Anthem Silver Pathway X HMO 2100
| Plan Type: | HMO |
| Plan Tier: | Silver |
| Medical Deductible - Individual: | $2,100 |
| Medical Deductible - Family: | $4,200 |
| Drug Deductible - Individual: | Included in Medical |
| Drug Deductible - Family: | Included in Medical |
| Out of Pocket Max - Individual: | $7,900 |
| Out of Pocket Max - Family: | $15,800 |
| Primary Care Visit: | $30 |
| Specialist Visit: | 20% Coinsurance after deductible |
| Emergency Room: | $500 Copay after deductible and 20% Coinsurance after deductible |
| Hospital - Physician: | 20% Coinsurance after deductible |
| Hospital - Facility: | $500 Copay per Stay after deductible and 20% Coinsurance after deductible |
| Link to Full SBC: | https://www.sbc.anthem.com/dps/ccd37B3 |
| Plan Brochure: | http://editiondigital.net/view/IU65/2019/ON_HIX_OH_KIT_2019 |
Other Coverage:
| Child Dental: | Yes |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $20 |
| Non-Preferred Brand Drugs: | 40% Coinsurance after deductible |
| Preferred Brand Drugs: | $50 |
| Specialty Drugs: | 40% Coinsurance after deductible |
| Link to Full Policy Formulary: | https://www.anthem.com/OHSelectdrugtier4 |
This Carrier Offers:
About The Carrier
One of the larger provider networks in Ohio. A wide range of choices in plans, coverage and price levels. Innovative cost-of-care products and programs that improve health and reduce expenses. Let Anthem help you customize medical benefits that work best for your employees and your budget.
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