Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
Starting at
$573
/month before subsidy
Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) is a 2026 Silver HMO health insurance plan from Anthem Blue Cross and Blue Shield, sold on the ACA Marketplace in Wisconsin under plan ID 79475WI0550018. The monthly premium starts at $573 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,500 ($11,000 for a family), and the individual out-of-pocket maximum is $9,200 ($18,400 for a family). After the deductible, coinsurance is 35% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 79475WI0550018
- Plan year
- 2026
- State
- Wisconsin
- Metal level
- Silver
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$5,500
Family: $11,000
Out-of-Pocket Max
$9,200
Family: $18,400
Coinsurance
35%
You pay after deductible
Network Type
HMO
WIN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$8,370
your estimated cost
- Deductible
- $5,500
- Copays
- $10
- Coinsurance
- $2,800
Managing type 2 diabetes
A year of routine care
$1,520
your estimated cost
- Deductible
- $100
- Copays
- $1,400
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,700
your estimated cost
- Deductible
- $2,500
- Copays
- $200
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver HMO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.
Consider this plan if you:
- Visit the doctor a few times per year
- Take regular prescription medications
- Want moderate protection against high medical bills
- May qualify for Cost-Sharing Reductions (CSR) to lower deductibles
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,340/month
Annual Premium
$6,876
OOP Maximum
$9,200
💡 What this means:
With a $5,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 35% (coinsurance) until you hit $9,200 total. Then insurance covers everything else for the year.
More plans from Anthem Blue Cross and Blue Shield in Wisconsin
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)from $497/mo
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)from $468/mo
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)from $425/mo
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)from $447/mo
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)from $462/mo
- Anthem Bronze Pathway/Lean HSA (+ Incentives)from $503/mo
- Anthem Bronze Pathway/Lean HSA (+ Incentives)from $473/mo
- Anthem Bronze Pathway/Lean HSA (+ Incentives)from $430/mo
Frequently asked questions about Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
How much does Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) cost per month?
Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) from Anthem Blue Cross and Blue Shield starts at $573 per month before any subsidy in Wisconsin. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)?
The individual medical deductible is $5,500, and the family deductible is $11,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)?
The most you would pay in a year for covered in-network care is $9,200 for an individual and $18,400 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) HSA-eligible?
No. Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) use?
Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.