Anthem Gold Pathway Guided Access HMO 1350 $20 $0 Virtual PCP $0 Select Drugs
Anthem Blue Cross and Blue Shield · 2026 plan year
Gold
- Ind. deductible
- $1,350
- Family deductible
- $2,700
- Ind. OOP max
- $9,600
- Family OOP max
- $19,200
Compare with other Gold 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 8
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $563 | $563 |
| 21 | $736 | $736 |
| 30 | $836 | $919 |
| 40 | $941 | $1,035 |
| 50 | $1,315 | $1,447 |
| 60 | $1,998 | $2,198 |
| 64 and over | $2,209 | $2,430 |
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 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $65.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 10.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 45.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 10.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | 40.00% Coinsurance after deductible |
| OFF_LABEL_DRUGS | 45.00% Coinsurance after deductible |
| Preferred Brand Drugs | $60.00 |
| Specialty Drugs | 45.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 45.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | 10.00% Coinsurance after deductible |
Other
| Benefit | In-network |
|---|---|
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 10.00% Coinsurance after deductible |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | $65.00 |
| Acupuncture | Not covered |
| Allergy Testing | 10.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Bone Marrow Transplant | 45.00% Coinsurance after deductible |
| Chemotherapy | 10.00% Coinsurance after deductible |
| Chiropractic Care | 10.00% Coinsurance after deductible |
| CLINICAL_TRIALS | 45.00% Coinsurance after deductible |
| Cosmetic Surgery | 45.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 45.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Care | $65.00 |
| Diabetes Education | $65.00 |
| Dialysis | 10.00% Coinsurance after deductible |
| Durable Medical Equipment | 10.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 10.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | 10.00% Coinsurance after deductible |
| Hearing Aids | 10.00% Coinsurance after deductible |
| HEART_TRANSPLANT | 45.00% Coinsurance after deductible |
| Home Health Care Services | 10.00% Coinsurance after deductible |
| Hospice Services | 10.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 35.00% Coinsurance after deductible |
| Infertility Treatment | 10.00% Coinsurance after deductible |
| Infusion Therapy | 10.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 10.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 10.00% 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 | 10.00% Coinsurance after deductible |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20.00 |
| Outpatient Rehabilitation Services | 10.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | 10.00% Coinsurance after deductible |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 10.00% Coinsurance after deductible |
| Radiation | 10.00% Coinsurance after deductible |
| Reconstructive Surgery | 45.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 10.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 10.00% 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 | 10.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 45.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | 10.00% Coinsurance after deductible |
| Transplant | 45.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 10.00% Coinsurance after deductible |
| Weight Loss Programs | $65.00 |
| Well Baby Visits and Care | No charge |
| Well Child Care | No charge |
| X-rays and Diagnostic Imaging | 10.00% Coinsurance after deductible |
Plan rules
Service area
This plan covers 2 geographic areas.
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