Tammy Burns is an experienced health insurance advisor specializing in Medicare and senior health issues, including Medicare Advantage Plans and prescription drug plans, as well as ACA certified for health insurance and other ancillary, life and annuity products.
Quick Anthem Medicare Advantage Plans review: Anthem offers competitive Medicare Advantage Plans in terms of features, affordability, and member satisfaction, although their geographic availability is limited.
Founded in 2004 and headquartered in Indianapolis, Indiana, Anthem is one of the largest providers of health insurance plans in the United States. It offers a range of Blue Cross Blue Shield Medicare Advantage Plans in 14 states. Prescription drug coverage is included in most plans, plus dental, vision, and hearing services and fitness memberships.
Since Anthem offers more types of Medicare products than its competitors, it can include additional services and benefits in its Medicare Advantage Plans and still keep fees low. Many plans have no premiums or deductibles, making them attractive for those eligible for Original Medicare.
It’s worth taking the time to compare plans to see which will provide the best fit for your health care needs and budget constraints.
Pros and Cons of Anthem Medicare Advantage Plans
What we like about Anthem Medicare Advantage Plans:
- Many affordable plans with extra benefits
- Televisits covered, including 24/7 nursing and pharmacy support
- Overall positive member satisfaction
The drawbacks of Anthem Medicare Advantage Plans:
- Only available in 14 states
- Not rated by the National Committee for Quality Assurance (NCQA), one of the main accrediting bodies for health insurance products
What Do Anthem Medicare Advantage Plans Cover?
Medicare Advantage, or Medicare Part C, is the type of health insurance plan that bundles all services provided under Medicare Part A (hospital, nursing care, hospice and home health costs) and Part B (outpatient services, ambulance and mental health costs). Most of Anthem’s plans include Medicare Part D (prescription drug coverage), which is optional extra coverage under Original Medicare. Additional benefits include dental, vision, and hearing care and fitness memberships.
The range of offerings, add-ons, and affordability of Anthem plans make them attractive and competitive. If you’re eligible for Medicare, you can enroll in an available Anthem Medicare Advantage Plan, or easily switch from one plan to another, during specific enrollment periods.
Anthem Medicare Advantage Plan Options
Anthem offers one of the widest ranges of Medicare Advantage Plan options among insurance providers at low costs. These plans are structured as HMOs, PPOs, and SNPs.
In a Health Maintenance Organization (HMO) plan, you choose a primary care provider who coordinates care and provides referrals to specialists within the network. With Preferred Provider Organizations (PPOs), you also choose a primary care doctor, but appointments can be made directly with specialists, including those outside the network. This flexibility comes with higher fees.
Specific medical conditions or low income may qualify you for a Special Needs Plan (SNP). These plans provide targeted services and support tailored to the care needed.
In addition to standard benefits, Anthem’s plans also provide 24/7 telehealth services and caregiver resources. These Essential Extras vary between plans and may include fitness tracking, a personal home helper, transportation services, and meal delivery.
Before making a decision, it’s helpful to compare some of the available Anthem Medicare Advantage Plans.
|Plan name||Monthly premium||Annual deductible||Office visits||Telehealth||Emergency room||Annual maximum out-of-pocket costs|
|Anthem MediBlue Essential (HMO)||$0||$0||$5 PCP/$40 specialist||Network telehealth providers||$90||In-network: $4,900 out-of-pocket limit|
|Anthem MediBlue Extra (HMO)||$25.30||$0||$0 PCP/$40 specialist||Network telehealth providers||$90||In-network: $7,550 out-of-pocket limit|
|Anthem MediBlue Access Core (Regional PPO)||$0||$0||In network $0 PCP/$30 specialist
Out of network $25 PCP/$50 specialist
|Network telehealth providers||$90||In-network: $4,900 out-of-pocket limit
Combined In- and Out-of-network: $4,900 out-of-pocket limit
|Anthem MediBlue Access (PPO)||$56||$1,000 for out-of-network Medicare-covered services||In network $0 PCP/$40 specialist
Out of network $25 PCP/$60 specialist
|Network telehealth providers||$90||In-network $5,500 out-of-pocket limit
Combined In- and Out-of-network: $10,000 out-of-pocket limit
|Anthem MediBlue Dual Advantage (HMO D-SNP)||$0||$0||$0 PCP/$0 specialist||Network telehealth providers||$0||In network: $7,550 out-of-pocket limit|
*Based on pricing in Columbus, Ohio
Anthem Medicare Advantage Plans Reviews and Ratings
While geographic availability is limited, members of Anthem Medicare Advantage Plans report positive experiences.
Anthem’s Medicare Advantage Plans aren’t rated by the National Committee for Quality Insurance (NCQA), a leading accreditation agency, making it difficult to draw comparisons about quality to others in their class.
Based on 986 ratings submitted to Consumer Affairs in the last year, Anthem is rated 4 out of 5 stars in overall satisfaction. Reviewers cite the ease with which they can access care, satisfaction with customer service, and the affordability of plans.
Anthem isn’t accredited by the Better Business Bureau (BBB), but it has an A+ rating with zero complaints.
Learn More From Our Sources
- U.S. Medicare | Getting Started with Medicare Advantage | Last accessed June 2021
- Anthem | Medicare Advantage Plans | Last accessed June 2021
- Investopedia Medicare Insurance | Anthem Medicare Advantage | Last accessed June 2021
- National Committee for Quality Assurance (NCQA) | Medicare Advantage Ratings 2019-2020 | Last accessed June 2021
- Consumer Affairs | Anthem Health Insurance Company | Last accessed June 2021
- Better Business Bureau (BBB) | Anthem Health Insurance Company | Last accessed June 2021