Anthem Medicare Advantage (HMO) Medicare Advantage Plan H8432-011 • 2027 • Suffolk County, NY
- Monthly Premium
- $96.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $100.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Suffolk County, NY
- Local Enrollment
- 3,536 beneficiaries in Suffolk County
Anthem Medicare Advantage (HMO) Introduction
CMS Plan ID H8432-011 identifies Anthem Medicare Advantage, a Medicare Advantage HMO plan offered by Anthem Blue Cross and Blue Shield HP. The plan uses a Health Maintenance Organization (HMO) provider network and comes with prescription drug coverage. Its costs for the 2027 plan year include a $96.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $100.00.
This plan is available to eligible beneficiaries who live in Suffolk County, New York. CMS reports local enrollment of 3,536 beneficiaries for this plan in Suffolk County. New members can contact the plan at (833)668-2339 (TTY 711) for help and additional plan information.
Compare Similar Plans in Suffolk County
Compare this plan with the two most-enrolled HMO plans available in Suffolk County, New York. Enrollment is based on CMS local enrollment data.
| Plan Detail | Anthem Medicare Advantage | Healthfirst Increased Benefits Plan | VNS Health EasyCare |
|---|---|---|---|
| CMS Plan ID | H8432-011-0 |
H3359-019-0 |
H5549-012-0 |
| Local Enrollment | 3,536 | 1,605 | 848 |
| Monthly Premium | $96.00 | $17.10 | $25.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $9,850.00 | $9,850.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $15 copay | $0 copay | $0 copay |
| Specialist | $55 copay | $0-$25 copay | $35 copay |
| Part D Deductible | $100.00 | $700.00 | $650.00 |
| CMS Star Rating | 3.0 | 3.5 | 4.0 |
| Dental | Not covered | $0 copay | $0 copay |
| Vision | Not covered | $0 copay | $0 copay |
| Hearing | Not covered | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Suffolk County, or compare Medicare Advantage plans across New York, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for Anthem Medicare Advantage includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H8432-011.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8432-011-0 Cost Compare.
Office Visits
- Primary care
- In-network: $15 copay
- Specialist
- In-network: $55 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $40-$300 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $40-$90 copay
- Diagnostic tests and procedures
- In-network: $0-$150 copay
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- Tier 1
$410 per day for days 1-5
$0 per day for days 6-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$218 per day for days 21-100 - Ground ambulance
- In-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $55 copay
- Outpatient group therapy
- In-network: $55 copay
- Inpatient psychiatric hospital care
- Tier 1
$410 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $35 copay
- Occupational therapy
- In-network: $35 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- Not covered
- Contact lenses
- Not covered
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- Not covered
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Anthem Medicare Advantage as a Part B benefit.
Prescription Drug Coverage
Anthem Medicare Advantage includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $90.00 |
| Supplemental Part D Premium: | $$6.00 |
| Total Part D Premium: | $96.00 |
| Low-Income Premium Subsidy: | $40.45 |
| Low-Income Premium Subsidy Paid by CMS: | $40.50 |
| Low-Income Subsidy Premium: | $55.50 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $100.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Anthem Blue Cross and Blue Shield HP starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Anthem Medicare Advantage may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 28% coinsurance | Coming soon |
| Specialty Tier | 32% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H8432)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Anthem Blue Cross and Blue Shield HP
- Website
- Anthem Blue Cross and Blue Shield HP Plan Page
- Providers
- Anthem Blue Cross and Blue Shield HP Providers Page
- Formulary
- Anthem Blue Cross and Blue Shield HP Formulary Page
- Pharmacy
- Anthem Blue Cross and Blue Shield HP Pharmacy Page
- New Member Health Plan Help
- (833)668-2339
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (833)668-2347
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Anthem Medicare Advantage is available to eligible Medicare beneficiaries residing in Suffolk County, New York, including communities such as Amityville, Babylon, North Babylon, West Babylon, Bayport, Bay Shore, Bellport, Blue Point, Bohemia, Brentwood, Brightwaters, Brookhaven, Centereach, Centerport, Central Islip, Cold Spring Harbor, Commack, Copiague, Coram, Deer Park, East Islip, East Northport, East Setauket, Farmingville, Greenlawn, Holbrook, Holtsville, Huntington, Huntington Station, Melville, Islandia, Islip, Islip Terrace, Kings Park, Lake Grove, Lindenhurst, Medford, Miller Place, Mount Sinai, Nesconset, Northport, Oakdale, Patchogue, Port Jefferson Station, Port Jefferson, Rocky Point, Ronkonkoma, Saint James, Sayville, Selden, Shoreham, Smithtown, Hauppauge, Sound Beach, Stony Brook, Wading River, West Islip, West Sayville, Wyandanch, Riverhead, Calverton, Center Moriches, Cutchogue, East Hampton, East Moriches, Eastport, East Quogue, Greenport, Hampton Bays, Manorville, Mastic, Mastic Beach, Mattituck, Middle Island, Montauk, Moriches, Ridge, Sag Harbor, Shelter Island, Shirley, Southampton, Southold, Water Mill, Westhampton, Westhampton Beach, Yaphank, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Anthem Blue Cross and Blue Shield HP (official source) | http://www.empireblue.com/shop | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.