Anthem Blue Cross And Blue Shield – Anthem Bronze Priority Lean Standard 0 Virtual Pcp 0 Select Drugs Incentives 02

Insurance Plan

Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

Type:HMO
Coverage:Individual

Summary

Plan Info & Network Details

Plan ID:79475WI0340225

State:WI

Metal Level:Expanded Bronze

HSA Eligible:No

Out-of-Network Coverage:No

Out-of-Country Coverage Description:Urgent/Emergency Coverage Only

Out-of-Service Area Description:TRAD/PAR network
National Network:No

Cost Sharing Details

Out of Pocket Maximum

Individual

$9200 per person

Family (Group)

$18400 per group

Deductible

Individual

$7500 per person

Family (Group)

$15000 per group

Coinsurance

Rate

50.00%

Out of Network Costs

Maximum

Individual

per person not applicable

Family (Group)

per group not applicable

Deductible

Individual

per person not applicable

Family (Group)

per group not applicable

Plan Features & Resources

The Plan Features & Resources section highlights important aspects of a health plan, such as specific options available to members, like the Child-Only Option, which enables enrollment for both adults and children separately. It also provides Additional Resources like downloadable brochures and links to the Premium Payment Website for managing payments. This section is designed to give users access to key features and helpful documents related to their plan.

Plan Features

Wellness Program: No
Disease Management Programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management
Notice Pregnancy : No
Referral Specialist : No
Child-Only Option: Allows Adult and Child-Only

Covered Services

Covered Services outlines the different types of services and areas covered by your insurance plan. This includes the Dental-Only Plan, which limits coverage to dental services only, excluding other health-related services. Out-of-Country Coverage refers to services provided outside the country, generally covered at an out-of-network level. Out-of-Service Area Coverage applies to services received outside of the designated service area, also typically covered at the out-of-network rate. Lastly, IN Coverage is specific to a certain state (for example, Indiana), indicating that coverage applies to services or providers within that state. These categories help define the scope of your plan's coverage and the areas where services are covered.

Cost Sharing for Common Conditions

Cost sharing for common conditions generally refers to the portion of health care costs that a person is responsible for under their health insurance plan. This includes different components like the deductible, copayment, coinsurance, and limits for specific medical conditions or treatments. The deductible is the amount a patient must pay out-of-pocket before their insurance begins covering the cost of care. Copayments are fixed amounts that the insured pays for medical services or prescriptions, while coinsurance is the percentage of costs that the insured must pay after the deductible has been met. Limits define the maximum amount a person will have to pay for a specific treatment or condition under their health insurance plan. Understanding these elements helps individuals plan for potential out-of-pocket expenses when managing common health conditions, ensuring they know what to expect financially.

Having a Baby

Deductible:$7,500
Copayment:$0
Coinsurance:$1,700
Limit:$60

Having Diabetes

Deductible:$4,000
Copayment:$700
Coinsurance:$0
Limit:$20

Having a Simple Fracture

Deductible:$2,100
Copayment:$500
Coinsurance:$0
Limit:$0

Plan Attributes

The Plan Attributes section provides an overview of the various features and details that define the structure of your insurance plan. This includes key attributes such as coverage limits, specific benefits, and services offered under the plan. It highlights important factors like the type of care covered, out-of-network options, and any additional resources available. Understanding these attributes will help you get a clear picture of your plan’s coverage and how it fits your healthcare needs.

No plan attributes available.

Service Area Coverage

The Service Area Coverage section outlines the geographical areas where your health plan provides coverage. It includes details on which counties or ZIP codes are covered, helping you to understand the locations where you can access healthcare services under your plan. This coverage may vary depending on whether the area is serviced by an in-network provider. Each county or ZIP code listed shows whether it is covered by the plan and any specific limitations or conditions tied to the location. Ensure your area is covered for full access to the plan's benefits.

No service area information available.

Hospitals That Accept This Insurance

The Hospitals That Accept This Insurance section provides a list of hospitals that are covered under the insurance plan you are currently reviewing. It includes important details such as the name of the hospital, the number of providers and beds available, the specialties offered, and the hospital's location. This section helps you find healthcare facilities that are included in your insurance network, ensuring that you receive the benefits your plan offers while seeking care. Data is available till 2025.

(0 Ratings)

University of Wisconsin Hospital and Clinics

2455

Providers

536

No. of Beds

Specialties:

General Acute Care Hospital

Location:

600 HIGHLAND AVE, MADISON, WI 53792-0001

(0 Ratings)

AURORA HEALTH CARE METRO, INC.

1625

Providers

1213

No. of Beds

Specialties:

General Acute Care Hospital
+5 more

Location:

2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215

(0 Ratings)

GUNDERSEN LUTHERAN MEDICAL CENTER INC

934

Providers

325

No. of Beds

Specialties:

General Acute Care Hospital
+4 more

Location:

1910 SOUTH AVE, LA CROSSE, WI 54601

(0 Ratings)

UnityPoint Health - Meriter

923

Providers

448

No. of Beds

Specialties:

General Acute Care Hospital
+2 more

Location:

202 S PARK ST, MADISON, WI 53715-1507

(0 Ratings)

PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INC.

755

Providers

400

No. of Beds

Specialties:

General Acute Care Hospital
+2 more

Location:

725 AMERICAN AVE, WAUKESHA, WI 53188

(0 Ratings)

THEDACARE REGIONAL MEDICAL CENTER-NEENAH INC

734

Providers

182

No. of Beds

Specialties:

General Acute Care Hospital

Location:

130 2ND ST, NEENAH, WI 54956-2883

(0 Ratings)

THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC

614

Providers

160

No. of Beds

Specialties:

General Acute Care Hospital

Location:

1818 N MEADE ST, APPLETON, WI 54911-3454

(0 Ratings)

AURORA MEDICAL CENTER GRAFTON

574

Providers

62

No. of Beds

Specialties:

General Acute Care Hospital

Location:

975 PORT WASHINGTON ROAD, GRAFTON, WI 53024

(0 Ratings)

AURORA MEDICAL CENTER KENOSHA

557

Providers

74

No. of Beds

Specialties:

General Acute Care Hospital
+7 more

Location:

10400 75TH ST, KENOSHA, WI 53142

(0 Ratings)

Aurora West Allis Medical Center

553

Providers

212

No. of Beds

Specialties:

General Acute Care Hospital

Location:

8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409

(0 Ratings)

BELLIN MEMORIAL HOSPITAL INC

492

Providers

242

No. of Beds

Specialties:

General Acute Care Hospital
+2 more

Location:

744 S WEBSTER AVE, GREEN BAY, WI 54301-3505

(0 Ratings)

AURORA BAYCARE MEDICAL CENTER

439

Providers

132

No. of Beds

Specialties:

General Acute Care Hospital
+6 more

Location:

2845 GREENBRIER RD, GREEN BAY, WI 54311-6519

+1988 more