Anthem BCBS Medicare Advantage Reviews

Anthem, a member of the Blue Cross Blue Shield Association, provides a variety of Medicare Advantage plans, known for their comprehensive coverage and additional benefits, available across numerous states.
By . Last update: June 11, 2024

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Anthem Medicare Advantage Reviews
The Anthem logo is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross Blue Shield (BCBS) offers a range of Medicare Advantage (Part C) plans designed to provide comprehensive health coverage. These plans often include additional benefits beyond standard Medicare, such as dental, vision, and prescription drug coverage, aimed at enhancing overall well-being and addressing diverse healthcare needs.[1]

In this review, we examine various Medicare Advantage plans offered by Anthem Blue Cross Blue Shield. We will explore coverage details, costs, and feedback from around the web to help you make an informed decision about whether these plans meet your unique healthcare requirements.

Table of Contents

Member Reviews for Anthem

The following Anthem reviews have been left by our members.

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

PROS

  1. Zero-Dollar Premiums: Many plans offer $0 premiums, making them affordable for a wide range of beneficiaries.
  2. Comprehensive Coverage: Plans often include additional benefits not covered by Original Medicare, such as dental, vision, and prescription drugs 
  3. Extra Benefits: Many plans include additional perks like gym memberships, wellness programs, and telehealth services at no extra cost .
  4. Large Network: Anthem typically has a large network of healthcare providers, offering access to a wide range of doctors, specialists, and hospitals.
  5. Cost Savings: Many plans offer lower out-of-pocket costs compared to traditional Medicare, such as reduced copayments and deductibles.
  6. Essential Extras Program: Provides a variety of additional Medicare coverage benefits (see "Extra Benefits" below).

CONS

  1. CMS Ratings: Below-average overall star ratings from CMS. Four-star rated plans available in only three states.
  2. Network Restrictions: Some plans require beneficiaries to use in-network providers, which can limit choice and flexibility.
  3. Prior Authorization Requirements: Certain services and treatments may require prior authorization, potentially delaying care.
  4. Geographic Limitations: Availability of plans can vary by location, with some areas having fewer options.
  5. Annual Changes: Like all Medicare Advantage plans, Anthem's offerings, including premiums, benefits, and provider networks, can change annually.
  6. Benefit Limitations: Some additional benefits, such as dental and vision coverage, may have annual limits or specific restrictions.

NOTE: Pros and cons list based on data taken directly from the carrier's website.[2]

FEATURED PARTNER OFFER [i]
Compare Top Medicare Advantage Plans from Anthem
Anthem Medicare Advantage Reviews
  • Compare affordable Anthem plans online
  • Additional benefits may include dental, vision, hearing, lifestyle and transportation
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On Medicare Enrollment's Website

How Do Anthem Medicare Advantage Plans Work?

Anthem Medicare Advantage plan members receive all of their Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits through their plan. This includes preventive care, screenings, vaccinations, doctor and specialist visits, and inpatient care.

All Anthem Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare rules mandate that all Medicare Part C plans offer coverage and benefits that match or exceed those of Original Medicare. However, Anthem sets its own out-of-pocket costs.

Some Anthem plans include extra benefits such as routine dental, vision, hearing, and wellness programs. These services aren't typically covered by Original Medicare.

When you join a Anthem Medicare Advantage plan, you can manage all your healthcare needs under one plan. This often comes with lower out-of-pocket costs and extra benefits suited to your health and lifestyle.

However, it's important to note that lower costs aren't guaranteed. Costs depend on the specific plan and how much you use healthcare services. Also, the Anthem plan you choose may have access restrictions, such as needing referrals and prior authorization. Original Medicare does not have these restrictions.

Extra Benefits from Anthem

Anthem provides a variety of additional Medicare coverage benefits through its Essential Extras program, which includes:

  • $500 per year for assistive safety devices such as handrails, temporary mobility ramps, and raised toilet seats.
  • A Flex account with a $500 annual allowance for extra dental, vision, and hearing needs.
  • Membership to SilverSneakers and health and fitness tracker devices.
  • A monthly allowance for healthy groceries, including vegetables, fresh or frozen meats, canned goods, and dairy items.
  • Meal delivery of 180 healthy meals annualy for members with qualifying illnesses or conditions.
  • 60 hours of companion care services per year to prevent social isolation or assist with tech support, medication management, errands, and transportation.
  • 124 hours of home health aid (care provider) assistance per year.
  • Pest control services.
  • 60 one-way trips for medical appointments and pharmacy visits.
  • Some plans offer a giveback, where a portion of the Part B premium is covered by the plan.

