Your source for health insurance quotes and plans.

Anthem Blue Cross and Blue Shield of Virginia SmartSense – Virginia Health Insurance Plan

A detailed comparison of the Anthem Blue Cross and Blue Shield of Virginia SmartSense health insurance plan as offered in Virginia 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 Virginia 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 Virginia health insurance quote for Virginia now or view all of our Anthem Blue Cross and Blue Shield of Virginia health insurance quotes.

  Network Non-Network
Copay $35 $35
OfficeVisit
  • Office Visit Copay for first 3 yearly visits: $35 Copay, deductible waived, for primary care physician or specialist visits.
  • Office Visit Coinsurance for remaining visits: 30% Coinsurance.
 Office Visits: 50% coinsurance
Deductible false Individual: $3,500, Family: $7,000 Individual: $3,500, Family: $7,000
Coinsurance 30% 50%
Coinsurance Limit
Out-of-Pocket Maximum
Lifetime Maximum Unlimited Unlimited
Prescription Drugs Retail Drugs (and Mail Order Drugs when available) -
  • For Drugs on Formulary (Generic and Brand Name/Specialty Drugs): $15 Copay or 40% Coinsurance
  • For Drugs Not on Formulary: Not covered
 Retail Drugs (and Mail Order Drugs when available): Same benefit as network, however, member is responsible for filing the claim and for filing the difference between the pharmacy charge and our allowable charge plus applicable copay or coinsurance
Emergency Room
    Emergency Room (Medical Emergency or Accident): 30% or 0% Coinsurance(Coinsurance is designated by the deductible you choose. If the network coinsurance is 30%, the non-network coinsurance is 50%. If the network coinsurance is 0%, the non-network coin
    Emergency Room (Medical Emergency or Accident): 30% or 0% Coinsurance (Coinsurance is designated by the deductible you choose. If the network coinsurance is 30%, the non-network coinsurance is 50%. If the network coinsurance is 0%, the non-network coi
Adult Preventative Care Includes preventive services recommended by the United States Preventive Services Task Force, PSA screenings, pap tests, and more: 0% Coinsurance, not subject to deductible. Member pays 30% coinsurance
Child Preventative Care Preventive Care Services - Preventive Care and Immunizations for Children age 6 and under (Includes coverage for office visits, lab tests, vision and hearing screenings and immunizations): 0% copay and deductible waived Preventive Care Services - Preventive Care and Immunizations for Children age 6 and under (Includes coverage for office visits, lab tests, vision and hearing screenings and immunizations): 0% copay and deductible waived
Lab / X-Ray Professional and Diagnostic Services (X-ray, lab, anesthesia, surgeon, etc ): 30% coinsurance. Professional and Diagnostic Services (X-ray, lab, anesthesia, surgeon, etc.): 50% coinsurance.
Maternity Not Covered Not Covered
Physical Therapy Outpatient Physical/Occupational Therapy: Member pays 30% after deductible; Limitations (in and out of network combined - 20 visits per member, per calendar year) Outpatient Physical/Occupational Therapy: Member pays 50% after deductible; Limitations (in and out of network combined - 20 visits per member, per calendar year)
Home Health Care Home Health Care: 30% after deductible (90 visit limit per year per person); Hospice: 30% after deductible Home Health Care: 50% after deductible (90 visit limit per year per person); Hospice: 50% after deductible
Mental Health Mental Health and Substance Abuse - Inpatient: 30% after deductible (25 day limit per year per person; 10 Inpatient days can converted to 15 partial days); Outpatient: Visits 1-3: Member pays $35 copay or 30% after deductible (deductible waived when there Mental Health and Substance Abuse - Inpatient: 50% after deductible (25 day limit per year per person; 10 Inpatient days can converted to 15 partial days); Outpatient: 50% after deductible
Hospital Care Inpatient Services (overnight hospital/facility stays): 30% coinsurance; Outpatient Services (without overnight hospital/facility stays): 30% coinsurance. Inpatient Services (overnight hospital/facility stays): 50% coinsurance; Outpatient Services (without overnight hospital/facility stays): 50% coinsurance.
Get Instant Quotes
Verisign Truste