Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)

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 WI

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

Partners HMO Bronze 6000 Ded/10600 MOOP HSAGroup Health Cooperative-SCW · Deductible $6,000 · Out-of-pocket max $10,600
Better Together HMO Bronze 6500 Ded/8750 MOOP HSAGroup Health Cooperative-SCW · Deductible $6,500 · Out-of-pocket max $8,750
NE WI Select $6,800 Plus Bronze HSAHealthPartners · Deductible $6,800 · Out-of-pocket max $10,600

Compare 4 plans Browse all Expanded Bronze plans in WI

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Bronze Off Exchange Plan Zero Cost Sharing Plan Variation

More Anthem Blue Cross and Blue Shield plans in WI

Anthem Bronze Pathway/Lean HSA (+ Incentives)Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

Monthly premiums by age

Rating Area 12

Age	Individual
Under 15	$267
21	$349
30	$397
40	$447
50	$624
60	$948
64 and over	$1,048

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	40.00% Coinsurance after deductible

Specialist

Benefit	In-network
Specialist Visit	$60.00 + 40.00% Coinsurance after deductible

Hospital

Benefit	In-network
Emergency Room Services	$500.00 Copay after deductible + 40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	$1500.00 Copay per Stay after deductible + 40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	40.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$75.00

Pharmacy

Benefit	In-network
Preferred Brand Drugs	30.00% Coinsurance after deductible
Generic Drugs	$10.00
Non-Preferred Brand Drugs	40.00% Coinsurance after deductible
Specialty Drugs	45.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	$1500.00 Copay per Stay after deductible + 40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	40.00% Coinsurance after deductible

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	$60.00 Copay with deductible + 40.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	Not covered
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Chemotherapy	40.00% Coinsurance after deductible
Chiropractic Care	40.00% Coinsurance after deductible
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	$1500.00 Copay after deductible + 40.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	$60.00 Copay with deductible + 40.00% Coinsurance after deductible
Dialysis	40.00% Coinsurance after deductible
Durable Medical Equipment	40.00% Coinsurance after deductible
Emergency Transportation/Ambulance	40.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	40.00% Coinsurance after deductible
Hearing Aids	40.00% Coinsurance after deductible
Home Health Care Services	40.00% Coinsurance after deductible
Hospice Services	40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	40.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	Not covered
Nutritional Counseling	Not covered
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	40.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	40.00% Coinsurance after deductible
Outpatient Rehabilitation Services	40.00% Coinsurance after deductible
Prenatal and Postnatal Care	40.00% Coinsurance after deductible
Private-Duty Nursing	Not covered
Prosthetic Devices	40.00% Coinsurance after deductible
Radiation	40.00% Coinsurance after deductible
Reconstructive Surgery	$1500.00 Copay after deductible + 40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	40.00% Coinsurance after deductible
Rehabilitative Speech Therapy	40.00% 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	Not covered
Skilled Nursing Facility	40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	$1500.00 Copay per Stay after deductible + 40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	40.00% Coinsurance after deductible
Transplant	$1500.00 Copay after deductible + 40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	40.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	40.00% Coinsurance after deductible