Anthem Medicare Advantage Plans Review

Available Anthem Medicare Advantage Plans

Medicare Advantage plans provide coverage that includes Medicare Parts A, B, and usually D (prescription coverage). Anthem MediBlue offers health maintenance organization (HMO) and preferred provider organization (PPO) Medicare Advantage plans. HMO plans allow you to pick your primary care physician, who can also assist you in identifying the best specialist when necessary.

PPO plans allow you to see any doctor/specialist in the plan without a referral. Additionally, you can see doctors outside of the plan, but services may be more expensive. Regardless, keep in mind that benefits will vary by location, so before enrolling, be sure the plan you want is offered near you.

Learn more about the different types of Medicare Advantage plan types, including HMO, PPO, SNP, PFFS, and MSA plans in our Medicare Advantage guide.

Anthem MediBlue HMO

Most Anthem MediBlue plans offer benefits that aren't included in Original Medicare (i.e., hearing, dental, and vision). Generally speaking, if you’re eligible to enroll in Medicare, you can choose an HMO plan. You can also enroll if you have a chronic condition. Or, if you have both Medicare and Medicaid, you’re eligible for a Medicare Advantage Special Needs Plan (SNP).

MediBlue HMO allows you to choose your primary care provider (PCP) within the plan’s network, where you’ll receive regular care and routine screenings. Your PCP will also be able to guide you to the appropriate specialists when necessary. HMO plans are a great choice if it’s important you work with a doctor routinely who understands your health history, medications, and unique care needs.

PPO

A PPO plan may be for you if you have a doctor/specialist preference, as you don’t need a referral like you do with an HMO plan. Like MediBlue HMO plans, you can enroll in a PPO if you’re eligible for Medicare. Additionally, if you have a chronic condition or have both Medicare/Medicaid, you can enroll in a SNP. While not required with MediBlue PPO, it’s a good idea to choose a primary care physician for checkups. Referrals aren’t mandatory if you need to see a specialist or want to see another doctor.

Nonetheless, selecting a doctor and health care facility within your plan’s network is almost always going to save you money. While you can see doctors or use facilities that are out of your provider’s network, they have to participate with Original Medicare. If you use an out-of-network provider, it may be more costly.

Extra Benefits and Perks

While MediBlue HMO and PPO plans have additional perks and benefits, they may vary depending on where you reside. In regards to the pandemic, Anthem is focusing on its Essential Extras benefits, which grants members with a variety of potential supplemental benefits (i.e., food, home care, and transportation) at no cost.

MediBlue HMO:

• $0 premiums, although you’re responsible for your Medicare Part B premium
• $5 in-network copays
• Deductibles (usually $0)
• Access to SilverSneaker fitness locations at no cost
• Dental, vision, and hearing
• 24/7 telehealth visits
• Inpatient/outpatient visits
• Preventative care screenings and physical exams
• Home health care
• Once discharged from the hospital, you’ll receive 20 meals at a $0 copay
• SilverSneakers Fitness program

MediBlue PPO:

• $0 premiums (you’re still required to pay Medicare Part B’s premium)
• Has copays as low as $0
• $0 deductibles (while this is generally the case for most in-network costs, it may be higher for out-of-work)
• SilverSneakers Fitness program
• Dental, vision, and hearing
• 24/7 telehealth visits
• Inpatient/outpatient visits
• Preventative care screenings and physical exams
• LiveHealth Online

How Much Do Anthem Medicare Advantage Plans Cost?

Anthem Medicare Advantage prices can have $0 premiums but could be as much as $200, depending on coverage type. Regardless, they vary widely from person to person and plan to plan. You’re also expected to pay your Part B premium; however, some Medicare Advantage plans assist with this. Also consider that deductibles vary with plan types. Some Part C plans have separate deductibles for medical care as well as prescription drugs. While copays are a flat rate for medical services, some Medicare Advantage plans have higher copays for out-of-network providers.

Reviews and Ratings

Several reputable third parties rate Medicare Advantage plans. See how Anthem did across the board:

• Centers for Medicare and Medicaid Services (CMS): 4 to 4.5 stars
• AM Best: Rates insurers based on credit. Anthem received an “A” (Excellent) rating, indicating the insurer is able to successfully meet financial obligations.
• Better Business Bureau (BBB): While not accredited by the BBB, Anthem has an A+ rating and no complaints.
• National Committee for Quality Assurance (NCQA): While Anthem’s Medicare Advantage plans aren’t rated by the NCQA, its commercial insurance plans have an average of 3.5 to 4 stars.
• J.D. Powers: Ranked Anthem 6 out of 9 (797 out of 1,000 points). Scores are measured per-member satisfaction in six categories: coverage and benefits, provider choice, cost, customer service, information and communication, and billing/payment.1

Customer Service

Telehealth visits can be made 24/7 via computer, tablet, or smartphone. Anthem’s customer service team can be contacted at (855) 949-3321, Monday through Friday from 8 a.m. to 8 p.m.

Final Thoughts on Anthem Medicare Advantage Plans

While Anthem’s Medicare Advantage plans are only available in 14 states, overall, it's a great pick. They’re cost-effective with low premiums, deductibles, and copays. Plus, many plans cover prescription drugs, you have the additional bonus of supplemental benefits like vision, hearing, dental and fitness, and there are a variety of plan types to choose from.