What Medicare Plans Does Anthem Offer?
Last Updated : 10/20/20186 min read
If you are looking for Medicare Advantage plans or ways to supplement your Original Medicare (Part A and Part B) coverage with a Medicare stand-alone Part D Prescription Drug Plan or Medicare Supplement insurance (Medigap), you may be interested in Anthem Medicare plans. Here’s a look at the Anthem Medicare plan options that may be available in your service area.
What Anthem Medicare Advantage plans are available?
The Medicare Advantage (Part C) program is designed to offer beneficiaries an alternate way to receive their Original Medicare benefits. Although all Anthem Medicare Advantage plans must provide at least the same coverage as Original Medicare (except for hospice care, which is still covered under Part A), they may also include additional benefits, such as prescription drug coverage, and coverage for routine vision and dental care. Some plans may even cover wellness programs, such as the Silver Sneakers wellness program.
To be eligible for Medicare Part C coverage, you must currently have Part A and Part B, live in the service area of a Medicare Advantage plan, and not have end-stage renal disease (with some exceptions).
Depending on where you live, you may be able to enroll in one of the following types of Anthem Medicare Advantage plans:
- Anthem MedicareAdvantage Health Maintenance Organization (HMO). These plans generally require you to use the Anthem Medicare provider network to be covered, with the exception of medically necessary emergency care. You’ll also need referrals from your primary care doctor to see specialists.
- Anthem MedicareAdvantage Preferred Provider Organization (PPO)*. You have a greater choice of providers, but your out-of-pocket costs are lower when you use Anthem’s preferred provider network. If you use a non-network provider, your copayments and coinsurance costs may be higher. You don’t need to a referral for specialist services.
- Anthem MedicareAdvantage Special Needs Plans (SNPs). There are three types of Special Needs Plans (SNPs), available to people who have certain chronic or disabling conditions, receive both Medicare and Medicaid benefits, or live in an institution (such as a nursing home). You must meet the eligibility criteria of the plan you’re considering enrollment for (for example, you must have diabetes to be eligible to enroll in a Chronic-Condition Special Needs Plan or SNP for people with diabetes). Plan benefits are designed around the treatment needs of people with these specific conditions, including provider networks, covered medications, and specialized services. All Special Needs Plans (SNPs) include prescription drug coverage.
Any of the above types of plans can include prescription drug coverage (also known as Medicare Advantage Prescription Drug plans); however, not every plan may include Part D coverage, so always check with the specific Medicare Advantage plan you’re considering if you’re interested in help with your medication costs. Depending on the Medicare Advantage plan you select, you may be able to add coverage for routine vision, preventive dental, and fitness programs, plus other benefits, by purchasing Anthem Medicare Optional Supplemental Benefits.
Keep in mind, not all Anthem Medicare Advantage plans are available in all areas, and plan benefits and premiums may vary from place to place. You must continue to pay your Part B premium if you enroll in an Anthem Medicare Advantage plan, and there may be an extra monthly premium for your Medicare Part C coverage depending on the plan you choose. You may be responsible for copayments, coinsurance, and/or deductibles.
What Anthem Medicare Part D Prescription Drug Plans are available?
Anthem offers different Medicare stand-alone Part D Prescription Drug Plans you can use to supplement your Original Medicare coverage. Unless you’re enrolled in a Medicare Advantage plan that doesn’t offer prescription drug coverage (such as a Medicare Savings Account plan), you shouldn’t enroll in both a Medicare Advantage Prescription Drug plan and a stand-alone Prescription Drug Plan. All Anthem Medicare plans that cover prescription drugs must include minimum benefits mandated by the Medicare Part D program.
Medicare plans that include prescription drug coverage use a formulary, or list of covered medications, to determine whether a prescription drug is covered; plans may change their formularies from time to time, but they will notify you in writing when they do. It’s important to enroll in Medicare Part D prescription drug coverage as soon as you are eligible, or you may pay a late-enrollment penalty with your monthly premium as long as you are covered if you go without it and don’t have creditable prescription drug coverage (insurance that is as good as the standard Part D benefit) for 63 days in a row or more. Like Medicare Advantage plans, plan benefits and premiums may vary by location.
Does Anthem Medicare offer Medicare Supplement plans (Medigap)?
Depending on where you live, you may be able to purchase Medigap coverage from Anthem Medicare plans. These plans help you pay for certain out-of-pocket costs under Original Medicare, such as Part A and Part B deductibles and coinsurance. There are 10 plan types available in most states, and benefits are the same across each plan type. Each plan type is designated by the letters A through N.
In some places, you may be able to purchase Anthem Extras packages with your Medigap plan for routine vision and dental care, as well as certain wellness program benefits. Plan benefits and premiums vary by location, and not all plans are available in every area.
Hopefully, you now have a better idea of your Medicare coverage choices. If you’d like to get started exploring Anthem Medicare plan options, you can use the Find Plans button on this page to compare plan options in your zip code; there are options to narrow your search by insurance company, plan type, and more.
* Out-of-network/non-contracted providers are under no obligation to treat Anthem plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Anthem Blue Cross and Blue Shield serves Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin.