Anthem Silver Pathway Essentials X 900 S05 $0 Select Drugs

HMO Colorado, Inc. · 2027 plan year

Silver

Ind. deductible: $900
Family deductible: $1,800
Ind. OOP max: $2,600
Family OOP max: $5,200

Other cost-sharing reduction variants for this plan:

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

More HMO Colorado, Inc. plans in CO

Anthem Bronze Mountain Enhanced X 10800 HSA $0 Select Drugs Anthem Bronze Pathway Essentials X 5650 Rx Copay $0 Select Drugs Anthem Bronze Pathway X 5650 Rx Copay $0 Select Drugs Anthem Bronze Pathway X 6000 HSA $0 Select Drugs Anthem Bronze Pathway X 8300 for HSA

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	20.00% Coinsurance after deductible

Specialist

Benefit	In-network
Specialist Visit	20.00% Coinsurance after deductible

Hospital

Benefit	In-network
Emergency Room Services	20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	20.00% Coinsurance after deductible
Urgent Care Centers or Facilities	20.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	20.00% Coinsurance after deductible
Medical Service Drugs	20.00% Coinsurance after deductible
Non-Preferred Brand Drugs	25.00% Coinsurance after deductible
Non-Preferred Generic Drugs	25.00% Coinsurance after deductible
Preferred Brand Drugs	20.00% Coinsurance after deductible
Preventive Drugs	No charge
Specialty Drugs	30.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Intensive Outpatient for Mental/Behavioral Health	20.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder	20.00% Coinsurance after deductible
Mental Health Wellness Visit	No charge
Mental/Behavioral Health Inpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Prenatal Care	20.00% Coinsurance after deductible
Office Visit - Mental/Behavioral Health	20.00% Coinsurance after deductible
Office Visit - Substance Use Disorder	20.00% Coinsurance after deductible
Partial Hospitalization for Mental/Behavioral Health	20.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder	20.00% Coinsurance after deductible
Postpartum Mental/Behavioral Health	20.00% Coinsurance after deductible
Postpartum Substance Use Disorder	20.00% Coinsurance after deductible
Residential Day Treatment for Mental/Behavioral Health	20.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder	20.00% Coinsurance after deductible
Substance Use Disorder Prenatal Care	20.00% Coinsurance after deductible
Telehealth Mental/Behavioral Health	20.00% Coinsurance after deductible
Telehealth Substance Use Disorder	20.00% Coinsurance after deductible

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	No charge
Acupuncture	20.00% Coinsurance after deductible
Allergy Testing	20.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies	20.00% Coinsurance after deductible
Autism Spectrum Disorders - Assessment and Evaluation Services	20.00% Coinsurance after deductible
Bariatric Surgery	20.00% Coinsurance after deductible
Basic Dental Care - Child	50.00% Coinsurance after deductible
Chemotherapy	20.00% Coinsurance after deductible
Chiropractic Care	20.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	20.00% Coinsurance after deductible
Dental Check-Up for Children	No Charge after deductible
Diabetes Education	20.00% Coinsurance after deductible
Diabetic Supplies	20.00% Coinsurance after deductible
Dialysis	20.00% Coinsurance after deductible
Durable Medical Equipment	20.00% Coinsurance after deductible
Emergency Transportation/Ambulance	20.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Gender Affirming Care	20.00% Coinsurance after deductible
Habilitation Services	20.00% Coinsurance after deductible
Hearing Aids	20.00% Coinsurance after deductible
Home Health Care Services	20.00% Coinsurance after deductible
Hospice Services	20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	20.00% Coinsurance after deductible
Infusion Therapy	20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	20.00% Coinsurance after deductible
Inpatient Rehabilitation	20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	20.00% Coinsurance after deductible
Major Dental Care - Child	50.00% Coinsurance after deductible
Nutritional Counseling	20.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	20.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	20.00% Coinsurance after deductible
Outpatient Rehabilitation Services	20.00% Coinsurance after deductible
Prenatal and Postnatal Care	No charge
Private-Duty Nursing	20.00% Coinsurance after deductible
Prosthetic Devices	20.00% Coinsurance after deductible
Prosthetics: Legs and Arms	20.00%
Prosthetics: Recreational	20.00%
Radiation	20.00% Coinsurance after deductible
Reconstructive Surgery	20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	20.00% Coinsurance after deductible
Rehabilitative Occupational Therapy	20.00% Coinsurance after deductible
Rehabilitative Physical Therapy	20.00% Coinsurance after deductible
Rehabilitative Speech Therapy	20.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	20.00% Coinsurance after deductible
Standalone Laboratory	20.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	20.00% Coinsurance after deductible
Telehealth PCP	20.00% Coinsurance after deductible
Telehealth Specialist	20.00% Coinsurance after deductible
Transplant	20.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	20.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	20.00% Coinsurance after deductible

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