Does the plan cover out-of-network care?

Routine out-of-network services are generally not covered. The SBC lists exceptions for certain emergency services.

What is the monthly premium?

The SBC does not state the premium. Request an official quote based on location and eligibility.

Anthem Bronze Essential 6500 Review (2026)

Q: Does the plan cover preventive care?

Yes. In-network preventive care, screening and immunization are listed at no charge.

Anthem Bronze Essential 6500 Overview

Anthem Bronze Essential 6500 (+ Incentives) S03 is a 2026 Individual and Family HMO documented in the Indiana Summary of Benefits and Coverage. The in-network deductible is $6,500 per individual and $13,000 per family, while the in-network out-of-pocket limit is $8,450 per individual and $16,900 per family. After the deductible, many listed in-network services have 10% coinsurance. In-network preventive care is listed at no charge, and the SBC says no specialist referral is required. Premiums are provided separately and vary according to location and eligibility.

Preventive care at no charge in-network; many covered services have 10% coinsurance after the deductible.

Expert Review of Anthem Bronze Essential 6500

This Bronze HMO has a relatively high deductible, so members may pay substantial costs before deductible-based benefits begin. Once the deductible is met, many covered in-network services listed in the SBC have 10% coinsurance. Preventive care is covered at no charge in-network. Routine out-of-network services are generally not covered, with exceptions such as emergency care. The cited document is for Indiana, so verify the plan availability, network, drug formulary and exact benefits for the applicant’s state before enrollment.

Pros

In-network preventive care is listed at no charge.
Many covered in-network services have 10% coinsurance after the deductible.
The SBC states that a specialist referral is not required.

Cons

The in-network individual deductible is $6,500.
Many covered services require the member to meet the deductible before coinsurance applies.
Routine out-of-network services are generally not covered.

About Elevance Health (Insurer Profile)

Elevance Health

Key Insights

Founded

1944

Elevance Health was established 82 years ago and has built strong credibility over time, backed by its long-standing presence in the market.

Claims Experience

0% CSR, calculated as a 3-year average

Elevance Health settles 0% of all claims it receives.

Network Hospitals

9000+

Elevance Health has a network of 9000+ hospitals, ensuring wide accessibility and convenience for policyholders.

Anthem Bronze Essential 6500 Features and Benefits

In-network deductible

$6,500 per individual and $13,000 per family for Non-IHCP in-network providers.

The SBC lists different treatment for Indian Health Care Providers (IHCP) and qualifying referrals.

Out-of-pocket limit

$8,450 per individual and $16,900 per family for Non-IHCP in-network providers.

Premiums, balance-billing charges and non-covered care do not count toward this limit.

Primary and specialist visits

After the deductible, primary care and specialist visits are listed at 10% coinsurance for Non-IHCP in-network providers.

The SBC states that virtual visits are available and no specialist referral is required.

Preventive care

Covered in-network preventive care, screening and immunization are listed at no charge.

Non-preventive services performed during the same visit may have different cost sharing.

Prescription drugs

The SBC lists 10% coinsurance for Level 1 drugs and 25% for Level 2 retail drugs for Non-IHCP in-network providers.

Drug coverage differs by tier and dispensing method. Check the current Select Drug List.

Hospital and emergency services

Many listed in-network hospital, emergency room and outpatient surgery services have 10% coinsurance after the deductible.

Emergency and ambulance rules differ from routine out-of-network care; review the full SBC.

What Anthem Bronze Essential 6500 Does Not Cover (Exclusions)

Conditions or treatments that the policy clearly says it will not cover.

Adult dental care.
Routine adult eye care.
Children’s dental check-ups.
Hearing aids.
Non-emergency care when travelling outside the United States.
Weight-loss programs.
Acupuncture.
Cosmetic surgery.
Infertility treatment.
Bariatric surgery.
Long-term care.
Routine foot care unless medically necessary.
Abortion, except in the circumstances described in the SBC.

Disclaimer: For illustration purposes only - exact terms are in the policy wording.

What's missing in Anthem Bronze Essential 6500

Adult dental care and routine adult eye care are excluded in the cited SBC.
Non-emergency care outside the United States is generally not covered.
Review the current Summary of Benefits and Coverage for exclusions, prior authorization requirements and service-specific limitations.

Anthem Bronze Essential 6500 FAQs

What is the deductible for Anthem Bronze Essential 6500?

The 2026 Indiana SBC lists $6,500 per individual and $13,000 per family for Non-IHCP in-network providers.

What is the out-of-pocket maximum?

The SBC lists $8,450 per individual and $16,900 per family for Non-IHCP in-network providers.

How much are primary care and specialist visits?

After the deductible, both are listed at 10% coinsurance for Non-IHCP in-network providers.

Does the plan cover preventive care?