Anthem Medicare Advantage 2024-2025 Review: Pros, Cons, Costs

Anthem Medicare Advantage plans offer flexible options for care and extra benefits, but they have below-average star ratings and a limited service area.

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The bottom line: Anthem's benefits are strong, but its star ratings and member experience scores are below-average, and plans are available in only 14 states. Jump to: Full Review

Anthem Medicare Advantage

Anthem

3.52

CMS Star Rating

(855) 432-0512

TTY 711

Speak to a licensed insurance agent on askchapter.org
GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

IS THIS PROVIDER AVAILABLE IN MY STATE?

Anthem Medicare Advantage pros and cons

Pros

Wide-ranging benefits: Most Anthem plans cover prescription drugs and have dental, vision, hearing and wellness benefits beyond what’s included in Original Medicare.

Flexibility for additional benefits: Anthem plans let some members choose from a menu of benefits and services — like transportation, money toward household utilities or an allowance to spend on assistive devices — to add to their plan at no extra cost.

Flexible care options: Anthem members may have access to a 24/7 nurse line and 24/7 online appointments for virtual care.

Cons

Available in few states: Anthem offers Medicare Advantage plans in only 14 states.

Below-average ratings: Anthem plans' average star rating from CMS, weighted by enrollment, is 3.52 stars (the national average for all providers is 3.92 stars).

Fewer members in high-rated plans: Of Anthem’s plans with star ratings, only 24% of members are in plans rated 4 stars or better for the 2025 plan year. That’s a lower rate than most major Medicare Advantage providers.

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UnitedHealthcare Medicare Advantage - UHC (product card)

UnitedHealthcare

3.82

CMS Star Rating

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Aetna Medicare Advantage

Aetna

4.27

CMS Star Rating

(855) 432-0512

TTY 711

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on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

IS THIS PROVIDER AVAILABLE IN MY STATE?
Humana Medicare Advantage

Humana

3.63

CMS Star Rating

(866) 215-2655

TTY 711

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from Humana

5am - 8pm, daily PST

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Cigna Medicare Advantage

Cigna

3.93

CMS Star Rating

(855) 432-0512

TTY 711

Speak to a licensed insurance agent on askchapter.org
GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

IS THIS PROVIDER AVAILABLE IN MY STATE?

» More options in our roundup of the best Medicare Advantage plans

Compare against other providers

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UnitedHealthcare Medicare Advantage - UHC

UnitedHealthcare

3.82

CMS Star Rating

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Humana Medicare Advantage

Humana

3.63

CMS Star Rating

(866) 215-2655

TTY 711

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GET A QUOTE

from Humana

5am - 8pm, daily PST

Call Humana
(866) 215-2655

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» More options in our roundup of the best Medicare Advantage plans

Our full review

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Governed by NerdWallet's strict guidelines for editorial integrity.

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.

Anthem Medicare Advantage star ratings

Average star rating, weighted by enrollment: 3.52

Anthem Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.52 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.92

Centers for Medicare & Medicaid Services. Fact Sheet - 2025 Medicare Advantage and Part D Star Ratings. Accessed Oct 18, 2024.
.

Of Anthem members in plans with a Medicare star rating, only 24% are in plans rated 4 stars or better for the 2025 plan year

Centers for Medicare & Medicaid Services. 2025 Star Ratings Data Tables (ZIP). Accessed Oct 18, 2024.
.

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.

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

What does Anthem Medicare Advantage cost?

About half (49%) of Anthem Medicare Advantage plans have $0 premiums

Centers for Medicare & Medicaid Services. CY2025 Landscape (202409.1) (ZIP). Accessed Oct 18, 2024.
. For Medicare Advantage prescription drug plans with a premium, Anthem’s average monthly cost is $42.24. You'll also still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024 ($185 in 2025).

(Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium

Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Oct 18, 2024.
.)

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.

Deductible: $0 in-network.

Out-of-pocket max: $7,950 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $45.

  • Emergency care: $110.

  • Inpatient hospital: $395.*

Dental allowance: $1,000.

Anthem Grocery (HMO-POS)

Monthly premium: $0.

Deductible: None.

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

Copays:

  • Primary care: $0.

  • Specialist: $35.

  • Emergency care: $125.

  • Inpatient hospital: $345.**

Dental allowance: $2,000.

Anthem Extra Help (HMO-POS)

Monthly premium: $8.10.

Deductible: None.

Out-of-pocket max: $2,900 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Emergency care: $140.

  • Inpatient hospital: $300.*

Dental allowance: $3,000.

Selected plans are available in ZIP code 23173.

*Inpatient hospital copay is per day for days 1-5.

**Inpatient hospital copay is per day for days 1-6.

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.

Anthem Medicare Advantage plan types

Anthem offers Medicare Advantage prescription drug plans 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.

Anthem Medicare Advantage third-party ratings

AM Best Financial Strength Rating: A (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In December 2023, 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 2024 U.S. Medicare Advantage Study — the 10th 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 10 biggest state Medicare markets, and here’s how Anthem ranked

. (Anthem only had enough market share to be considered in two states.)

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 nearly 2 million Medicare Advantage beneficiaries, but the company lost 25,000 members for the 2024 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.

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 a preferred medical provider or 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).
Anthem Medicare Advantage

Anthem

3.52

CMS Star Rating

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

(855) 432-0512 / TTY 711

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org

GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.

States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.99 (Below average)

IS THIS PROVIDER AVAILABLE IN MY STATE?

States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.99 (Below average)

IS THIS PROVIDER AVAILABLE IN MY STATE?

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.

Cons

  • Available in only 14 states.
  • Below-average overall star ratings from CMS.
  • Higher average maximum out-of-pocket costs on plans.

Medicare Advantage review methodology

The Medicare Advantage marketplace is concentrated among just a handful of companies; in many places, one insurer serves more than half of the market. NerdWallet reviewed 26 Medicare Advantage brands, with some insurers having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.) At the national level, these reviews include nine of the 10 largest brands by enrollment. At the state level, our research includes at least one major insurer in 47 of the 49 states that offer Medicare Advantage plans, and includes the top two insurers in 35 of those 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.

NerdWallet’s Medicare Advantage reviews are based on ratings data from the Centers for Medicare & Medicaid Services, as well as pricing, plan availability by state, plan types available, consumer experience, extra benefits offered and more. 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.

Medicare will have big changes in 2025. Compare Medicare Advantage plans