Anthem Medicare Review

Anthem Blue Cross Medicare Advantage Ratings at a Glance

Anthem Inc. is a public company headquartered in Indiana that employs about 98,200 people. It is one of the biggest players in the U.S. health maintenance (HMO) providers and health and medical insurance markets. The company is a market leader in the HMO providers business, generating approximately 13.9% of all industry revenue. 

Anthem Insurance is a part of the Blue Cross and Blue Shield Association and provides health care plans in seven states (Indiana, Kentucky, Virginia, Nevada, Wisconsin, California and New York).

Anthem offers Medicare Advantage plans, HMO plans, preferred provider organization (PPO) plans, Special Needs Plans (SNPs) and stand-alone prescription drug plans to individuals who live in the states it operates in.

Medicare Advantage Plans

Anthem’s Medicare Advantage plans (Medicare Part C) encompass many healthcare needs in a simple, low-cost plan. Parts A and B of Original Medicare are covered by these plans, plus extra benefits you won't get with Medicare alone. Most of Anthem's Medicare Advantage plans cover Part D prescription drugs and offer dental, vision and hearing-care benefits.

Anthem's Medicare Advantage plans are either administered through a health maintenance organization or a preferred provider organization. HMO and PPO health care teams, doctors, and hospitals provide discounted care if you choose an in-network provider.

• Anthem MediBlue HMO: A primary care physician (PCP) will see you for well-care, checkups and regular exams. If you need a specialist, the PCP can refer you to the right one. 

• Anthem MediBlue PPO: You can see any healthcare provider in-network without a referral. While you can see doctors outside of the plan, there is an additional charge for out-of-network care.

Medicare Supplement Plans

Medicare Supplement plans augment Original Medicare. The plans don't cover all Original Medicare expenditures. The only differences between carriers are pricing and extra benefits or coverage. These plans are universal.

Medicare Supplement coverage lets you use any Medicare-accepting doctor or hospital. All Anthem Medicare Supplement plans support Part A and Part B coinsurance. The plans include SilverSneakers® workout memberships, ScriptSave/WellRx prescription savings and SpecialOffers discounts on vitamins and weight-reduction programs.

Medicare Part D Plans (Stand-Alone Prescription Drug Plan)

Medicare Part D prescription drug plans (PDPs) cover prescription medications not covered by Original Medicare. Anthem Part D has $1 copays at network pharmacies. You can acquire prescription coverage through Anthem's Medicare Advantage plans or a separate PDP to supplement its Medicare Supplement (Medigap) plans or Original Medicare coverage.

Anthem's network includes thousands of pharmacies, many of which are preferred pharmacies. These pharmacies are part of Anthem's network and usually have lower out-of-pocket costs for covered drugs than pharmacies that are not on the network. Anthem gives you two choices for Part D plans.

• MediBlue RX Standard Part D Plan: The deductibles for the MediBlue RX Standard Part D Plan start at $350, and only a few drugs are covered. Most generic drugs at preferred pharmacies cost between $1 and $5 out of pocket.

• MediBlue RX Plus Part D Plan: This plan has a $0 deductible and a longer list of covered drugs than the standard plan. It is called the MediBlue RX Plus Part D Plan. Most generic drugs at preferred pharmacies cost between $1 and $3 out of pocket.

Special Needs Plans (SNP)

Special Needs Plans are Medicare Advantage plans for people with low incomes or certain medical conditions. You might want to learn about chronic condition SNPs if you have a long-term illness like diabetes, heart disease or a lung disorder. There is another type of SNP for people with both Medicare and Medicaid. Anthem's Dual Eligible SNPs can help you by giving you more benefits and coverage.

• Dual-Eligible SNP (D-SNP): People with Medicare and Medicaid can get more help from a D-SNP. To get Medicare, you must be at least 65 years old or have certain health problems. Medicaid is based on how much money you make, not on how old you are. If your income is low enough, you can get help even if you are younger than 65. Anthem's D-SNPs cover things like vision, dental, hearing and health items you can buy over-the-counter (OTC) and prescription drugs.