What Types of Plans Does Anthem Offer?

Not all Anthem plans are the same. And, Anthem may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types Anthem offers:[6]

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a Anthem HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

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

NOTE: Anthem may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do Anthem Plans Cost?

The cost of a Anthem plan will vary depending on the specific plan chosen, your location, usage of healthcare services, and the plan's out-of-pocket costs. We detail out-of-pocket costs on all Anthem Medicare Advantage Plans in our plan finder.

Typically, Anthem charges a monthly premium, which can vary depending on the coverage level and additional benefits included. You must also keep paying your Part B premium. Additionally, if you are a high-income earner, Medicare may apply a monthly Income Related Monthly Adjustment Amount (IRMAA).[5]

Anthem’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from Anthem in Colorado is $0.00 per month, but in New Hampshire the average cost is $24.90 per month. These averages do not include Special Needs Plans.

Anthem's Premiums vs. Competitors

The following list shows Anthem's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

Anthem
$22.24
Humana
$7.75
Wellcare
$10.11
AARP
$5.51
Cigna
$22.97

You also need to factor in copayments or coinsurance for healthcare services like doctor visits or hospital stays. The costs in each Anthem plan we reviewed varied depending on the level of coverage and the type of services received.

Some plans offer $0 premiums or minimal copayments for certain services, while others might have higher premiums with lower out-of-pocket expenses. Carefully reviewing the cost and coverage details of each plan is the only way to find the one that aligns best with your needs.[7]

We analyzed the following popular Anthem plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H4036-030-0 reviewed in Fulton County, GA.
  • Monthly premium: $59
  • Out-of-pocket max: $6,050
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H4036-031-0 reviewed in Fulton County, GA.
  • Monthly premium: $0
  • Out-of-pocket max: $6,700
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H4036-033-0 reviewed in Fulton County, GA.
  • Monthly premium: $0
  • Out-of-pocket max: $6,700
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is Anthem a Good Medicare Advantage Plan?

Anthem Blue Cross Blue Shield is one of the prominent providers of Medicare Advantage plans, offering various options tailored to different health needs and preferences. The quality of an Anthem plan can depend on individual circumstances, such as health requirements and budget.

Several consumer intelligence companies and review websites provide insights into the performance and quality of Anthem's Medicare Advantage plans.

J.D. Power Ranking

In the 2023 U.S. Medicare Advantage Study, J.D. Power evaluated member satisfaction with Medicare Advantage plans based on eight factors, including trust, ease of getting health services, and problem resolution. Anthem Blue Cross Blue Shield was ranked in several key markets. Specifically, Anthem ranked well in California, Florida, New York, Pennsylvania, and Texas, indicating a strong performance in these states.

AM Best Financial Strength Rating

AM Best, a credit rating agency specializing in the insurance industry, has Anthem Blue Cross Blue Shield down for an A rating (Excellent). This rating indicates that Anthem is well-positioned to meet its ongoing insurance obligations.[3]

NCQA Health Plan Score

The National Committee for Quality Assurance (NCQA) rates health plans based on quality of care, patient satisfaction, and continuous improvement efforts. In the most recent NCQA report, Anthem’s Medicare Advantage plans received ratings between 3.0 and 4.0 stars. These ratings reflect Anthem’s performance in delivering quality healthcare services to its members.[4]

ConsumerAffairs Reviews

ConsumerAffairs aggregates user reviews and feedback to provide an overview of consumer satisfaction. Anthem's Medicare Advantage plans receive mixed reviews, with some members praising the comprehensive coverage and additional benefits, while others report issues with customer service and network restrictions.

Better Business Bureau (BBB) Rating

The Better Business Bureau gives Anthem Blue Cross Blue Shield an F rating, indicating a poor commitment to resolving consumer complaints, which is backed up by reports on ConsumerAffairs.

