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Anthem – Lumenos HIA Plus – COLORADO
A comparison of the Lumenos HIA Plus offered by Anthem is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | Lumenos HIA Plus Application | Lumenos HIA Plus Application |
| Brochure | Lumenos HIA Plus Brochure | Lumenos HIA Plus Brochure |
| Copay | N/A | N/A |
| Office Visit | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Deductible | $5,000 Individual, $10,000 Family | $10,000 Individual, $20,000 Family |
| Coinsurance | Lumenos HIA Plus | Lumenos HIA Plus |
| Coinsurance Limit | Lumenos HIA Plus | Lumenos HIA Plus |
| Out-of-Pocket Maximum | Lumenos HIA Plus | Lumenos HIA Plus |
| Lifetime Maximum | $5,000,000 | $5,000,000 |
| Prescription Drugs | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Emergency Room | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Adult Preventative Care | Lumenos HIA Plus | Subject to deductible and coinsurance. |
| Child Preventative Care | Lumenos HIA Plus | Subject to deductible and coinsurance. |
| Lab / X-Ray | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Maternity | Benefits are paid for complications of pregnancy only, Routine maternity care is not covered. | Benefits are paid for complications of pregnancy only, Routine maternity care is not covered. |
| Physical Therapy | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Skilled Nursing | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Home Health Care | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Mental Health | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Hospital Care | Subject to deductible and coinsurance. | Subject to deductible and coinsurance. |
| Optional Benefits | Lumenos HIA Plus | Lumenos HIA Plus |