• Chronic Condition SNP (C-SNP): A C-SNP gives people with long-term illnesses like diabetes, heart disease or chronic heart failure, lung disease and end-stage kidney disease extra help and care. Most of Anthem's Medicare Advantage C-SNPs also include coverage for prescription drugs, zero or low monthly premiums and deductibles and other benefits that are customized to your health needs.

• Institutional SNP (I-SNP): If you currently require or anticipate that you will require long-term care, skilled nursing facility, long-term care nursing facility or intermediate care for a period of 90 days or longer, you are eligible for the I-SNP.

Dental & Vision Care

Getting your eyes checked and your teeth cleaned regularly can help you stay healthy by finding problems and illnesses early before they worsen. But Original Medicare doesn't pay for regular eye or dental care. This means that Medicare won't pay for routine cleaning of your teeth or an eye exam for contacts or glasses.

You may already have coverage for your teeth and eyes if you have Medicare Advantage. Most Medicare Advantage plans include regular care for your teeth, eyes and ears. You can also add more dental and vision coverage to these plans.

If you have a Medicare Supplement plan, a Part D plan or both, you may want to buy an Anthem Extras package to cover dental and vision care.

Anthem Extras plans offer dental and vision coverage, or just dental coverage, to go with your Medicare Supplement plan. Each dental plan covers a different level of care, from regular checkups and root canals to crowns and fillings.

Standard is the least expensive package, and Premium Plus is the most expensive.

The Standard package has the following:

• Dental care: Routine cleanings and exams every two years are paid for in full. There is no out-of-pocket cost.

• Vision care: Every 12 months, you can get an eye exam for $20. Every two years, you can get new glasses lenses for $20. You can spend up to $100 on frames every 24 months and get a 20% discount.

Anthem members can set up an online account to identify physicians, manage medicines, pay payments and check claims. To speak with a licensed agent for help finding the right plan, you can call 855-949-3321 from 8 a.m. to 8 p.m. Monday through Friday. Live Chat is also available for Anthem members.

The NAIC calculates an insurance company's complaint-to-premium ratio. A complaint index value of less than 1 shows the company received fewer complaints than expected based on its market share. Anthem's complaint index was below 1 (0.61).  

AM Best rates Anthem with an  A (Excellent) rating effective Dec. 3, 2020, and 

J.D. Power ranked Anthem's Medicare Advantage plans with a 797 customer satisfaction rating, compared to 806 for the industry. Anthem ranked fifth.

Anthem has a Medicare Advantage plan that will work for you regardless of your financial situation or specific medical requirements. Anthem offers many plans that may appeal to you because of their low cost; for example, many of their HMO and PPO plans have no premiums or deductibles. Anthem's website has up-to-date pricing information that varies by state and insurance plan type.

An Anthem Medicare Advantage plan will provide you with coverage for your hearing, vision, dental care and prescription medication needs. You may also be eligible to get additional beneficial advantages that improve your health and quality of life on a day-to-day basis.

Policyholders of the Anthem Medicare Advantage plan receive the following benefits:

• SilverSneakers membership as a fitness center participant

• Provision of insurance for over-the-counter medical goods

• Transportation to medical and other appointments

• Free lunches with the delivery of an order.

• Caregiver or emergency services available at the touch of a button

• Telehealth visits around the clock

With an Anthem Medicare Advantage plan, you can establish a connection with your service providers from the comfort of your own home using your computer, tablet or smartphone.

Anthem’s website is straightforward, explaining its plans and benefits in detail. Users will find it simple to read about the benefits and compare the different options for coverage Anthem provides.

Anthem’s website is very user-friendly, and anyone with questions can talk to a licensed agent at  855-949-3321, from 8 a.m. to 8 p.m. Monday through Friday. 

Anthem Versus Competitors

Anthem is in competition with several other Medicare Advantage providers on a national level. You can use this chart to compare coverage options and find the best Medicare Advantage plan for your healthcare needs.

Anthem offers more Medicare plans than several of its competitors, including dental and vision coverage. Many of Anthem's policies are affordable, with no copays or deductibles for HMO and PPO plans. Anthem offers a fair range of plan types and prices and has favorable customer service ratings and excellent financial strength ratings. Anthem is a solid choice to consider when searching for Medicare Advantage plans. 

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