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 Medicare Advantage plan types, including HMO, PPO, SNP, PFFS, and MSA plans in our Medicare Advantage guide.

Anthem Medicare Advantage HMO

Most Anthem Medicare Advantage HMO 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). You can also enroll in a C-SNP (Chronic Illness Special Needs Plan) if you have certain chronic conditions.

Anthem Medicare Advantage 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 can also 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.

Anthem Medicare Advantage 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 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 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 HMO and PPO plans have additional perks and benefits, they may vary depending on where you reside. Anthem’s Essential Extras benefits grant members a variety of potential supplemental benefits (like food, home care, and transportation) at no cost.

Expert Insights

From Danielle Kunkle Roberts, Medicare Expert

Medicare Advantage plans were also built with an out-of-pocket maximum cap on your medical spending. Think of this as a safety net. If you have heavy health spending that results in a certain out-of-pocket limit, then the plan kicks in and pays the rest for the remainder of the calendar year (Part D expenses are calculated separately).

Anthem Medicare Advantage HMO:

• $0 monthly premiums, although you’re responsible for your Medicare Part B premium
• Copays as low as $0
• Deductibles as low as $0
• Access to SilverSneaker fitness locations at no cost
• Dental, vision, and hearing
• 24/7 telehealth visits
• Inpatient/outpatient visits
• Preventive care screenings and physical exams
• Prescription drug coverage
• Once discharged from the hospital, you’ll receive 20 meals at a $0 copay
• No cost SilverSneakers Fitness program
• Over-the-counter allowance for health items like vitamins, aspirin, dental care products, and vision care products

Anthem Medicare Advantage PPO:

• $0 monthly premiums (you’re still required to pay Medicare Part B’s premium)
• Has copays as low as $0
• $0 deductibles (may be higher for out-of-network care)
• No cost SilverSneakers Fitness program
• Dental, vision, and hearing
• 24/7 telehealth visits
• Inpatient/outpatient visits
• Preventive care screenings and physical exams
• Prescription drug coverage
• Over-the-counter allowance for health items like vitamins, aspirin, dental care products, and vision care products

How Much Do Anthem Medicare Advantage Plans Cost?

Anthem Medicare Advantage prices can have $0 premiums but could cost as much as $200, depending on coverage type. Regardless, they can vary widely from person to person and plan to plan.

For example, in California, Anthem Medicare Advantage HMO has a $0 monthly premium and a copay that can range from $0 to $20, while PPO monthly premiums range from $0 to $44 with a copay that’s $0 to $10. 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.

Expert Insights

From Danielle Kunkle Roberts, Medicare Expert

For many years, people on Medicare had only Medigap plans to choose from. While these plans have excellent coverage, not everyone can afford them. These people often opted to have only Original Medicare. When illnesses struck, they would find themselves with bills for expensive deductibles and coinsurance that they could not afford. Medicare Part C plans were created to provide a solution to these problems by providing lower-cost plans with no health questions.

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 can 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: Gave Anthem a score of 663 (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.

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.

Anthem vs. the Competition

Many insurance carriers provide Medicare Advantage plans, but availability and benefits vary. Of all the Medicare Advantage carriers, UnitedHealthcare and Humana sold the most plans in 2024. 4 Here is how Anthem’s competition stacks up:

Anthem vs. Aetna

Aetna Medicare Advantage has availability in 36 states, and features low premiums and deductibles like Anthem. Anthem has 24/7 telehealth access, while Aetna provides a 24/7 nurse hotline. Through Aetna’s PPO and HMO plans, subscribers have access to walk-in clinics at CVS Minute Clinic due to Aetna’s partnership with CVS.

Anthem vs. BCBS

Blue Cross Blue Shield Medicare Advantage has much wider availability with plans in 49 states, including Washington, D.C., plus Puerto Rico. However, they don’t have as many SNP plans as Anthem does. Both Anthem and BCBS provide additional benefits like SilverSneakers and some of BCBS’s plans have a Blue365 discount program.

Anthem vs. Humana

Humana Medicare Advantage goes far beyond Anthem in terms of availability, with coverage in all 50 states. The carrier offers coverage in more counties than any other Medicare Advantage carrier. Anthem offers customers several plans to choose from, depending upon location, unlike Human’s fairly limited four plan offerings. Like Anthem, Humana offers $0 premium options, and their extra perks for health and wellness are similar.

Check out SeniorLiving.org’s picks for the best Medicare Advantage plans to further compare your options.

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.