Anthem Bronze Pathway Guided Access HMO 5000 $45 $0 Virtual PCP $0 Select Drugs

Anthem Blue Cross and Blue Shield · 2026 plan year

Expanded BronzeHSA eligible
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$10,600
Family OOP max
$21,200

Compare with other Expanded Bronze plans in GA

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

Other cost-sharing reduction variants for this plan:

More Anthem Blue Cross and Blue Shield plans in GA

Monthly premiums by age

Rating Area 3

AgeIndividualIndividual + tobacco
Under 15$383$383
21$500$500
30$568$625
40$639$703
50$894$983
60$1,358$1,494
64 and over$1,501$1,651

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$45.00

Specialist

BenefitIn-network
Specialist Visit25.00% Coinsurance after deductible

Hospital

BenefitIn-network
Emergency Room Services$500.00 Copay after deductible + 50.00% 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 Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$85.00

Pharmacy

BenefitIn-network
Generic Drugs$30.00
Non-Preferred Brand Drugs40.00% Coinsurance after deductible
OFF_LABEL_DRUGS45.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs45.00% 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 Services25.00% Coinsurance after deductible

Other

BenefitIn-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental25.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing25.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Bone Marrow Transplant$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Chemotherapy25.00% Coinsurance after deductible
Chiropractic Care25.00% Coinsurance after deductible
CLINICAL_TRIALS$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Cosmetic Surgery$500.00 Copay after deductible + 50.00% Coinsurance after deductible
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 Care25.00% Coinsurance after deductible
Diabetes Education25.00% Coinsurance after deductible
Dialysis25.00% Coinsurance after deductible
Durable Medical Equipment25.00% Coinsurance after deductible
Emergency Transportation/Ambulance25.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services25.00% Coinsurance after deductible
Hearing Aids25.00% Coinsurance after deductible
HEART_TRANSPLANT$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Home Health Care Services25.00% Coinsurance after deductible
Hospice Services25.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Infertility Treatment25.00% Coinsurance after deductible
Infusion Therapy25.00% Coinsurance after deductible
Inpatient Physician and Surgical Services25.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services25.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling25.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$45.00
Outpatient Rehabilitation Services25.00% Coinsurance after deductible
Prenatal and Postnatal Care25.00% Coinsurance after deductible
Private-Duty NursingNot covered
Prosthetic Devices25.00% Coinsurance after deductible
Radiation25.00% Coinsurance after deductible
Reconstructive Surgery$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy25.00% Coinsurance after deductible
Rehabilitative Speech Therapy25.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility25.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services25.00% Coinsurance after deductible
Transplant$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders25.00% Coinsurance after deductible
Weight Loss Programs25.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
Well Child CareNo charge
X-rays and Diagnostic Imaging25.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 15 geographic areas.

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