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Anthem Medicare Advantage 2024 Review
Anthem Medicare Advantage plans offer flexible options for care and extra benefits, but they have below-average star ratings and a limited service area.
Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 18 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Alex Rosenberg Lead Writer | Medicare, health care, legislation
Alex Rosenberg is a NerdWallet writer focusing on Medicare and information technology. He has more than 10 years of experience researching and writing about health care, insurance, technology, data privacy and public policy. His research has supported lawmakers in the Wisconsin State Legislature as well as health systems and national health authorities in the U.S. and more than 10 other countries. He is based in Stoughton, Wisconsin.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Anthem
3.6
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
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.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Low (49% or less)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.98 (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 ratings from CMS.
4-star rated plans available in only three states.
States available
14 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Low (49% or less)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.98 (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 ratings 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
Here’s what you should know about Anthem Medicare Advantage.
Anthem Medicare Advantage pros and cons
Anthem’s offerings have advantages and disadvantages.
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 relatively 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 3.6 stars (the national average for all providers is 4.04 stars).
Fewer members in 4-star or better plans: Of Anthem’s plans with star ratings, 40% of members were in plans rated 4 stars or better as of March 2024. That’s a lower rate than most major Medicare Advantage providers.
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 3.6 stars
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
. (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:
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
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:
HMO plans
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-POS plans
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.
PPO plans
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.
SNPs
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. 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.
Premiums, deductibles, covered drugs, costs for each tier and pharmacy arrangements all differ by plan.
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 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 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
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
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.
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.
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).
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.
