Anthem Medicare Advantage and Medigap Overview

Medicare.net is powered by Health Network Group, LLC, which is related to Health Compare Insurance Services, Inc., who is a licensed, authorized agent of: Anthem Blue Cross of California, Anthem Blue Cross of Colorado, Anthem Blue Cross of Connecticut, Anthem Blue Cross of Georgia, Anthem Blue Cross of Indiana, Anthem Blue Cross of Kentucky, Anthem Blue Cross of Maine, Anthem Blue Cross of Missouri, Anthem Blue Cross of New Hampshire, Anthem Blue Cross of Nevada, Anthem Blue Cross of New York, Anthem Blue Cross of Ohio, Anthem Blue Cross of Texas, Anthem Blue Cross of Virginia, Anthem Blue Cross of Wisconsin, Blue Cross Blue Shield of Illinois, Blue Cross Blue Shield of Montana, Blue Cross Blue Shield of New Mexico, Blue Cross Blue Shield of Oklahoma, Capital Blue Cross of Pennsylvania, Highmark of West Virginia, Premera in Washington, Premera in Alaska, and Vibra in Pennsylvania.

Anthem provides health insurance coverage to around 40 million members and ranks among the largest insurers in the country, serving 14 states as a Blue Cross and Blue Cross Blue Shield independent licensee. The company has several subsidiaries, including CareMore Health Group, UniCare and HealthLink. With a large market share and multiple coverage options available in most areas, Anthem is an established provider of Medicare and Medigap options. If you live in one of the areas served by Anthem, you will likely have several plan options available.

Most plans available through Anthem maintain a star rating of 3 to 4.5 (on a scale from 1 to 5) from the Centers for Medicare & Medicaid Services. In most areas, available coverage options will include Medicare Advantage, Medicare supplement and Medicare prescription drug (Part D) plans. Medicare Advantage plans (Part C) usually include both HMO and PPO selections. Anthem strives to keep copays low and appreciates the fact that preventive services reduce future health issues, which is why many of the company’s Medicare Advantage plans include a list of preventive services covered without a copay.

The A.M. Best Financial Strength Rating for Anthem and its Blue Cross Blue Shield core subsidiaries is A, while the Long-Term Issuer Credit Ratings is “a+”, signaling a strong financial state. Financial security is important because it shows that the company is managed well and can be relied upon to continue paying claims for its members. This also means that it’s unlikely to let you down when you need coverage. 

Anthem Medicare Advantage

Anthem sells a variety of Medicare Advantage plans to those living in the 15 states where it operates: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Texas, Virginia, Wisconsin. Plan availability and pricing will always depend on where you live, your age and gender, and other factors. That’s why it’s essential to get a quote based on your unique information. To give you some idea of what you might find from Anthem Medicare Advantage plans, we’ve compared three plans from Franklin County, Ohio, from 2019 in the chart below. 

	MediBlue Essential HMO	MediBlue Access PPO	MediBlue Extra HMO
Monthly premium	$0	$56	$33
Copay (primary)	$5	$10 (in network)	$0 in network
Deductibles	$0 for medical$60 for drug (tiers 3-5)	$0 for medical in network($1,000 out of network)$50 for drug (tiers 3-5)	$0 for medical$415 for drug (tiers 2-5)
Network	In-network coverage only	Coverage for network and non-network care	In-network coverage only
Rx coverage?	Yes	Yes	Yes
Rx cost	$4 copay for tier 1	$4 copay for tier 1	$0 copay for tier 1
Special features	Preventive dental, hearing aids and $175 for eyeglasses; meals after hospitalization, and gym membership	Preventive dental, hearing aids and $150 for eyeglasses; credit for over-the-counter items, and gym membership	Comprehensive dental, hearing aids and $125 for eyeglasses; transportation and OTC benefits; meal deliveries, massage, day center visits, plus more
Out-of-pocket max	$4,900	$6,400 (in network)	$6,700
CMS Star Rating	3.5	4	3.5

Understanding Anthem Medigap Options

Along with Medicare Advantage, Anthem has several Medicare supplement plans available. These plans, also known as Medigap policies, provide extra coverage to supplement original Medicare (Parts A and B). Policies are standardized at the federal level in every state except for Massachusetts, Minnesota and Wisconsin. These states set up different requirements for Medigap plans.

Federal standardization means you’ll find that every plan type looks the same, by letter, in every state, whether you buy it from Anthem or another company. Plan N in Kentucky, for instance, will cover all the same benefits as Plan N in New Hampshire. Pricing and the company selling the plan are the only distinguishing factors.

Your best bet for learning about the Medicare supplement options available to you is to get a quote based on where you live and your personal info. The company offers five options: A, B, F, G and N. Note that Anthem does not sell the high-deductible version of Medigap Plan F.

Anthem Medigap Plan A

All insurers who offer Medigap policies are required to offer Plan A, which covers basic benefits to supplement Medicare Parts A and B. Plan A can be a useful addition to your original Medicare coverage, but it does cover fewer services than any other Medigap plan. Plan A covers the basics in terms of a Medicare supplemental policy:

• Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
• Part A hospice care coinsurance or copayment
• Part B coinsurance or copayment
• The first three pints of blood

Anthem Medigap Plan B

Medigap Plan B is very similar to Plan A. The difference is that this coverage will also pay the deductible for your original Medicare Part A coverage. Because the Part A deductible, which is $1,556 in 2022, applies to each benefit period, a Medigap plan that covers the deductible will be especially beneficial if you’re hospitalized multiple times throughout the year. Of course, because this plan covers a little more than Plan A does, it typically costs a little more as well. The benefits included in Plan B are:

• Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Part B coinsurance or copayment
• The first three pints of blood

Anthem Medigap Plan F

Note: Medigap Plan F is no longer available to newly eligible Medicare members as of January 1, 2020.

The most comprehensive Medigap option is Plan F. It’s one of the only plans to cover the Part B deductible, which costs $233 in 2022. Because this plan covers so much, it can be pricier than other options. One thing to note with Plan F is that it is no longer available as of 2020. Medigap plans that pay the Part B deductible were eliminated. This new rule applies to all insurance companies, not just Anthem. However, people who were eligible for Medicare before 2020 may still be able to buy Plan F. Here’s what Plan F covers:

• Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B deductible
• Part B coinsurance or copayment
• Part B excess charges
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Anthem Medigap Plan G

The Medicare supplement plan that’s most similar to Plan F is Plan G. The only difference is that Plan G doesn’t cover the Part B deductible. This is an important distinction since it means that Plan G is still available, unlike Plan F. It also means that Plan G usually costs a bit less than Plan F. With this plan, you get coverage for:

• Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B coinsurance or copayment
• Part B excess charges
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Anthem Medigap Plan N

Some people are looking for a Medicare supplement plan that covers more than just the basics but costs less than a fully comprehensive plan. If you’re one of those people, then Plan N can be a good choice. It includes quite a few more benefits than Plan A. But Plan N requires a copay for some services, so it’s usually priced fairly competitively. Plan N covers:

• Part A coinsurance and hospital costs (up to 365 days after Medicare hospital benefits end)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B coinsurance or copayment
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

If you’re not sure about Medicare policies or whether you should be choosing Medigap, Medicare Advantage or something else entirely, don’t hesitate to ask for help. We’re experts when it comes to the ins and outs of Medicare, and we can point you in the right direction. To learn more about your coverage options, get a personalized quote today.