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Anthem Blue Cross and Blue Shield of Connecticut SmartSense with Standard Rx – Connecticut Health Insurance Plan

A detailed comparison of the Anthem Blue Cross and Blue Shield of Connecticut SmartSense with Standard Rx health insurance plan as offered in Connecticut is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific Anthem Blue Cross and Blue Shield of Connecticut plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new Anthem Blue Cross and Blue Shield of Connecticut health insurance quote for Connecticut now or view all of our Anthem Blue Cross and Blue Shield of Connecticut health insurance quotes.

  Network Non-Network
Copay $30 50% Coinsurance
OfficeVisit Doctors' Office Visits -
  • Office Visit Copay for first 3 yearly visits: $30 Copay, deductible waived, for primary care physician or specialist visits
  • Office Visit Coinsurance for remaining visits: 30% Coinsurance
 Doctors' Office Visits: 50% Coinsurance
Deductible false Individual: $5,000, Family: $10,000 Individual: $5,000, Family: $10,000
Coinsurance 30% 50%
Coinsurance Limit
Out-of-Pocket Maximum N/A N/A
Lifetime Maximum None None
Prescription Drugs Standard Drug Coverage -
  • Separate $250 per person deductible for Tier 2 preferred brand drugs
  • Tier 1 Drugs: $15 Copay, deductible waived
  • Tier 2 Drugs: 40% Coinsurance
  • Tier 3 Drugs: Member is responsible for entire cost after Anthem
 Standard Drug Coverage -
  • Separate $250 per person deductible for Tier 2 preferred brand drugs
  • 50% Coinsurance up to the maximum allowable amount. Member is responsible for difference between Anthem allowable charge and actual cost of the dr
Emergency Room 30% Coinsurance 50% Coinsurance
Adult Preventative Care 0% Coinsurance, not subject to deductible (Covers nationally recommended preventive care for adults including PSA screenings, Pap tests, mammograms and more) 50% Coinsurance (Covers nationally recommended preventive care for adults including PSA screenings, Pap tests, mammograms and more)
Child Preventative Care 0% Coinsurance, not subject to deductible (Covers nationally recommended preventive care for children including immunizations and more) 50% Coinsurance (Covers nationally recommended preventive care for children including immunizations and more)
Lab / X-Ray 30% Coinsurance 50% Coinsurance
Maternity Not Covered Not Covered
Physical Therapy 30% Coinsurance (15 visits per year per person, in and out-of-network combined) 50% Coinsurance (15 visits per year per person, in and out-of-network combined)
Home Health Care
  • Home Health Care (member can not pay more than 25%/$420 Social Services - as state mandate): 25% Coinsurance (100 visit limited per person, in and out-of-network combined)
  • Hospice Care: 30% Coinsurance (Coverage if member is diagnosed as termina
    		•
  • Home Health Care (member can not pay more than 25%/$420 Social Services - as state mandate): 25% Coinsurance (100 visit limited per person, in and out-of-network combined)
  • Hospice Care: 50% Coinsurance (Coverage if member is diagnosed as termina
    		•
    Mental Health Mental Health Care/Substance Abuse (as stated in mandate) -
    • Inpatient: 30% Coinsurance
    • Outpatient: $30 Copay or 30% Coinsurance after deductible (applies to the 3 office visit copay limit)
    		 Mental Health Care/Substance Abuse (as stated in mandate) -
    • Inpatient: 50% Coinsurance
    • Outpatient: 50% Coinsurance
    Hospital Care
  • Professional and Diagnostic Services (X-ray, lab, anesthesia, surgeon, etc.): 30% Coinsurance
  • Inpatient Services (overnight hospital/facility stays): 30% Coinsurance
  • Outpatient Services (without overnight hospital/facility stays): 30% Coins
    		•
  • Professional and Diagnostic Services (X-ray, lab, anesthesia, surgeon, etc.): 50% Coinsurance
  • Inpatient Services (overnight hospital/facility stays): 50% Coinsurance
  • Outpatient Services (without overnight hospital/facility stays): 50% Coins
    		•
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