450A BC Silver EPO HSA
Anthem Blue Access EPO
Anthem Silver Blue Access EPO 20/50 HSA — $4,000 deductible, 30% coinsurance, HSA-compatible, no referrals. In-network only.
Monthly premiums
- Member
- $1,489.00/mo
- Member & Children
- $2,473.00/mo
- Member & Spouse
- $2,847.00/mo
- Member & Family
- $4,030.00/mo
HSA-compatible Anthem EPO — $4,000 deductible, then $20 PCP / $50 specialist copays and 30% coinsurance.
Plan details
- Deductible (Individual)
- $4,000
- Deductible (Family)
- $8,000
- Out-of-Pocket Max (Individual)
- $8,450
- Out-of-Pocket Max (Family)
- $16,900
- Coinsurance (In-Network)
- 30%
- Primary Care Copay
- $20
- Specialist Copay
- $50
- Urgent Care Copay
- $100
- ER Copay
- $500
Benefits
Deductible
$4,000 / $8,000
OON: Not Covered · HSA-compatible
Max Out of Pocket
$8,450 / $16,900
OON: Not Covered
Copay
$20 / $50 / $100
PCP / Specialist / Urgent Care (after deductible)
Coinsurance
30% after deductible
Emergency Room
$500 copay
After deductible; waived if admitted
Rx Coverage
$10 / $50 / $90
Generic / Preferred / Non-Preferred; after deductible
Pregnancy
Covered
30% prenatal; $1,500 delivery admission
Mental Health
Covered
$20 outpatient; $1,500 inpatient admission
Hospital Admission
$1,500 copay
Per admission, after deductible
Referrals
Not Required
Dependents
To Age 26
Coverage
Nationwide
Anthem Blue Access EPO
Work Requirement
Work Required
Plan documents
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