Anthem Medicare Advantage 2024 Review

Anthem Medicare Advantage plans offer flexible options for care and extra benefits, but they have below-average ratings and a limited service area.
Kate Ashford, CSA®
Alex Rosenberg
By Alex Rosenberg and  Kate Ashford, CSA® 
Updated
Edited by Holly Carey

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Anthem Medicare Advantage - ME

Anthem

3.45

CMS Star Rating

Anthem's plans offer a range of benefits and flexible care, but plans are available in only 14 states and receive below-average star ratings.

(855) 608-4561 / TTY 711

8am - 11pm EST, 7 days a week

Speak to a licensed insurance agent on MedicareEnrollment.com

GET A QUOTE

from MedicareEnrollment.com

States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.89 (Below average)


States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.89 (Below average)


Pros

  • Most plans cover prescription drugs and offer some coverage for dental, hearing and vision care.
  • Anthem's "Essential Extras" benefits let members choose extra plan benefits that meet their needs, such as $500/year toward assistive devices or $150/quarter toward household utilities.

Cons

  • Available in only 14 states.
  • Below-average overall star rating and member experience scores from CMS.
  • 4-star rated plans available in only three states.

Anthem is one of the brands of parent company Elevance Health. Anthem-branded Medicare Advantage plans are available in 14 states as part of the Blue Cross Blue Shield collective

Anthem. Anthem Health Plans. Accessed Oct 23, 2023.
.

Anthem plans offer competitive premiums and plenty of $0-premium options, but their ratings for quality and member experience are below average

NerdWallet analysis of CMS data. 2024 Star Ratings Data Tables (Oct 13 2023). Accessed Oct 23, 2023.
.

Here’s what you should know about Anthem Medicare Advantage.

Anthem Medicare Advantage star ratings

Average star rating, weighted by enrollment: 3.45

CMS maintains star ratings for Medicare Advantage and Medicare Part D plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures. Based on the most recent year of data and weighted by enrollment, Anthem’s 2024 Medicare Advantage plans get an average rating of 3.45 stars

NerdWallet analysis of CMS data. 2024 Star Ratings Data Tables (Oct 13 2023). Accessed Oct 23, 2023.
.

For comparison, the average star rating for plans from all providers in 2024 is 4.04

Centers for Medicare & Medicaid Services. Fact Sheet - 2024 Medicare Advantage and Part D Star Ratings . Accessed Oct 23, 2023.
.

Of Anthem members in contracts with a Medicare star rating, 11% were in contracts rated 4.0 or above as of October 2023

NerdWallet analysis of CMS data. Monthly Enrollment by Contract, 2023-10. Accessed Oct 23, 2023.
.

You can find a plan’s rating with the Medicare plan-finding tool.

Anthem Medicare Advantage pros and cons

Anthem’s offerings have advantages and disadvantages.

Pros

Cons

  • Available in relatively few states: Anthem offers Medicare Advantage plans in only 14 states. Most of Anthem's competitors have a larger footprint.

  • Below-average ratings: Anthem plans' average star rating from the Centers for Medicare & Medicaid Services (CMS), weighted by enrollment, is 3.45 stars (the national average for all providers is 4.04 stars), and its scores for member experience metrics are below the average among major providers.

    NerdWallet analysis of CMS data. 2024 Star Ratings Data Tables (Oct 13 2023). Accessed Oct 23, 2023.
    .

  • Fewer members in 4-star or better plans: Of Anthem’s plans with star ratings, 11% of members were in plans rated 4 stars or better as of October 2023. That’s a lower rate than most major Medicare Advantage providers.

What does Anthem Medicare Advantage cost?

Costs for Medicare Advantage plans depend on your plan, geographic location and health needs.

Premiums

One of the costs to consider is the plan’s premium. About 3 in 5 (59%) Anthem Medicare Advantage plans have $0 premiums

Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005. Accessed Oct 23, 2023.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024, although some plans cover part or all of this cost

Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Oct 23, 2023.
. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network or how often you may go out-of-network for care.

  • Whether you require extra benefits and whether the plan charges for them.

Here are examples of Anthem Medicare Advantage costs for the most popular plans in a mid-range city:

Anthem Medicare Advantage plan

Pricing

Anthem Medicare Advantage (PPO)

Monthly premium: $0.

