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California Health Insurance: Anthem Blue Cross Bronze Pathway 5850 EPO

Anthem Bronze 5850 EPO	In-Network
Cost Share Information
Individual Deductible	$5,850
Family Deductible	$11,700
Out of Pocket Limit-Individual	$7,150 (including deductible)
Out of Pocket Limit-Family	$14,300 (including deductible)
Co-Insurance	20%
Lifetime Maximum	None
Office Visits
Primary Care	$50 deductible waived visits 1-2; 20% after deductible visits 3+
Specialist	20% after deductible
Adult Preventive Care	No Charge
Child Preventive Care	No Charge
Maternity Prenatal/Postnatal Care	Pre-No charge; Post-$50 ded waived visits 1-2/20% after deductible visits 3+
Rehabilitation Services	20% after deductible
Chiropractic Care	Refer to carrier
Inpatient Services
Inpatient Hospital	50% after deductible
Maternity Delivery/Inpatient	50% after deductible
Outpatient Services
Outpatient Facility	20% after deductible
Mental Health Outpatient	20% after deductible
Lab/X-Ray	20% after deductible
Emergency Care
Emergency Room	$350 (waived if admitted) + 20% after deductible
Urgent Care	$50 + 20% after deductible
Ambulance	20% after deductible
Prescription Drugs
Rx Deductible	Integrated Medical/Rx
Rx Generic	20% after deductible (T1); 30% after deductible (T2)
Rx Preferred	20% after deductible (T1); 30% after deductible (T2)
Rx Non-Preferred	20% after deductible (T1); 30% after deductible (T2)
Recovery/ Special Needs
Home Health Care	20% after deductible; 100 visits per year
Durable Medical Equipment	20% after deductible

Optional Benefits	None

If you you have questions about the Anthem Blue Cross Bronze 5850 EPO plan or any other plans from Anthem Blue Cross of California please call The Lynn Company at (800)-326-5966 for more information on California Health Insurance Plans.

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Please note that we cannot bind insurance via email, fax, or voicemail. Any quotes given are subject to underwriting guidelines by the respective insurance carriers. Any reference of coverage used are not intended to express legal opinion as to the nature of coverage, but rather just a brief generalization of coverages. Please read your policy for coverage details.

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California Health Insurance: Anthem Blue Cross Bronze Pathway 5850 EPO

Anthem Bronze 5850 EPO