Anthem's Medicare Star Ratings

Anthem's average 5-star rating: 3.48*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 16 contracts covering 1,212,184 members.

If you want the government’s take on the quality of Anthem’s Medicare Advantage plans, check out the Centers for Medicare and Medicaid Services' star ratings, which rank each plan from 1 (worst) to 5 (best) stars. The health agency assigns ratings based on quality of care and customer satisfaction measurements, and updates ratings every year.[9]

All Medicare Advantage plans are assessed using CMS's health plan criteria. Plans that come with prescription drug coverage are evaluated on additional drug plan metrics. Based on the latest year of data and adjusted for enrollment numbers, Anthem’s 2024 Medicare Advantage plans have an average rating of 3.48 stars.[9] [11]

As of January 1, 2024, 15% of members with Anthem are in contracts that have earned a Medicare star rating of 4 stars or more.

Discover the ratings for plans available in your area using our Medicare Advantage Plan Finder tool.

Plan Availability

Anthem's Medicare Advantage plans are available in 12 states, including:

CA, CO, CT, GA, IN, KY, MO, NH, NV, OH, VA, and WI.

In total, Anthem offers Medicare Advantage plan in 0 out of 3,140 U.S. counties.[8]

Anthem's Top Plans

Here's a list of Anthem's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

Frequently Asked Questions

The following are the most frequently asked questions we found about Anthem's Medicare Advantage plans:

Original Medicare is a Private Fee-for-Service (PFFS) health insurance system. Beneficiaries can use any healthcare provider that accepts Medicare. Most Medicare Advantage plans are a form of managed care health insurance, including HMOs and PPOs. As such, they have networks of doctors and hospitals that plan members use to receive care. With Original Medicare, the federal government pays about 80% of all Medicare-approved costs and the beneficiary pays the remaining 20% out-of-pocket. However, the 20% gap in coverage can be supplemented with a Medigap plan. With Medicare Advantage, members must pay all copays out-of-pocket until spending reaches the plan maximum, which can be up to $7,550. To learn more about how plans work, read How Does Medicare Advantage Work.

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

Most Medicare Advantage plans are HMOs and PPOs that are similar to employer group coverage or plans you get on the Health Exchange (Obamacare). The big difference is the cost to the beneficiary. By law, all Medicare Advantage plans must provide the same coverage included in Original Medicare (Part A and B), but plans can also include extra benefits (the advantage) such as routine dental, hearing, and vision care. Most plans include prescription drug coverage. However, even though plans must offer the same coverage as Original Medicare, they are not required to provide coverage in the same way. The big difference is how plan members are charged for services (copays), how services are regulated (referrals), and the use of provider networks. For more information about the pros and cons of Medicare Advantage, see: What are the Advantages and Disadvantages of Medicare Advantage Plans?.

With a Medicare Advantage plan you pay most of your costs when you use healthcare services through deductibles, copayments and/or coinsurance. As a result, private health plans can be difficult to budget. Learn More...

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from Anthem. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

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

About Anthem

Headquartered in Indianapolis, Indiana, Anthem Blue Cross Blue Shield is one of the largest health insurance providers in the United States. Its offerings include Medicare Advantage Plans (Medicare Part C), Medicare Part D Plans (prescription drug plans), Medicare Supplement Plans (Medigap plans), Medicaid coverage, and dental and vision plans.

In 2022, Anthem Inc. rebranded to Elevance Health Inc. Despite the change, Anthem Blue Cross Blue Shield companies continue to operate under the Anthem name in 14 states. Anthem provides Medicare Advantage coverage in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.[3]

You can enroll in an Anthem plan in your area during your Initial Enrollment Period (IEP) at age 65, during the annual Open Enrollment Period (Oct 15 - Dec 7), or during a Special Enrollment Period (SEP), which Medicare grants based on special circumstances, such as moving or losing employer coverage.

Company
Anthem Insurance Companies, Inc
Phone Number
855-949-3321
Website
https://www.anthem.com/medicare
Facebook Page
https://www.facebook.com/AnthemBlueCrossBlueShield/
X (Twitter) Page
https://x.com/anthembcbs

Citations

MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: