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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Finding the Anthem Pathway Network?

By on | 4 Comments

Question: I have an Anthem Platinum Guided Access cead plan. It says Pathway X HMO on the card. I can’t find a list of in-network providers anywhere.

Answer: Use this link: https://www.anthem.com/health-insurance/provider-directory/searchcriteria?qs=*U+6hK7rK6dMu/ioZcqYOcg==&brand=abc. The page looks like this Anthem Find a Doc.png (click image to enlarge). Section 4 is the important part. After selecting California, you will click on the Plan Type/Network selection and a drop-down menu will appear that looks like this Network.png. Scroll within the menu to find the Pathway Networks. The correct selections for your scenario would look like this Search.png. Now you are ready to click the “search” button and go.

4 Comments

I signed up for an anthem EPO plan in December through covered CA, and submitted my Credit card info by telephone on 1/4/2014. I have still not been billed and have not received ID cards. I have repeatedly contacted Anthem via their website, email, and phone. I spoke to phone support last week. The rep claims my application is “pending”. Is there anything else I can do now except select another company for coverage?

Hi Billing.

Two things to check:

1.) Create a new member account at www.BlueShieldCA.com . Access your plan info and see what health plan has been provided to you by Blue Shield. Also access your claims history to make sure what you’re seeing is what Blue Shield is listing.

2.) Login to your CovCal account and access the ENROLLMENT screen to see what plan CovCal has you under. Sounds like you may have done this already.

As your agent, I can get through to Blue Shield and expect I could clear things up for you as long as Blue Shield could see me as your designated agent representative. Not sure how long it would take through the CovCal system for info to get to Blue Shield, but I do have some ways to move things along some.

Call me, I expect I can help.
My info, search for me as your ‘Agent’ at the CovCal website, through the top-of-page ‘Find Help Near You’ blue link, when you’re logged in.

I have Silver 87 enhanced CC plan which is the BS EPO enhanced 200 subsidy plan. BS is billing me for a medical deductible which does not apply to my plan (dr. visits and labs are copay only). Does CC take any responsibility for making sure the insurance company follows the plan benefits? It’s impossible to reach anyone at BS to fix this and I”m holding off on med services as a result. I think the CSR part is maybe not connected? The APTC shows and my bill reflects the lower cost. Any ideas on how to get the BS plan to match the CC coverage?

I see a “Pathway-X HMO / Individual via Exchange” plan type/network available in the drop-down selection there. That would be the correct selection for the Anthem Guided Access plans thru Covered California. Guided Access is Anthem’s term for “HMO” compared to Direct Access is their term for “PPO” or “EPO”

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