Is a specialist referral required?

No. The cited SBC states that a referral is not required to see a specialist.

What is the monthly premium?

The SBC states that premium information is provided separately. Obtain an official quote for the applicable location and applicant.

Anthem Bronze Pathway HMO 6000 S03 Benefits and Costs

Q: How much is primary care?

The SBC lists $50 per in-network non-IHCP primary-care visit, with no deductible applied.

Anthem Bronze Pathway HMO 6000 Overview

Anthem Bronze Pathway HMO 6000 $50 $0 Virtual PCP $0 Select Drugs S03 is a 2026 Individual and Family HMO plan documented for Georgia and Indiana. The official Summary of Benefits and Coverage lists a $6,000 individual or $12,000 family deductible for non-IHCP in-network care. The in-network out-of-pocket limit is $10,600 per individual or $21,200 per family. The SBC also lists selected services available before the deductible, including primary care, preventive care and vision services, subject to plan rules.

2026 Bronze Pathway HMO with $50 primary care, $6,000 individual deductible and select drug benefits.

Expert Review of Anthem Bronze Pathway HMO 6000

The plan lists a $50 in-network primary-care visit with no deductible applied and no-charge in-network preventive care. Specialist visits and many other services can involve 50% coinsurance after the deductible. Imaging, emergency care and hospital admissions can create substantial out-of-pocket costs. The plan uses a provider network and routine out-of-network care is generally not covered. Review the complete SBC, drug list and provider directory before enrolling.

Pros

Listed in-network preventive care is covered at no charge.
Primary-care visits have a $50 copay without applying the deductible.
The SBC includes virtual-care benefits and selected prescription-drug coverage.

Cons

The $6,000 individual deductible can leave members paying substantial upfront costs.
Specialist and many hospital services involve 50% coinsurance after the deductible.
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 Pathway HMO 6000 Features and Benefits

Primary care

In-network non-IHCP primary-care visits cost $50 per visit; the deductible does not apply.

Virtual-care benefits are available under the SBC.

Preventive care

Listed in-network preventive care, screenings and immunizations are covered at no charge.

Non-preventive services may have cost sharing.

Specialist care

In-network non-IHCP specialist visits are subject to 50% coinsurance after the deductible.

A referral is not required under the cited SBC.

Diagnostic tests and imaging

Office lab and X-ray services are listed at no charge; imaging is listed at $400 per day followed by 50% coinsurance.

Confirm service setting, authorization and applicable policy rules.

Prescription drugs

The SBC lists separate coinsurance for generic, preferred brand, non-preferred brand and specialty drug tiers.

Check the official Select Drug List and pharmacy requirements.

Hospital services

In-network hospital facility care is listed at $500 per admission followed by 50% coinsurance.

Substantial cost sharing may apply after the deductible.

Waiting Periods in Anthem Bronze Pathway HMO 6000

The cited SBC does not specify a general medical waiting period. Enrollment windows, effective dates and service-specific requirements may apply.

What Anthem Bronze Pathway HMO 6000 Does Not Cover (Exclusions)

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

Adult routine eye care is generally not covered.
Adult dental care is generally not covered.
Infertility treatment is generally not covered.
Private-duty nursing is generally not covered.
Weight-loss programs and bariatric surgery are generally not covered.
Acupuncture is generally not covered.
Cosmetic surgery is generally not covered.
Long-term care is generally not covered.
Non-emergency care while travelling outside the United States is generally not covered.
Routine foot care is generally not covered unless medically necessary.

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

What's missing in Anthem Bronze Pathway HMO 6000

The SBC does not publish a monthly premium; request an official location-specific quote.
Adult routine dental and adult routine eye care are listed among services generally not covered.
Review the current Summary of Benefits and Coverage for exclusions, prior authorization requirements and service-specific limitations.

Anthem Bronze Pathway HMO 6000 FAQs

What is the individual deductible?

The cited 2026 SBC lists $6,000 for non-IHCP in-network care.

What is the family deductible?

The cited SBC lists $12,000 for non-IHCP in-network family coverage.

What is the out-of-pocket limit?

The cited SBC lists $10,600 per individual and $21,200 per family for non-IHCP in-network care.

How much is primary care?