Pathway

The Pathway plan provides access to high-quality health care in Colorado through Anthem’s Pathway networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services.

Colorado in-network hospital systems include Rocky Mountain Children’s Hospital, Boulder Community Hospital, HCA Hospitals and UC Health Hospitals. Children’s Hospital Colorado will be out-of-network, except for emergencies.

Members living outside of Colorado will have access to Anthem’s full national PPO network on the Pathway plan, the same out-of-state network as the High Deductible plan.

Your Primary Care ProviderPrimary Care Provider (PCP)A physician (medical doctor or doctor of osteopathic medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services manages your care, but you do not need a referralReferralA written order from your primary care provider for you to see a specialist or receive certain health care services for any covered service that cannot be performed by your primary care provider. This applies to our Anthem Exclusive and Kaiser plans.   to see a specialist.

No out-of-network coverage is available except for urgentUrgent CareCare for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care and/or emergency careEmergency CareA medical or behavioral health condition that must be treated at the emergency department of a hospital due to an illness, injury, symptom or condition severe enough to risk serious danger to your health (or, with respect to a pregnant woman, the health of her unborn child) if you didn’t get medical attention. See where and when to get care..