Anthem BCBS offers health plans that can be customized for individuals, children, and families that include consumer-directed plans. Anthem no longer offers PPOs on the individual market.

Starting in 2018 Anthem Indiana will only be offering off-exchange plans in Benton, Newton, White, Jasper and Warren counties.

2017 On-Exchange Plans

2017 Anthem On-Exchange Brochure

Blue Cross Gold Plans

Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan (1GFE)
Network name Pathway X HMO/POS
Plan includes out-of-network coverage? No
Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $1,000
Individual CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max $7,150
Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services (percentage may vary for some covered services) 10%
Preventive care1 No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) $30 copay
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 10% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 10% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then $300 copay and 50% coinsurance
Urgent care Deductible, then $50 copay and 10% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then $500 copay and 10% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then $500 copay and 50% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 10% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Retail pharmacy tier 14: level 1 / level 2 $10 copay / $20 copay
Retail pharmacy tier 24: level 1 / level 2 $40 copay / $50 copay
Retail pharmacy tier 3: level 1 / level 2 40% coinsurance / 50% coinsurance
Retail pharmacy tier 4: level 1 / level 2 40% coinsurance / 50% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 10% coinsurance
Speech therapy (limits apply) Deductible, then 10% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 10% coinsurance

Blue Cross Silver Plans

Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State Plan (1GFA) Anthem Silver Pathway X 2500 (1GF6)
Anthem Silver Pathway X for HSA (1GF2)
Network name Pathway X HMO/POS Pathway X HMO/POS
Pathway X HMO/POS
Plan includes out-of-network coverage? No No No
Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $2,000 $2,500 $3,000
Individual Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services $7,150 $7,150 $4,500
CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max (percentage may vary for some covered services) 20% 10% 10%
Preventive care1 No additional cost to you. No additional cost to you.
No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) $35 copay per visit for the first 3 visits, then deductible and 20% coinsurance $40 copay per visit for the first 3 visits, then deductible and 10% coinsurance
Deductible, then 10% coinsurance
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then $300 copay and 50% coinsurance Deductible, then $300 copay and 50% coinsurance
Deductible, then $300 copay and 50% coinsurance
Urgent care Deductible, then $50 copay and 20% coinsurance Deductible, then $50 copay and 10% coinsurance
Deductible, then $50 copay and 10% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then $500 copay and 20% coinsurance Deductible, then $500 copay and 10% coinsurance
Deductible, then $500 copay and 10% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then $500 copay and 50% coinsurance Deductible, then $500 copay and 50% coinsurance
Deductible, then $500 copay and 50% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Retail pharmacy tier 14: level 1 / level 2 $10 copay / $20 copay $15 copay / $25 copay
10% coinsurance / 20% coinsurance
Retail pharmacy tier 24: level 1 / level 2 $50 copay / $60 copay $50 copay / $60 copay
10% coinsurance / 20% coinsurance
Retail pharmacy tier 3: level 1 / level 2 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
40% coinsurance / 50% coinsurance
Retail pharmacy tier 4: level 1 / level 2 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
40% coinsurance / 50% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Speech therapy (limits apply) Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 20% coinsurance Deductible, then 10% coinsurance
Deductible, then 10% coinsurance
Anthem Silver Pathway X 3500 (1GEY) Anthem Silver Pathway X 4350 (1XA2)
Anthem Silver Core Pathway X 5300 (2EQD)
Network name Pathway X HMO/POS Pathway X HMO/POS
Pathway X HMO/POS
Plan includes out-of-network coverage? No No No
Individual deductible $3,500 $4,350 $5,300
Individual out-of-pocket limit $6,150 $5,700 $6,600
Coinsurance (percentage may vary for some covered services) 0% 30% 25%
Preventive care1 No additional cost to you. No additional cost to you.
No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) $45 copay $25 copay $30 copay
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 0% coinsurance $50 copay
Deductible, then 25% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 0% coinsurance Deductible, then 30% coinsurance
Deductible, then 25% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then $300 copay and 50% coinsurance Deductible, then $300 copay and 50% coinsurance
Deductible, then $300 copay and 50% coinsurance
Urgent care Deductible, then $50 copay $90 copay
Deductible, then $50 copay and 25% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then $500 copay Deductible, then 30% coinsurance
Deductible, then $500 copay and 25% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then $500 copay and 50% coinsurance Deductible, then $500 copay and 50% coinsurance
Deductible, then $500 copay and 50% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 0% coinsurance Deductible, then 30% coinsurance
Deductible, then 25% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy Tier 1: No deductible

Tier 2, 3, 4: $1,000 Combined pharmacy deductible

Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Retail Pharmacy tier 14: level 1 / level 2 $15 copay / $25 copay $10 copay / $20 copay
$10 copay / $20 copay
Retail pharmacy tier 24: level 1 / level 2 $50 copay / $60 copay $40 copay / $50 copay
$40 copay / $50 copay
Retail pharmacy tier 3: level 1 / level 2 40% coinsurance / 50% coinsurance 50% coinsurance / 50% coinsurance
40% coinsurance / 50% coinsurance
Retail pharmacy tier 4: level 1 / level 2 40% coinsurance / 50% coinsurance 50% coinsurance / 50% coinsurance
40% coinsurance / 50% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 0% coinsurance Deductible, then 30% coinsurance
Deductible, then 25% coinsurance
Speech therapy (limits apply) Deductible, then 0% coinsurance Deductible, then 30% coinsurance
Deductible, then 25% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 0% coinsurance Deductible, then 30% coinsurance
Deductible, then 25% coinsurance

