Skyline Benefit

Individual health carrier | 2026

Anthem Individual and Family Health Plans

Marketplace and direct individual health plans with medical, prescription, virtual care, preventive care, and mental health benefits.

2026 plan guide

How the coverage is structured

Anthem offers California individual and family coverage both through Covered California and directly from the carrier. The right option depends on financial-assistance eligibility, county availability, provider access, prescriptions, and expected care.

01

Marketplace or direct enrollment

Premium subsidies are available only through Covered California. Direct plans may be considered when financial help does not apply or when comparing off-marketplace choices.

02

Network and service area

Anthem materials identify Pathway HMO and EPO service areas. Plan availability and participating doctors can change, so confirm the exact plan network by ZIP code before enrolling.

03

Included health benefits

Anthem describes prescription coverage, virtual care, preventive visits, and mental health services across its individual and family medical plans, subject to each plan's terms.

04

Dental and vision

Some marketplace options may include dental or vision benefits, while stand-alone coverage may also be available. Review whether adult and pediatric benefits are included or purchased separately.

Before and after enrollment

Using the plan with fewer surprises

Use the carrier materials as a starting point, then verify the current Evidence of Coverage, provider directory, and formulary for the exact plan you are considering.

01

Check doctors and hospitals

Search the specific Pathway network rather than relying only on the Anthem name. Confirm each doctor, facility, and medical group for the plan year.

02

Review prescriptions

Check the current drug list, pharmacy network, prior-authorization rules, and any home-delivery options for ongoing medications.

03

Use digital member tools

Anthem materials point members to anthem.com and the Sydney Health app for provider searches, virtual care, digital ID cards, claims, benefits, and prescription tools.

04

Compare total yearly cost

Balance premium, deductible, copays, coinsurance, and the out-of-pocket maximum against the care your household expects to use.

Official source documents

Review the carrier materials

These PDFs provide additional detail from the carrier. They open in a new tab and should be read with the current Evidence of Coverage and Summary of Benefits and Coverage for the plan you select.

Before you enroll

Plan availability and benefits can change.

This page summarizes carrier materials for the 2026 plan year. It is not a policy, contract, quote, or guarantee of eligibility or benefits. The current carrier application, Evidence of Coverage, Summary of Benefits and Coverage, provider directory, and formulary control.

Confirm options with an advisor