The bottom line: Anthem's standard benefits are strong and some plans offer a menu of extra perks. But its quality ratings from the Centers for Medicare & Medicaid Services (CMS) could be better, and its plans get more customer complaints than average. Jump to: Full Review
Anthem Medicare Advantage pros and cons
Pros
- Standard benefits: Most Anthem plans cover prescription drugs and include some coverage for dental, vision and hearing services. Some plans may include a flex card to cover certain expenses.
- Flexibility for additional benefits: Some Anthem plans offer a choice from a menu of extra services at no extra cost. Example offerings include transportation or allowances to cover costs for assistive devices or dental, hearing and vision services.
Cons
- Below-average government quality ratings: Anthem plans' average star rating from CMS, weighted by enrollment, is 3.63 out of 5, which is below the average for all companies.
- Customer complaints: Anthem plans get about 40% more member complaints than the average among companies NerdWallet analyzed.
- Out-of-pocket costs: Anthem has some of the highest maximum out-of-pocket costs, on average, among large Medicare Advantage companies.
- Available in few states: Anthem offers Medicare Advantage plans in only 13 states.
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Our full review
45+ Medicare companies and brands analyzed by our team of experts.
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NerdWallet’s Medicare content, including articles, reviews and recommendations, is produced by a team of writers and editors who specialize in Medicare. Their work has appeared in The Associated Press, Washington Post, Nasdaq, MSN, MarketWatch, Yahoo! Finance and other national and regional media outlets. They have been cited in publications including Healthline, and appeared on NerdWallet's "Smart Money" podcast.
NerdWallet star rating for Anthem Medicare Advantage
Anthem Medicare Advantage plans earned 3.3 out of 5 stars for overall performance. NerdWallet’s ratings are determined by our editorial team. The scoring formula takes into account premiums, out-of-pocket costs, government quality ratings, customer complaints, disenrollment survey data, third party quality accreditation and more.
NerdWallet star ratings are different from CMS ratings for Medicare plans.
Our data-driven, consumer-first scoring rubric for Medicare Advantage plans includes crucial metrics like cost and a wider range of data sources for quality and customer satisfaction in addition to the information incorporated into CMS ratings.
Government quality ratings for Anthem Medicare Advantage
Average CMS star rating, weighted by enrollment: 3.63
Anthem Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.63 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2026, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 4.02.
Of Anthem members in plans with a Medicare star rating, 46% are in plans rated 4 stars or better for the 2026 plan year.
CMS maintains its own database of star ratings, which rank each plan 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.
You can find a plan’s rating with Medicare's plan finding tool.
How much does Anthem Medicare Advantage cost?
Premiums
About 56% of Anthem Medicare Advantage plans have a $0 premium.
Anthem plans with a premium cost about $32.37 per month on average, weighted by enrollment.
With any Medicare Advantage plan, you’ll also be responsible for paying your Medicare Part B premium, which is at least $202.90 per month in 2026.
Most people pay this standard amount, but if your income is above a certain threshold, you’ll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans pay some or all of your Part B premium.
Prescription drugs
About 91% of Anthem Medicare Advantage plans include prescription drug coverage.
Here’s what you might pay for prescription drugs at some common price points.
Tier 1 (Preferred generics) 99% of Anthem's Medicare Advantage plans have $0 copays/coinsurance.
$2.73: Average out-of-pocket cost for a drug with a $15 retail price, among Anthem plans with copays or coinsurance at Tier 1 (after deductible, if any).
Tier 2 (Most generics) 69.8% of Anthem's Medicare Advantage plans have $0 copays/coinsurance.
$11.70: Average out-of-pocket cost for a drug with a $50 retail price, among Anthem plans with copays or coinsurance at Tier 2 (after deductible, if any).
Tier 3 (Preferred brands) None of Anthem's Medicare Advantage plans have $0 copays/coinsurance.
$48.91: Average out-of-pocket cost for a drug with a $200 retail price, among Anthem plans with copays or coinsurance at Tier 3 (after deductible, if any).
Other out-of-pocket costs
Anthem Medicare Advantage plans have an average maximum out-of-pocket (MOOP) spending cap of $7,175, weighted by enrollment. That’s higher than average among the companies NerdWallet reviews.
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.
To get a sense of costs, Medicare.gov and most other Medicare shopping tools can help you compare plans' premiums and out-of-pocket costs for certain services and prescription drugs in your location.
Why do people leave Anthem Medicare Advantage plans?
CMS surveys people who voluntarily leave their Medicare plans about their reasons for leaving. Here’s the breakdown of problems people identified with their former Anthem Medicare plans.
Problems getting covered care: 7% (All-company average: 11%).
Problems with doctor/hospital networks: 19% (All-company average: 17%).
Financial issues: 15% (All-company average: 17%).
Problems with prescription drug benefits: 1% (All-company average: 3%).
