California Health Insurance: Anthem Blue Cross Bronze 60 D EPO

Anthem Bronze 60 D EPO

In-Network

Cost Share Information 
Individual Deductible  $6,300
Family Deductible  $12,600
Out of Pocket Limit-Individual  $6,800 (including deductible)
Out of Pocket Limit-Family  $13,600 (including deductible)
Co-Insurance  100%
Lifetime Maximum  Unlimited
Office Visits 
Primary Care  $75 deductible waived for 1st 3 visits
Specialist  $105 deductible waived for 1st 3 visits
Adult Preventive Care  No Charge
Child Preventive Care  No Charge

Maternity Prenatal/Postnatal Care 

Pre-No charge; Post-$75 deductible waived

1st 3 visits

Rehabilitation Services  $75 deductible waived
Chiropractic Care  Refer to carrier
Inpatient Services 
Inpatient Hospital 100% after deductible (up to OOP)
Maternity Delivery/Inpatient  100% after deductible (up to OOP)
Outpatient Services 
Outpatient Facility  100% after deductible (up to OOP)
Mental Health Outpatient  $75 deductible waived 1st 3 visits 
Lab/X-Ray  $40 deductible waived/100% after deductible 
Emergency Care 
Emergency Room  100% after deductible (up to OOP)
Urgent Care  $75 deductible waived 1st 3 visits 
Ambulance  100% after deductible (up to OOP)
Prescription Drugs 
Rx Deductible  $500 individual/$1000 family 
Rx Generic 

100% after deductible (up to OOP);

$500 max/script 

Rx Preferred 

100% after deductible (up to OOP);

$500 max/script 

Rx Non-Preferred 

100% after deductible (up to OOP);

$500 max/script 

Recovery/ Special Needs 
Home Health Care 

100% after deductible (up to OOP);

100 visits per year 

Durable Medical Equipment  100% after deductible (up to OOP)
 
Optional Benefits  None 
 
If you you have questions about the Anthem Blue Cross Bronze 60 D EPO plan or any other plans from Anthem Blue Cross of California please call The Lynn Company at (800)-326-5966 for more information on California Health Insurance Plans
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