Question: We enrolled for the Anthem Blue Cross Preferred Direct Access Pathway PPO plan. My PCP is part of Palo Alto Medical Foundation / Sutter Health. When I lookup his profile directly from Anthem’s website, the insurance plans he accepts show “Preferred Direct Access - CA”. He also shows the other tiers offered - Core, Essential, Premier Direct Access of the Pathway PPO and Guided Access HMO plans available through Anthem BC for 2014. But if I login to the Anthem website as a member, the search does NOT include my doctor s “In-Network” under the Pathway PPO /Preferred Direct Access Plan. This is true of most if not all doctors from PAMF listed on Anthem’s website.
Answer: The name “Preferred Direct Access” refers to gold-level plans in Anthem’s small-group plan portfolio and off-exchange individual and family plan portfolio. “Pathway” is the network name used by all individual plans effective 1/1/14 and later. “Pathway X” is for Anthem individual plans sold through Covered California. he Pathway X network is exactly the same as the Pathway network without the X. When using the Anthem “Find-a-Doctor” online app, select the Pathway network first, then the plan type and name.