2023 Cigna Medicare product and Benefits Exam answers

Our Verdict

Anthem offers various Medicare Advantage plans (also known as Medicare Part C) that provide benefits often missing from Original Medicare, including vision, hearing, dental and other wellness services.

Key Features

• One of the largest providers of Medicare Advantage plans, offering coverage in 14 states as part of the Blue Cross Blue Shield network.
• Offers Medicare Advantage health maintenance organization (HMO) plans, preferred provider organization (PPO) plans and special needs plans (SNPs)
• Through its affiliated companies, Anthem serves approximately 118 million people.

Based in Indianapolis, Indiana, Anthem, Inc. was formed in 2004 from a merger of WellPoint Health Networks and Anthem. The company offers a variety of personalized benefits as part of its effort to shift from a benefits provider to a whole-health company. In terms of Medicare Advantage options, Anthem offers a range of plans, as well as educational resources, such as free Medicare events where customers can learn more about their Medicare Advantage plan options. The sessions are held virtually and in person, and a licensed Medicare professional is available to answer questions at the in-person events.

Anthem Inc. rebranded to Elevance Health Inc. in 2022. However, Anthem Blue Cross Blue Shield companies continue to operate in 14 states under the Anthem name with Elevance as the parent company. These states include Colorado, Maine, Missouris, Connecticut and Virginia.

Anthem Medicare Advantage at a Glance

• Plan options: Anthem Medicare Advantage plans include HMO, PPO and SNP plans, all of which offer the coverage of Original Medicare plus extra benefits, which may include vision, hearing, dental and a variety of special offerings that vary by plan and region. Prescription coverage (Medicare Part D) may be included in some Medicare Advantage plans depending on your location.
• Provider network: Although Anthem Blue Cross Blue Shield Medicare Advantage plans are only available in 14 states, members have access to the entire Blue Cross Blue Shield network nationwide.
• Average monthly premium:  A number of Anthem Medicare Advantage plans offer $0 monthly premiums. However, the cost of a plan ultimately depends on your location and any additional coverage you choose to purchase.

How It Works

Anthem Blue Cross Blue Shield offers Medicare Advantage plans in 14 states, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. These plans provide Original Medicare Part A and Part B coverage, plus other benefits like dental, vision, hearing and prescription drugs (in some cases). They also set a limit on how much you pay out of pocket for medical expenses that are covered by these benefits.

Anthem Medicare Advantage plan offerings include HMO, PPO and SNP plans, each of which offer a variety of benefits, depending on your financial and health needs.

HMO plans allow you to choose a primary care provider within the Anthem network and offer $0 monthly premiums, as well as fixed, low copays when you visit your healthcare provider. Anthem’s Mediblue HMO plans also typically offer $0 deductibles, meaning Anthem will share the cost of medical expenses as soon as your coverage begins. Vision, dental and hearing benefits are included (with the exception of hearing aids), as well as membership to Silver Sneaker fitness programs and 24/7 telehealth access.

PPO plans enable you to pick a primary care provider of your choice, including providers who are out-of-network. However, they must participate in the Medicare program. Choosing an out-of-network provider may also increase your costs. Anthem Medicare Advantage PPO plans allow you to seek specialist care without referrals and typically offer $0 monthly premiums, low copays and $0 deductibles. Additional benefits include dental, vision and hearing coverage. Prescription drug coverage may also be included in some plans, depending on your location. Fitness memberships and 2/47 telehealth access are offered as well.

SNP plans are options for those living with certain medical conditions or diseases, as well as people with lower incomes. These plans offer Medicare Part B premium coverage ($164.90 a month for most enrollees in 2023), extra support from your care team, transportation services, prescription drug coverage, free meals, fitness memberships and more. Chronic Condition SNPs (C-SNPs) are available specifically for people with chronic conditions, such as heart disease, diabetes or a lung disease, and dual-eligible SNPs (D-SNPs) are available for people who are eligible for both Medicare and Medicaid.

Anthem offers a number of additional Medicare Advantage benefits through its Essential Extras benefits, which include:

• $500 per year for assistive safety devices, such as handrails, temporary mobility ramps, raised toilet seats and more
• A Flex account with a $500 annual allowance for additional dental, vision and hearing needs
• Health and fitness tracker devices
• A monthly allowance for healthy groceries like vegetables, fresh or frozen meats, canned goods, dairy items and more
• Meal delivery for 180 healthy meals per year for members with qualifying illnesses or conditions
• 60 hours of companion care services per year to prevent social isolation and/or help with tech support, medication management, errands and transportation
• 124 hours of home health aid assistance per year
• Pest control
• 60 one-way trips to medical appointments and/or pharmacy visits

The Cost

The cost of an Anthem Medicare Advantage plan depends on what plan you choose, where you live and any added benefits you purchase to support your health needs. If you need prescription drug coverage, Medicare Part D is an important consideration when selecting a plan, and cost estimates vary by prescription needs.

It’s important to shop for a plan that meets your needs. When reviewing your Medicare Advantage plan options, the following factors may help determine your costs:

• Monthly premiums are the amount you pay for coverage and may vary by company and health plan. You still pay the monthly Medicare Part B premium, as well as any premium costs associated with your plan. Some plans may have a $0 premium and may offer to pay all or a portion of your Part B premium. Some Anthem Medicare Advantage plans also include Medicare drug coverage (Part D).
• Deductibles, the amount you pay for a service before your insurance contributes to expenses.
• Out-of-pocket maximums don’t include your monthly premium. The federal government sets the maximum amount that Medicare Advantage beneficiaries can pay out of pocket every year. Once you reach that limit, the insurance company pays 100% of any covered service for the remainder of that coverage year.
• Copays are fixed amounts you pay during a visit to a health care provider. Some Medicare Part C plans may have a higher copay for healthcare providers who are out of network.

For example, see how costs across three Anthem Medicare Advantage plan options offered in Tippecanoe County, Indiana, compare below.

The Fine Print

Look closely at each Anthem Medicare Advantage plan and the specific benefits that meet your needs. Be mindful that plan availability and coverage varies by location, and coverage areas are determined by county. Search your ZIP code on the Anthem Medicare Advantage website to find plans available in your area.

What Experts Say

Anthem has been innovative in the Medicare Advantage space, according to Jake McGeoy, senior manager of agent relations at Ritter Insurance Marketing in Reisterstown, Maryland. “Anthem seems to be very good at identifying the ‘extras’ that members are looking for,” he says. “The Flex Card has been a big hit, [and] members like being able to pick and choose their benefits to create a personalized plan.” McGeoy also notes the broad network of providers available under the Anthem Blue Cross plans. “Anthem has Medicare Advantage plans in 24 states and 14 of those are Blue Cross Anthem plans,” he adds. “The Blue Cross PPO plans have access to the entire BCBS network. The other Anthem plans are part of Anthem Health, now called Elevance.”

Frequently Asked Questions (FAQs)

Is Anthem a good Medicare Advantage Plan?

Anthem offers competitive plans and a variety of benefits in their Medicare Advantage plans. Anthem’s 2022 Medicare Advantage plans scored ratings from 3.5 to 5 stars from the Centers for Medicare and Medicaid Services (CMS).

Is Anthem Medicare considered an Advantage plan?

Yes, Anthem offers Medicare Advantage plans including HMOs, PPOs and SNPs. In addition to Medicare Part C benefits, Anthem also offers drug coverage and “Essential Extras” which may include pest control, food services or transportation. These benefits vary by plan and geographic region.

What is the biggest disadvantage of Medicare Advantage?

Anthem Medicare Advantage plans are only available in a limited number of states.