New Anthem Blue Cross Silver HMO Plan, Expanded Los Angeles Network

Individual HMO announcements for 2017

For 2017, Anthem Blue Cross will offer a new Silver Pathway HMO 2650 plan for Individual business. This plan meets Affordable Care Act (ACA) rules and will be sold off the exchange only. We also will expand our Pathway HMO network in Los Angeles County for members who buy plans on or off the exchange.

Silver Pathway HMO 2650

The new Anthem Silver Pathway HMO 2650 is modeled after another popular HMO plan sold in other states where we do business. In many cases, the HMO 2650 will be the lowest-cost option (after the Minimum Coverage plan for customers under age 30). It has a $2,650 individual deductible, a $5,100 individual out-of-pocket maximum and 25% coinsurance for inpatient and outpatient services.

Predictable copays include:

• $20 for the first three primary care office visits
• $10 for generic drugs (at a level 1 pharmacy)

Adding HMO medical groups in Los Angeles County

Effective January 1, 2017, Anthem Blue Cross will add medical groups to our Pathway HMO network in Los Angeles County for HMO members in our Pathway (off the exchange) and Pathway X (on the exchange) plans. When consumers select Pathway X – HMO on our Find a Doctor site as shown below:

The following message now appears on the search results page, with a link to a list of new medical groups:

“As of January 1, 2017, Anthem will be adding medical groups to the Pathway HMO network in Los Angeles County. The new HMO Medical groups are available here. Doctors associated with these new groups will display on Find a Doctor later in January. Please remember to check if your doctor or hospital is covered by your plan as shown on your ID card prior to seeing them for 2017.”

Our 2017 HMO plans are offered in the following California counties: El Dorado, Fresno, Los Angeles, Kings, Madera, Orange, Placer, Riverside, Sacramento, San Bernardino, Santa Clara, San Diego and Yolo.

Reminders about Pathway and Pathway X network

Anthem Blue Cross has the same network of doctors and hospitals on the exchange (Pathway X) and off the exchange (Pathway).

Also, our network is the same for our EPO and PPO members. So, for example, an EPO member can see a doctor or go to a hospital in a PPO area, as long as that doctor or hospital is in our Pathway network.

This article applies to:

• California
• Individual (under 65)