Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs)

Anthem Blue Cross and Blue Shield · 2026 plan year

Silver
Ind. deductible
$4,000
Family deductible
$8,000
Ind. OOP max
$9,200
Family OOP max
$18,400

Compare with other Silver plans in OH

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

More Anthem Blue Cross and Blue Shield plans in OH

Monthly premiums by age

Rating Area 4 — the lowest-priced of the 17 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$340
21$445
30$505
40$569
50$795
60$1,207
64 and over$1,335

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$35.00

Specialist

BenefitIn-network
Specialist Visit$70.00

Hospital

BenefitIn-network
Emergency Room Services$500.00 Copay after deductible + 30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$3.00
Non-Preferred Brand Drugs35.00% Coinsurance after deductible
Preferred Brand Drugs$40.00
Specialty Drugs40.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services30.00% Coinsurance after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$70.00
AcupunctureNot covered
Allergy Testing30.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - Adult40.00%
Basic Dental Care - ChildNot covered
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$35.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education$70.00
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids30.00% Coinsurance after deductible
Home Health Care Services30.00% Coinsurance after deductible
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Infertility Treatment30.00% Coinsurance after deductible
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - ChildNot covered
Nutritional Counseling30.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Prenatal and Postnatal Care30.00% Coinsurance after deductible
Private-Duty Nursing30.00% Coinsurance after deductible
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$35.00
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)$20.00
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services30.00% Coinsurance after deductible
Transplant$500.00 Copay after deductible + 30.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders30.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 88 geographic areas.

Open enrollment coming up?

Get notified when it opens — we'll remind you so you don't miss your window.