Does the plan have a separate prescription drug deductible?

Yes. The SBC lists $600 per individual and $1,200 per family for in-network prescription drugs.

What is the monthly premium?

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

Anthem Gold Pathway 2300 Review (2026)

Q: How much is a specialist visit?

The SBC lists a $50 in-network specialist copay and says no referral is required.

Anthem Gold Pathway 2300 Overview

Anthem Gold Pathway 2300 ($0 Virtual PCP + $0 Select Drugs + Incentives) is a 2026 Individual and Family HMO documented for Kentucky and Indiana. The official SBC lists an in-network deductible of $2,300 per individual and $4,600 per family, plus an in-network out-of-pocket limit of $7,250 per individual and $14,500 per family. Primary care visits are $15 and specialist visits are $50, with the deductible not applying to these visits. The plan also lists a separate prescription drug deductible of $600 per individual and $1,200 per family. Premiums are provided separately and depend on the member’s circumstances and location.

$15 primary care and $50 specialist copays; $5 Tier 1 generic prescriptions under the 2026 SBC.

Expert Review of Anthem Gold Pathway 2300

This Gold HMO offers fixed primary care and specialist copays before the main deductible, which may help members who expect regular office visits. However, hospital facility costs and imaging can involve substantial coinsurance, and the separate prescription drug deductible is important to consider. Routine out-of-network care is generally not covered. Confirm local availability, the provider network, drug formulary and full policy terms before enrollment.

Pros

Primary care visits have a stated $15 copay before the main deductible.
Specialist visits have a stated $50 copay and do not require a referral under the SBC.
In-network preventive care is listed at no charge.

Cons

The individual in-network deductible is $2,300.
A separate prescription drug deductible applies to certain drug tiers.
Hospital facility and imaging services can involve substantial coinsurance.

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 Gold Pathway 2300 Features and Benefits

In-network deductible

$2,300 per individual and $4,600 per family.

Applies to in-network services according to the SBC; some listed services are covered before the deductible.

Out-of-pocket limit

$7,250 per individual and $14,500 per family for in-network providers.

Premiums, balance-billing charges and non-covered care are not included in this limit.

Primary care visits

$15 per visit; the main medical deductible does not apply.

Virtual visit benefits are also listed; confirm the applicable service terms.

Specialist visits

$50 per visit; the main medical deductible does not apply.

The SBC says no referral is required for specialist visits.

Prescription drug coverage

A separate $600 individual / $1,200 family prescription drug deductible applies to certain drug tiers. Tier 1 generic drugs are listed at $5 per retail prescription.

Higher tiers have different copays or coinsurance. Check the current Select Drug List.

Preventive and virtual care

Preventive care is listed at no charge in-network; virtual visits are available.

Services that are not preventive may have different cost-sharing.

What Anthem Gold Pathway 2300 Does Not Cover (Exclusions)

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

Adult dental care.
Adult routine eye care.
Infertility treatment.
Weight-loss programs.
Acupuncture.
Cosmetic surgery.
Long-term care.
Routine foot care.
Bariatric surgery.
Non-emergency care outside the United States.
Routine out-of-network services unless an exception applies.

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

What's missing in Anthem Gold Pathway 2300

Adult dental care is excluded in the referenced SBC.
Adult routine eye care is excluded in the referenced SBC; check separate vision options independently.
Review the current Summary of Benefits and Coverage for exclusions, prior authorization requirements and service-specific limitations.

Anthem Gold Pathway 2300 FAQs

What is the deductible for Anthem Gold Pathway 2300?

The 2026 SBC lists $2,300 per individual and $4,600 per family for in-network providers.

What is the out-of-pocket limit?

The SBC lists $7,250 per individual and $14,500 per family for in-network providers.

How much is a primary care visit?

The SBC lists a $15 in-network primary care copay, with the main medical deductible not applying.

How much is a specialist visit?