ended March 31, 2014. However, some individuals who qualified for a special enrollment period were allowed to enroll past the March 31st deadline. The 2015 open enrollment period will be from November 15, 2014 to February 15, 2015. See our Open Enrollment article for more information.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.

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