Blue Cross Bronze Plans

Anthem Bronze Pathway X POS 5000 (1GEV) Anthem Bronze Pathway X 4950 (1XAE) Anthem Bronze Pathway X 20% for HSA (1GEW)
Network name Pathway X HMO/POS Pathway X HMO/POS Pathway X HMO/POS
Plan includes out-of-network coverage? Yes No No
Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $5,000 / $15,000

Network / Non-network

$4,950 $5,200
Individual Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services $7,150 / $30,000

Network / Non-network

$7,150 $6,550
CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max (percentage may vary for some covered services) 40% / 60%

Network / Non-network

50% 20%
Preventive care1 No additional cost to you. No additional cost to you. No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) $50 copay per visit for the first 2 visits, then deductible and 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then $500 copay and 50% coinsurance Deductible, then $300 copay and 50% coinsurance Deductible, then $500 copay and 50% coinsurance
Urgent care Deductible, then $50 copay and 40% coinsurance Deductible, then $75 copay and 50% coinsurance Deductible, then $50 copay and 20% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then $500 copay and 40% coinsurance Deductible, then $500 copay and 50% coinsurance Deductible, then $500 copay and 20% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then 50% coinsurance Deductible, then $1,500 copay and 50% coinsurance Deductible, then 20% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Retail pharmacy tier 14: level 1 / level 2 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance 20% coinsurance / 30% coinsurance
Retail pharmacy tier 24: level 1 / level 2 40% coinsurance / 50% coinsurance 50% coinsurance / 50% coinsurance 20% coinsurance / 30% coinsurance
Retail pharmacy tier 3: level 1 / level 2 40% coinsurance / 50% coinsurance 50% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
Retail pharmacy tier 4: level 1 / level 2 40% coinsurance / 50% coinsurance 50% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Speech therapy (limits apply) Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 40% coinsurance Deductible, then 50% coinsurance Deductible, then 20% coinsurance
Anthem Bronze Pathway X 5300 (1GEX) Anthem Bronze Pathway X 5850 (1XAB) Anthem Bronze Pathway X 6500 (1GET)
Network name Pathway X HMO/POS Pathway X HMO/POS Pathway X HMO/POS
Plan includes out-of-network coverage? No No No
Individual deductible $5,300 $5,850 $6,500
Individual out-of-pocket limit $7,150 $7,150 $7,150
Coinsurance (percentage may vary for some covered services) 20% 35% 30%
Preventive care1 No additional cost to you. No additional cost to you. No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) $45 copay per visit for the first 2 visits, then deductible and 20% coinsurance Deductible, then 35% coinsurance $50 copay per visit for the first 2 visits, then deductible and 30% coinsurance
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then $500 copay and 50% coinsurance Deductible, then $300 copay and 50% coinsurance Deductible, then $400 copay and 50% coinsurance
Urgent care Deductible, then $50 copay and 20% coinsurance Deductible, then $75 copay and 35% coinsurance Deductible, then $50 copay and 30% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then $500 copay and 20% coinsurance Deductible, then $500 copay and 35% coinsurance Deductible, then $450 copay and 30% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then 20% coinsurance Deductible, then $1,000 copay and 50% coinsurance Deductible, then 30% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2: No deductible

Tier 3, 4: Medical deductible applies

Retail Pharmacy tier 14: level 1 / level 2 20% coinsurance / 30% coinsurance 35% coinsurance / 45% coinsurance $20 copay / $30 copay
Retail pharmacy tier 24: level 1 / level 2 20% coinsurance / 30% coinsurance 35% coinsurance / 45% coinsurance $80 copay / $90 copay
Retail pharmacy tier 3: level 1 / level 2 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
Retail pharmacy tier 4: level 1 / level 2 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance 40% coinsurance / 50% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Speech therapy (limits apply) Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 20% coinsurance Deductible, then 35% coinsurance Deductible, then 30% coinsurance
Anthem Bronze Pathway X 0% for HSA (1GES)
Anthem Bronze Pathway X 7150 (1XAG)
Network name Pathway X HMO/POS
Pathway X HMO/POS
Plan includes out-of-network coverage? No No
Individual deductible $6,550 $7,150
Individual out-of-pocket limit $6,550 $7,150
Coinsurance (percentage may vary for some covered services) 0% 0%
Preventive care1 No additional cost to you.
No additional cost to you.
Office visit: primary care physician (PCP)2,3 (Other office services may be subject to deductible and plan coinsurance) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Office visit: specialist (Other office services may be subject to deductible and plan coinsurance) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Outpatient diagnostic tests (Ex. X-ray, EKG) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Outpatient advanced diagnostic tests (Ex. MRI, CT scan) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Urgent care Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Emergency room care (Copay waived if admitted into the hospital from the emergency room.) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Hospital: inpatient admission (includes maternity, mental health / substance use) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Hospital: outpatient surgery hospital facility

(includes maternity, mental health / substance use)

Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Pharmacy deductible3 (for tiers with deductible, cost share applies after deductible) Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Level 1 / Level 2 Pharmacy

Tier 1, 2, 3, 4: Medical deductible applies

Retail pharmacy tier 14: level 1 / level 2 0% coinsurance / 0% coinsurance
0% coinsurance / 0% coinsurance
Retail pharmacy tier 24: level 1 / level 2 0% coinsurance / 0% coinsurance
0% coinsurance / 0% coinsurance
Retail pharmacy tier 3: level 1 / level 2 0% coinsurance / 0% coinsurance
0% coinsurance / 0% coinsurance
Retail pharmacy tier 4: level 1 / level 2 0% coinsurance / 0% coinsurance
0% coinsurance / 0% coinsurance
Physical and occupational therapy (limits apply) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Speech therapy (limits apply) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Office visit: chiropractic (limits apply) Deductible, then 0% coinsurance
Deductible, then 0% coinsurance
Contact Us

Phone: (312) 726-6565
Email: [email protected]

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