QHP Index

Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)

Expanded Bronze · HMO · Anthem Blue Cross and Blue Shield · Wisconsin

At age 40 it costs $424.95 a month before any subsidy.

What CMS publishes about it

Plan ID79475WI0550012
InsurerAnthem Blue Cross and Blue Shield
Metal levelExpanded Bronze
Plan typeHMO
Deductible (individual)$5,000
Deductible (family)$10,000
Drug deductibleIncluded in the medical deductible
Most you could pay in a year$10,600
Family maximum$21,200
Primary care visit40% Coinsurance after deductible
Specialist visit$60 and 40% Coinsurance after deductible
Emergency room$500 Copay after deductible and 40% Coinsurance after deductible
Inpatient stay$1,500 Copay per Stay after deductible and 40% Coinsurance after deductible
Generic drugs$10
Preferred brand drugs30% Coinsurance after deductible
Specialty drugs45% Coinsurance after deductible
Adult dental includedNo
Child dental includedNo
Share of premium buying essential health benefits100.00%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-855-748-1813

Where it is sold, and what it costs there

4 counties. The premium is the price before any tax credit; what you pay depends on your income.

CountyAt 21At 30At 40At 50At 60
Calumet County $332.51$377.40 $424.95$593.86 $902.43
Outagamie County $332.51$377.40 $424.95$593.86 $902.43
Sheboygan County $332.51$377.40 $424.95$593.86 $902.43
Winnebago County $332.51$377.40 $424.95$593.86 $902.43

Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.

Get told when this changes

When this plan’s price or benefits change.

Double opt-in, one click to unsubscribe. We never sell or share the list, and we are not an insurance agent or broker: this is a notification about published data, not a sales call. Privacy.

Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.