- What do Anthem Medicare Advantage Plans cover?
- What are Anthem’s Medicare Advantage Plan options?
- Pros and cons of Anthem Medicare Advantage plans
- Anthem Medicare Advantage Plans reviews and ratings
- How Anthem Medicare Advantage Plans compare
- How to choose a Medicare Advantage Plan
- When can you enroll in an Anthem Medicare Advantage Plan?
Anthem Medicare Advantage Plans Review
Fact checked Reviewed by: Leron Moore, Medicare consultant - Updated: Jan 13, 2022
Is an Anthem Medicare Advantage Plan a good fit for you?
Anthem offers varied Medicare Advantage plans, including HMOs, PPOs, and two Special Needs Plans (SNPs). All plans come with affordable premiums and extra services. If an Anthem plan is available in your area, you have access to at least one plan that includes drug coverage and at least one zero premium plan.
|Medicare rating: 3.5 to 4 stars||A.M. Best financial strength rating: A||BBB rating: A+||NCQA rating: Not Rated||Consumer Affairs rating: 3.9||J.D. Power ranking: 6th out of 10|
Anthem, Inc. merged with Wellpoint Health Networks, Inc. in 2004 and is currently one of the largest health benefits companies in the United States. Anthem Blue Cross Blue Shield is the trade name for Anthem’s Medicare Advantage Plans, which are offered in 14 states. The number of types of plans available and their costs vary depending on where you live.
Anthem’s Medicare Advantage Plans include plenty of additional benefits with a focus on preventive care. As with any Medicare Advantage Plan you consider, investigate Anthem’s rules for how you obtain services and what prescription medications are listed on their formulary. Prior authorizations for treatments and medications apply, and in-network providers offer the lowest costs.
What do Anthem Medicare Advantage Plans cover?
Anthem Medicare Advantage Plans are comparable in their scope of coverage to other Medicare Advantage Plans, offering all the benefits of Original Medicare, along with coverage for additional health services. Medicare Advantage Plans, also called Medicare Part C, often include prescription drugs, vision and dental coverage, and wellness programs. Your out-of-pocket costs depend on the plan you choose, as do rules for how you get services, such as whether you have to choose a primary care doctor or get a referral to see a specialist.
Your hospital and medical insurance benefits are covered, and you’ll get prescription drug coverage with most plans. Additional benefits from Anthem Medicare Advantage Plans may include:
- SilverSneakers membership
- Preventive vaccines, exams, and screenings
- Intensive behavioral therapy for cardiovascular disease or obesity
- Diabetes self-management training
- Medical nutrition therapy for people with diabetes or renal disease
- Smoking and tobacco use cessation counseling
- Worldwide emergency
- Over-the-counter drugs
What are Anthem’s Medicare Advantage Plan options?
Anthem offers four different types of Medicare Advantage Plans, although the options available to you may vary based on your location. Options include Anthem Mediblue HMO, Anthem Mediblue PPO, Dual-eligible Special Needs Plan (D-SNP), and a Chronic Condition Special Needs Plan (C-SNP).
With HMOs, you’re required to choose a primary care physician (PCP) and get health care services from in-network providers. Because these plans are limited in their coverage, the premiums are typically affordable.
In general, PPO plans offer greater flexibility, allowing you to see out of network providers and specialists without obtaining referrals. These plans may have higher premiums and out-of-pocket costs if you use out of network providers.
Dual-eligible plans are specifically for those eligible for both Medicare and Medicaid. Chronic condition plans provided targeted services and care coordination for certain chronic illnesses such as lung disease or diabetes..
Compare these 2022 Anthem Medicare Advantage Plans with drug coverage in Atlanta, Georgia:
|Anthem Medicare Advantage Plans|
|Plan name||Monthly premium*||Annual deductible||Office visits||Annual maximum out-of-pocket cost|
|Anthem Mediblue Plus (HMO)||$0 $170.10 std Part B prem||$0 (health) $150 (drug)||$5 primary / $45 specialist||$6,700 in network|
|Anthem Mediblue Extra (HMO)||$30.50 $170.10 std Part B prem||$0 (health) $480 (drug)||$0 primary / $25 specialist||$5,900 in network|
|Anthem Mediblue Access Basic (PPO)||$0 $170.10 std Part B prem||$0 (health) $150 (drug)||$5 primary / $40 specialist||$6,700 in network $10,000 in and out of network combined|
|Anthem Mediblue + Kroger Access (PPO)||$0 $170.10 std Part B prem||$0 (health) $150 (drug)||$5 primary / $40 specialist||$6,700 in network $10,000 in and out of network combined|
|Anthem Mediblue Dual Access (PPO D-SNP)**||$0 $170.10 std Part B prem||$0 (health) $380 (drug)||$0 primary / $0 specialist||$6,700 in network $10,000 in and out of network combined|
*Based on pricing in Atlanta, Georgia
**Dual access SNP for Medicare and Medicaid eligible, may get financial assistance for Part B premiums and drug costs
Pros and cons of Anthem Medicare Advantage plans
What we like about Anthem Medicare Advantage Plans:
The drawbacks of Anthem Medicare Advantage Plans:
Anthem Medicare Advantage Plans reviews and ratings
Anthem’s Medicare Advantage Plans are specifically rated by Medicare and J.D. Power. Other reviews and ratings are based on Anthem as a whole or on Anthem Blue Cross Blue Shield as a subsidiary of Anthem, Inc.
Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau, and more rate Anthem plans.
|Medicare rating: 3.5 to 4 stars||Anthem’s Medicare Advantage Plans have an overall quality rating ranging from 3.5 to 4 out of 5 stars from the Centers for Medicare & Medicaid Services. Each plan’s star rating is visible when you search for a plan in your area.|
|A.M. Best financial strength rating: A||A.M. Best sets credit ratings for insurers. A.M. Best’s Financial Strength Rating for the core Blue Cross Blue Shield-branded insurance subsidiaries of Anthem, Inc. is A (Excellent). The Blue Cross Blue Shield-branded entities, also referred to as Anthem Health Group (Anthem Health), are part of the core subsidiaries of Anthem. An A rating indicates that Anthem Blue Cross Blue Shield has an excellent ability to meet financial obligations.|
|BBB rating: A+||Anthem isn’t accredited by the Better Business Bureau (BBB), but it has an A+ rating with zero complaints.|
|NCQA rating: Not Rated||Anthem’s Medicare Advantage Plans aren’t rated by the National Committee for Quality Insurance (NCQA), a leading accreditation agency. No data is reported for the Medicare Advantage Plans, however, Anthem’s commercial health insurance plans are rated at an average of 3.5 to 4 stars.|
|Consumer Affairs rating: 3.9 stars||Based on 1,357 ratings submitted to Consumer Affairs in the last year, Anthem is rated 3.9 out of 5 stars in overall satisfaction. The reviews are not specific to Medicare Advantage Plans, but some reviewers complained about problems with prior authorizations, lack of coverage, and limited formularies for drugs. Good reviews included satisfaction with extra benefits.|
|J.D. Power ranking: 6th out of 10||In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on these important factors: coverage, benefits, provider choice, cost, customer service, information, communication, billing, and payment. Anthem scored 797 points out of 1,000, coming in sixth out of the top 10 Medicare Advantage providers.|
How Anthem Medicare Advantage Plans compare
Is Anthem the best Medicare Advantage Plan provider? See how this insurer compares on major ratings.
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||NCQA rating||J.D. Power ranking|
|Aetna||4 stars||A||A+||2.5 to 4.5 stars||Fifth out of 10|
|Anthem Blue Cross Blue Shield||4 to 4.5 stars||A+||A+||Not rated||Sixth out of 10|
|Cigna||4 stars||A-||Not rated||2.5 to 4.5 stars||Seventh out of 10|
|Highmark||4.5 stars||A||A-||2.5 to 4.5 stars||Second out of 10|
|Humana||4 stars||A-||A+||1.5 to 4.5 stars||Third out of 10|
|Kaiser||5||A||A-||4.5 to 5 stars||First out of 10|
|Premera||3.5 to 4.5 stars||A||B-||3 stars||Not ranked|
|Providence||5 stars||Not rated||F||4 stars||Not ranked|
|UnitedHealthcare||3.5 stars||A-||A-||4 stars||Fourth out of 10|
How to choose a Medicare Advantage Plan
Ask these questions as you consider whether an Anthem Medicare Advantage Plan is right for you:
- Is your doctor covered?
- Are your prescriptions covered?
- What’s your monthly premium?
- What are your out-of-pocket costs?
- What additional benefits does the plan offer?
When can you enroll in an Anthem Medicare Advantage Plan?
You can enroll in a Medicare Advantage Plan if you’re enrolled in Original Medicare. Enrollment is available during these periods:
- Your Initial Enrollment Period: Seven months around and at your 65th birthday when you’re newly eligible for Medicare.
- Open Enrollment Period: Annually between October 15 and December 7.
- Medicare Open Enrollment: Annually between January 1 and March 31, but only if you’re already enrolled in a Medicare Advantage Plan and want to make a change
- Featured Sources [-]
Anthem, Inc. | Company History | Last Accessed January 2022
Anthem | Anthem Medicare Advantage Plans – Part C | Last Accessed January 2022
Better Business Bureau | Anthem Blue Cross Blue Shield | Last Accessed January 2022
Consumer Affairs: Anthem Health Insurance | Last Accessed January 2022
J.D.Power | 2021 Medicare Advantage Study | Last Accessed January 2022
Medicare: How Do Medicare Advantage Plans Work? | Last Accessed January 2022
NCQA: NCQA Health Insurance Plan Ratings 2019-2020 – Summary Report | Last Accessed January 2022
Leron Moore, Medicare consultant
Leron Moore has guided Medicare beneficiaries and their families as a Medicare professional for nearly 15 years. First as a Medicare provider enrollment specialist, and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.