| Field | Data |
|---|---|
| Health Insurance Plan ID | 17575IN0700043 |
| Health Insurance Plan Year | 2023 |
| State | Indiana |
| Health Insurance Issuer | Anthem Ins Companies Inc(Anthem BCBS) |
| Last Plan Update Date | Sat, 13 May 2023 00:00 GMT |
| Last Import Date | Sun, 28 May 2023 07:51 GMT |
| Health Insurance Plan Variant | 17575IN0700043-02 |
| Available Variants of the Health Plan | |
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 1 |
| Begin Primary Care Cost-Sharing After Number Of Visits | 0 |
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 0 |
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Zero Cost Sharing Plan Variation |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 62% |
| Formulary ID | INF013 |
| Formulary URL | URL |
| HIOS Product ID | 17575IN070 |
| Import Date | 2/23/2023 1:01 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | $0.00 |
| Inpatient Copayment Maximum Days | 0 |
| HSA Eligible | No |
| New/Existing Plan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 100.00% |
| Issuer ID | 17575 |
| Issuer Marketplace Marketing Name | Anthem Blue Cross and Blue Shield |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Silver |
| Multiple In Network Tiers | Yes |
| National Network | No |
| Network ID | INN005 |
| Out of Country Coverage | No |
| Out of Country Coverage Description | Urgent/Emergency Coverage Only |
| Out of Service Area Coverage | No |
| Out of Service Area Coverage Description | TRAD/PAR network |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 17575IN0700043-02 |
| Plan Marketing Name | Anthem Silver Pathway Essentials 6000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) |
| Plan Type | HMO |
| Plan Variant Marketing Name | Anthem Silver Pathway Essentials 6000 AI |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $0 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $0 |
| SBC Scenario, Having Diabetes, Deductible | $0 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Second Tier Utilization | 38% |
| Service Area ID | INS021 |
| Source Name | HIOS |
| Plan ID | 17575IN0700043 |
| State Code | IN |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | Not Applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | per group not applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | per person not applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $0 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $0 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $0 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Group | $0 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Person | $0 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual | $0 |
| TEHBDedOutOfNetFamilyPerGroup | per group not applicable |
| TEHBDedOutOfNetFamilyPerPerson | per person not applicable |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | Not Applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group | $0 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $0 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group | $0 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual | $0 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | Not Applicable |
| Unique Plan Design | Yes |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | No |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Anthem Silver Pathway Essentials 6000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs), 17575IN0700043 Health Insurance Plan, 17575IN0700043
Does Anthem Silver Pathway Essentials 6000 ($0 Virtual PCP + $0 Virtual Chat + $0 Select Drugs) Health Insurance Plan, 17575IN0700043 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (17575IN0700043) Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management
Does (17575IN0700043) Health Insurance Plan, Variant (17575IN0700043-02) have Out Of Country Coverage?
No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan). Details: Urgent/Emergency Coverage Only
Does (17575IN0700043) Health Insurance Plan, Variant (17575IN0700043-02) have Out of Service Area Coverage?
No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan). Details: TRAD/PAR network
Does (17575IN0700043) Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Asthma?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Asthma.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Heart disease?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Heart disease.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Depression?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Depression.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Diabetes?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Diabetes.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for High blood pressure & high cholesterol.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Low back pain?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Low back pain.
Does Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan, Variant (17575IN0700043-02) offer Disease Management Programs for Pain management?
Yes, the Anthem Silver Pathway Essentials 6000 AI Health Insurance Plan Variant 17575IN0700043-02 offers Disease Management Program for Pain management.
Disclaimer: This is based on the import(Date: Sun, 28 May 2023 07:51 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API