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California Health Insurance: Anthem Blue Cross Bronze Pathway 1900 EPO

Anthem Bronze Pathway 1900 EPO	In-Network
Cost Share Information
Individual Deductible	$1,900
Family Deductible	$3,800
Out of Pocket Limit-Individual	$6,350 (including deductible)
Out of Pocket Limit-Family	$12,700 (including deductible)
Co-Insurance	30%
Lifetime Maximum	Unlimited
Office Visits
Primary Care	$35 ded waived visits 1-3; 30% after deductible visits 4+
Specialist	30% after deductible
Adult Preventive Care	No Charge
Child Preventive Care	No Charge
Maternity Prenatal/Postnatal Care	Pre-No charge; Post-$35deductible waived visits 1-3/30% after deductible visits 3+
Rehabilitation Services	30% after deductible
Chiropractic Care	Refer to carrier
Inpatient Services
Inpatient Hospital	50% after deductible
Maternity Delivery/Inpatient	50% after deductible
Outpatient Services
Outpatient Facility	30% after deductible
Mental Health Outpatient	30% after deductible
Lab/X-Ray	30% after deductible
Emergency Care
Emergency Room	$200 (waived if admitted) + 30% after deductible
Urgent Care	$50 + 30% after deductible
Ambulance	30% after deductible
Prescription Drugs
Rx Deductible	Integrated Medical/Rx
Rx Generic	$9 deductible waived (T1); $19 deductible waived (T2)
Rx Preferred	$40 deductible waived(T1); $50 deductible waived (T2)
Rx Non-Preferred	40% after deductible (T1); 50% after deductible (T2)
Recovery/ Special Needs
Home Health Care	30% after deductible; 100 visits per year
Durable Medical Equipment	30% after deductible

Optional Benefits	None

If you you have questions about the Anthem Blue Cross Bronze 1900 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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California Health Insurance: Anthem Blue Cross Bronze Pathway 1900 EPO

Anthem Bronze Pathway 1900 EPO