Anthem Blue Cross Blue Shield Copay



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Anthem Blue Cross and Blue Shield Name of Carrier BluePreferred for Group Name of Plan F-20-500/6350-90% 15/40/60/30% PART A: TYPE OF COVERAGE 1. TYPE OF PLAN Preferred Provider plan 2. OUT-OF-NETWORK CARE COVERED?1 Yes, but the patient pays more for Out-of-Network care 3. AREAS OF COLORADO WHERE PLAN IS AVAILABLE Plan is available throughout. .The only HIP Plus copay is for using the emergency room when it's not an emergency. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance.

Anthem MediBlue Plus (HMO) H9525-008 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Anthem Blue Cross and Blue Shield available to residents in Kentucky. Smoke on the water guitar pro tab. This plan includes additional Medicare prescription drug (Part-D) coverage. The Anthem MediBlue Plus (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $5,300 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,300 out of pocket. This can be a extremely nice safety net.

Anthem MediBlue Plus (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.

Anthem Blue Cross and Blue Shield works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Anthem MediBlue Plus (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Anthem Blue Cross and Blue Shield and not Original Medicare. Remote play ps4. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Anthem Blue Cross and Blue Shield except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.



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2021 Anthem Blue Cross and Blue Shield Medicare Advantage Plan Costs

Name:
Plan ID:
H9525-008
Provider:Anthem Blue Cross and Blue Shield
Year:2021
Type: Local HMO
Monthly Premium C+D: $0
Part C Premium: $0
MOOP: $5,300
Part D (Drug) Premium: $0
Part D Supplemental Premium $0
Total Part D Premium: $0
Drug Deductible: $0
Tiers with No Deductible:0
Gap Coverage:Yes
Benchmark:not below the regional benchmark
Type of Medicare Health:Enhanced Alternative
Drug Benefit Type:Enhanced
Similar Plan:H9525-004

Anthem MediBlue Plus (HMO) Part-C Premium

Anthem Blue Cross and Blue Shield plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.


H9525-008 Part-D Deductible and Premium

Anthem MediBlue Plus (HMO) has a monthly drug premium of $0 and a $0 drug deductible. This Anthem Blue Cross and Blue Shield plan offers a $0 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Anthem Blue Cross and Blue Shield above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.


Anthem Blue Cross and Blue Shield Gap Coverage

In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Anthem Blue Cross and Blue Shield plan does offer additional coverage through the gap.


H9525-008 Formulary or Drug Coverage

Anthem MediBlue Plus (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.



2021 Anthem MediBlue Plus (HMO) Summary of Benefits



Additional Benefits


No


Comprehensive Dental


Diagnostic services$0 copay
Endodontics70% coinsurance
Extractions50% coinsurance
Non-routine services$0 copay
Periodontics70% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services70% coinsurance
Restorative services50% coinsurance


Deductible


$0


Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI)$180-225 copay
Diagnostic tests and procedures$0-225 copay
Lab services$0-25 copay
Outpatient x-rays$50-130 copay


Doctor Visits


Primary$5 copay per visit
Specialist$35 copay per visit


Emergency care/Urgent Care


Emergency$90 copay per visit (always covered)
Urgent care$40 copay per visit (always covered)


Foot Care (podiatry services)


Foot exams and treatment$0-35 copay
Routine foot care$0 copay


Ground Ambulance


$260 copay


Hearing


Fitting/evaluation$0 copay
Hearing aids$0 copay
Hearing exam$35 copay


Inpatient Hospital Coverage


$300 per day for days 1 through 7
$0 per day for days 8 through 90


Medical Equipment/Supplies


Diabetes supplies$0 copay
Durable medical equipment (e.g., wheelchairs, oxygen)0-20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs)20% coinsurance per item


Medicare Part B Drugs


Chemotherapy20% coinsurance
Other Part B drugs20% coinsurance


Mental Health Services


Inpatient hospital - psychiatric$275 per day for days 1 through 6
$0 per day for days 7 through 90
Outpatient group therapy visit$40 copay
Outpatient group therapy visit with a psychiatrist$40 copay
Outpatient individual therapy visit$40 copay
Outpatient individual therapy visit with a psychiatrist$40 copay


MOOP


$5,300 In-network


Option


No


Optional supplemental benefits


Yes


Outpatient Hospital Coverage


$0-275 copay per visit

Bcbs

Package #1


Deductible
Monthly Premium$17.00


Package #2


Deductible
Monthly Premium$23.00


Package #3


Deductible
Monthly Premium$51.00


Preventive Care


$0 copay


Preventive Dental


Cleaning$0 copay
Dental x-ray(s)$0 copay
Fluoride treatment$0 copay
Oral exam$0 copay
Virginia

Rehabilitation Services


Occupational therapy visit$40 copay
Physical therapy and speech and language therapy visit$40 copay


Skilled Nursing Facility


$0 per day for days 1 through 20
$184 per day for days 21 through 100


Transportation


$0 copay


Vision


Contact lenses$0 copay
Eyeglass frames$0 copay
Eyeglass lenses$0 copay
Eyeglasses (frames and lenses)$0 copay
OtherNot covered
Routine eye exam$0 copay
UpgradesNot covered


Wellness Programs (e.g. fitness nursing hotline)


Covered

Anthem Blue Cross Blue Shield Copay

Reviews for Anthem MediBlue Plus (HMO) H9525


2019 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing

Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment

Anthem Bcbs Virginia


Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy

Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination

Member Complaints and Changes in Anthem MediBlue Plus (HMO) Plans Performance

Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement
Timely Decisions About Appeals

Health Plan Customer Service Rating for Anthem MediBlue Plus (HMO)

Total Customer Service Rating
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language

Anthem MediBlue Plus (HMO) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language
Appeals Auto
Appeals Upheld

Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement

Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs

Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes


Ready to Enroll?


Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST

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Coverage Area for Anthem MediBlue Plus (HMO)

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Anthem Blue Cross Blue Shield High Deductible

Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.