Out-of-pocket max: $7,550.

Copays:

  • Primary care: $0.

  • Specialist: $40.

  • Tier 1 prescription drugs: $4.

Anthem Grocery (HMO)

Monthly premium: $0.

Out-of-pocket max: $4,900.

Copays:

  • Primary care: $0.

  • Specialist: $35.

  • Tier 1 prescription drugs: $0.

Anthem I Carelon Medicare Advantage (HMO)

Monthly premium: $0.

Out-of-pocket max: $3,850.

Copays:

  • Primary care: $0.

  • Specialist: $0-$20.

  • Tier 1 prescription drugs: $0.

Selected plans are available in ZIP code 23173.

To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Anthem plans or compare across carriers. You can also shop directly from Anthem’s website by entering your ZIP code.

Anthem Medicare Advantage plan types

There are several kinds of Anthem Medicare Advantage plans, and they vary in terms of structure, costs and benefits. Anthem offers Medicare Advantage prescription drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage plans without drug coverage.

Plan offerings include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point-of-service (POS) plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Anthem offers three types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

  • Institutional SNP: For people living in an Anthem network nursing home or assisted living community or another plan-approved spot.

Available Anthem Part D prescription drug plans

Most of Anthem’s Medicare Advantage plans include Part D drug coverage, but the company also sells stand-alone Part D prescription drug plans, or PDPs, in 12 states

Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005. Accessed Oct 23, 2023.
. These plans provide drug coverage for people enrolled in Medicare Part A and Part B, so they don’t provide medical coverage.

Anthem offers two plan options in each state where it sells stand-alone prescription drug plans: a standard option and a “plus” option with enhanced coverage. For example, if you live in Madison, Wisconsin, you have these two options from Blue Cross Blue Shield of Wisconsin:

  • Anthem MediBlue Rx Standard.

  • Anthem MediBlue Rx Plus.

Here’s how those plans compare:

Plan feature

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Monthly premium

$83.60.

$89.50.

Annual deductible

$545.

None.

Drug copay, Tier 1*

$1.

$1.

Drug copay, Tier 2*

$2.

$4.

Drug copay, Tier 3*

20%.

$47.

*For a 30-day supply of a covered Part D prescription drug at a preferred retail pharmacy after meeting any applicable deductible.

Source: Anthem. Compare Part D Plans.

Premiums, deductibles, covered drugs, costs for each tier and pharmacy arrangements all differ by plan. You can enter information about your prescriptions and choose your pharmacy on Anthem’s website to check how each available plan would cover your medications.

Anthem Medicare Advantage third-party ratings

A few companies weigh in on health plans or on the strength of the company in question, and we’ve included two:

AM Best Financial Strength Rating: A (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In December 2022, AM Best affirmed its Financial Strength Rating of A for the core Blue Cross Blue Shield-branded insurance subsidiaries of parent company Elevance Health

. An A rating in this category indicates that AM Best believes the company has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking

In its 2023 U.S. Medicare Advantage Study — the ninth it’s done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the five biggest Medicare markets, and here’s how Elevance Health, Anthem’s parent company, ranked out of all major providers. (Elevance Health sells plans in three of the five markets.)

Anthem Medicare Advantage service area

Anthem offers Medicare Advantage plans in 14 states.

Anthem's parent company, Elevance Health, is the fourth-largest for-profit Medicare Advantage provider

. Elevance plans cover more than 1.7 million Medicare Advantage beneficiaries, and the company added 142,000 new members for the 2023 plan year.

About Anthem

Anthem's parent company, Elevance Health, is headquartered in Indianapolis and was formed in 2004 out of a merger between WellPoint Health Networks and Anthem. In 2022, the company changed its name to Elevance Health, but it continues to sell Medicare products under the Anthem brand.

Elevance Health offers commercial health insurance for individuals and employers; Medicare Advantage, Medicare Supplement Insurance and Medicaid plans; life, disability, dental and vision insurance; and services for other government health insurance programs.

Anthem Medicare Advantage customer service number

Here’s how Anthem members can contact customer service:

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

Still deciding on the right carrier? Compare Medicare Advantage plans

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