Problems getting information from the plan: 7% (All-company average: 9%).
(Members can give more than one reason for leaving on the survey and might leave plans for other reasons, so the categories won’t add up to 100%.)
Anthem Medicare Advantage plan types
Anthem offers Medicare Advantage 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.
Third-party ratings of Anthem
AM Best Financial Strength Rating: A (Excellent)
AM Best is a credit rating agency that specializes in the insurance industry. In December 2025, AM Best affirmed its Financial Strength Rating of A for the insurance subsidiaries of parent company Elevance Health, collectively referred to as Anthem Health.
An A rating in this category indicates that AM Best believes the company has an excellent ability to meet its ongoing insurance obligations.
JD Power Ranking
JD Power releases an annual study measuring member satisfaction with Medicare Advantage plans. It uses eight factors, such as level of trust, ability to get health services, ease of doing business and resolving problems or complaints.
Here’s how Anthem ranked among major companies in the Medicare markets where it has enough market share to appear on the survey:
California: 8th out of 8.
Georgia: 2nd out of 5.
Ohio: 1st out of 4.
Anthem Medicare Advantage service area
Anthem offers Medicare Advantage plans in 13 states.
Anthem's parent company, Elevance Health, is the fourth-largest for-profit Medicare Advantage provider with nearly 1.9 million members. The company lost about 368,000 members from 2025 to 2026, according to health care analytics firm Chartis.
About Anthem
Anthem's parent company, Elevance Health, is headquartered in Indianapolis. It 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. Its Medicare products include Medicare Advantage and Medicare Supplement Insurance, but it recently stopped selling Medicare Part D plans. It also offers other products such as life, disability, dental and vision insurance.
» MORE: Read our review of Anthem Medicare Supplement Insurance
Anthem Medicare Advantage customer service
Here’s how Anthem members can contact customer service:
Call a state-specific phone number. Log in or select your state on Anthem’s Contact Us page to find the number and hours.
Chat on anthem.com or in Anthem’s Sydney Health app for Android or iOS.
Email help@anthem.com.
Compare Medicare Advantage companies
Get more information below about some of the major Medicare Advantage insurance companies. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have preferred medical providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
- 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.
- Below-average quality ratings from CMS.
- Customers file more complaints than average.
- Available in only 13 states.
- Higher average maximum out-of-pocket costs on plans.
NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.
- 1.NerdWallet analysis of CMS data. 2026 Star Ratings Data Tables. Accessed Apr 23, 2026.
- 2.NerdWallet analysis of CMS data. Monthly Enrollment by Plan. Accessed Apr 23, 2026.
- 3.NerdWallet analysis of CMS data. CY2026 Landscape 202603. Accessed Apr 23, 2026.
- 4.Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Apr 23, 2026.
- 5.NerdWallet analysis of CMS data. Beneficiary Cost File. Accessed Apr 23, 2026.
- 6.NerdWallet analysis of CMS data. 2026 Star Ratings Data Table - Disenrollment Reasons (Oct 8 2025). Accessed Apr 23, 2026.
- 7.AM Best. AM Best Takes Various Credit Rating Actions on Elevance Health, Inc. and Most of Its Subsidiaries. Accessed Apr 23, 2026.
- 8.JD Power. Medicare Advantage Plan Member Satisfaction Facing Headwinds; Digital Innovation an Emerging New Solution, JD Power Finds. Accessed Apr 23, 2026.
- 9.Chartis. Medicare Advantage Enrollment Depicts Industry at a Crossroads. Accessed Apr 23, 2026.
Medicare Advantage review methodology
NerdWallet’s Medicare Advantage ratings are based on premiums, out-of-pocket costs, prescription drug coverage, quality data from the Centers for Medicare & Medicaid Services, consumer experience and more. We calculate each health insurance company’s rating on a curved 5-point scale.
NerdWallet’s editorial team analyzed companies covering about 87% of all Medicare Advantage beneficiaries in the United States. We reviewed 25 Medicare Advantage brands, with some insurance companies having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.)
The Medicare Advantage marketplace is concentrated among just a handful of companies. In many places, one company serves more than half of the market. At the national level, NerdWallet’s reviews include each of the 10 largest brands by enrollment.
At the state level, our research includes at least one major insurer in every state where Medicare Advantage plans are sold, and includes the top two insurers in 40 of those 49 states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
Compare Medicare Advantage plans
Insurance company | CMS star rating | States available | Members in high-rated plans | Member experience | Learn more | |
|---|---|---|---|---|---|---|
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.11 | 4.11/5 | 48 states and Washington, D.C. | Medium (50% to 84%) | 3.74 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.79 | 3.79/5 | 46 states and Washington, D.C. | Low (49% or less) | 3.82 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet | 4.20 | 4.20/5 | 43 states and Washington, D.C. | Medium (50% to 84%) | 3.89 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.76 | 3.76/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.96 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |