Anthem Gold Pathway X Enhanced 500/40% ($0 Select Rx)

Anthem Blue Cross and Blue Shield · 2027 plan year

Gold
Ind. deductible
$500
Family deductible
$1,000
Ind. OOP max
$8,000
Family OOP max
$16,000

Compare with other Gold plans in NH

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

More Anthem Blue Cross and Blue Shield plans in NH

Monthly premiums by age

Rating Area 1

AgeIndividualIndividual + tobacco
Under 15$377$377
21$493$542
30$559$615
40$630$693
50$880$968
60$1,337$1,471
64 and over$1,478$1,626

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$25.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Non-Preferred Brand Drugs45.00% Coinsurance after deductible
Preferred Brand Drugs$60.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$25.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$60.00
AcupunctureNot covered
Allergy Testing40.00% Coinsurance after deductible
Bariatric Surgery40.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy40.00% Coinsurance after deductible
Chiropractic Care$25.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education$60.00
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services40.00% Coinsurance after deductible
Hearing Aids40.00% Coinsurance after deductible
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility Treatment40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$20.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling$25.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$25.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services40.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy40.00% Coinsurance after deductible
Rehabilitative Speech Therapy40.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$60.00
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$25.00
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 1 geographic area.

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