Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Anthem Blue Cross and Blue Shield · 2026 plan year

Silver

Ind. deductible: $3,100
Family deductible: $6,200
Ind. OOP max: $10,150
Family OOP max: $20,300

Compare with other Silver plans in MO

Side by side: deductibles, out-of-pocket limits and copays.

Medica with SSM Health Silver $0 Copay PCP VisitsMedica · Deductible $3,500 · Out-of-pocket max $10,450
UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals)UnitedHealthcare · Deductible $3,500 · Out-of-pocket max $10,300
Medica with MU Health Care Silver $0 Copay PCP VisitsMedica · Deductible $3,500 · Out-of-pocket max $10,450

Compare 4 plans Browse all Silver plans in MO

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan 94% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Zero Cost Sharing Plan Variation

More Anthem Blue Cross and Blue Shield plans in MO

Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Bronze Pathway Essentials 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Silver Pathway Essentials 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Gold Pathway Essentials 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 6 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$335	$335
21	$438	$470
30	$497	$534
40	$559	$601
50	$782	$840
60	$1,188	$1,277
64 and over	$1,313	$1,411

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$25.00

Specialist

Benefit	In-network
Specialist Visit	$75.00

Hospital

Benefit	In-network
Emergency Room Services	30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	30.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$75.00

Pharmacy

Benefit	In-network
Generic Drugs	$3.00
Non-Preferred Brand Drugs	35.00% Coinsurance after deductible
Preferred Brand Drugs	30.00% Coinsurance after deductible
Specialty Drugs	40.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	30.00% Coinsurance after deductible

Other

Benefit	In-network
Chemotherapy	30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	30.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	$75.00
Acupuncture	Not covered
Allergy Testing	30.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies	30.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Bone Marrow Testing	30.00% Coinsurance after deductible
Chiropractic Care	$25.00
Clinical Trials	40.00% Coinsurance after deductible
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	40.00% Coinsurance after deductible
Dental Anesthesia	30.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	$75.00
Dialysis	30.00% Coinsurance after deductible
Durable Medical Equipment	30.00% Coinsurance after deductible
Emergency Transportation/Ambulance	30.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	30.00% Coinsurance after deductible
Hearing Aids	30.00% Coinsurance after deductible
Home Health Care Services	30.00% Coinsurance after deductible
Hospice Services	30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	30.00% Coinsurance after deductible
Inherited Metabolic Disorder - PKU	35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	30.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	Not covered
Newborn Hearing Screening	40.00% Coinsurance after deductible
Nutritional Counseling	30.00% Coinsurance after deductible
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$25.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	30.00% Coinsurance after deductible
Outpatient Rehabilitation Services	30.00% Coinsurance after deductible
Prenatal and Postnatal Care	30.00% Coinsurance after deductible
Private-Duty Nursing	30.00% Coinsurance after deductible
Prosthetic Devices	30.00% Coinsurance after deductible
Radiation	30.00% Coinsurance after deductible
Reconstructive Surgery	40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$25.00
Rehabilitative Speech Therapy	30.00% Coinsurance after deductible
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	No charge
Routine Foot Care	$75.00
Skilled Nursing Facility	30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	30.00% Coinsurance after deductible
Transplant	40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	30.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	30.00% Coinsurance after deductible