450A BC Gold EPO Low
Anthem Blue Access EPO
Anthem Gold Blue Access EPO 15/35 — $1,750 deductible, 10% coinsurance, $15/$35 copays, no referrals. In-network only.
Monthly premiums
- Member
- $1,756.00/mo
- Member & Children
- $2,930.00/mo
- Member & Spouse
- $3,378.00/mo
- Member & Family
- $4,774.00/mo
Lower-cost Gold — $15 PCP / $35 specialist copays before the $1,750 deductible, 10% coinsurance.
Plan details
- Deductible (Individual)
- $1,950
- Deductible (Family)
- $3,900
- Out-of-Pocket Max (Individual)
- $8,700
- Out-of-Pocket Max (Family)
- $17,400
- Coinsurance (In-Network)
- 10%
- Primary Care Copay
- $15
- Specialist Copay
- $35
- Urgent Care Copay
- $60
- ER Copay
- $750
Benefits
Deductible
$1,950 / $3,900
OON: Not Covered
Max Out of Pocket
$8,700 / $17,400
OON: Not Covered
Copay
$15 / $35 / $60
PCP / Specialist / Urgent Care (before deductible)
Coinsurance
10% after deductible
Emergency Room
$750 copay
Waived if admitted
Rx Coverage
$10 / $40 / $80
Generic / Preferred / Non-Preferred; Rx ded on Tier 2–3
Pregnancy
Covered
10% after deductible
Mental Health
Covered
$15 outpatient; 10% inpatient
Hospital Admission
10% coinsurance
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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