Anthem MediBlue Access 2020 Medicare Advantage PPO Plan for Ashtabula County, OH
Anthem MediBlue Access is a Medicare Advantage plan from Anthem Blue Cross and Blue Shield that's available to Medicare beneficiaries living in Ashtabula County, Ohio.
- It is a Preferred Provider Organization (PPO) health plan.
- It includes a prescription drug plan (Part D).
- It has the same health insurance benefits as Original Medicare.
- It offers extras that Medicare does not cover.
- The maximum out-of-pocket cost with this plan is $5,500 .
- The monthly premium is $56.00 (plus your Part B premium).
Anthem MediBlue Access vs. Traditional Medicare in Ashtabula County
This PPO plan replaces your Original Medicare coverage in Ashtabula County. If you join this plan, you must agree to let Anthem Blue Cross and Blue Shield manage your Medicare benefits, including:
- Medicare Part A (hospital insurance).
- Medicare Part B (medical insurance).
- Medicare Part D (prescription drug coverage).
- Additional benefits included in the plan not covered by Medicare.
This PPO health insurance allows you to choose your own primary care doctor, specialists, and other healthcare providers in Ashtabula County. If you're on a budget you can lower your out-of-pocket costs by using the plan's provider network.
Anthem MediBlue Access Review
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 9 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Medications are expensive, so you'll want to know how this plan covers your prescriptions.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
IMPORTANT: Unlike Original Medicare, your out-of-pocket expenses are capped with this plan. As a result, you won't be vulnerable to excessive medical bills due to an accident or a critical illness.
CRITICAL: Anthem MediBlue Access includes a Medicare drug plan with its own deductible and co-pays. If you have regular prescriptions, make sure your medications are covered at a favorable price before you join this plan. Prescription drug plans vary significantly by plan. Make sure you have the best coverage.
Anthem MediBlue Access's monthly premium in Ashtabula County is $56.00. That includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H4036-010 Summary of Benefits).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $50.00 per year. That means you pay 100% of your prescription costs until you've spent $50.00, then the plan will begin paying it's share.
IMPORTANT: When evaluating Anthem MediBlue Access, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
Maximum Out-of-Pocket (MOOP) Limit
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Anthem MediBlue Access plan MOOP is $5,500 . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in Ashtabula County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Contact Anthem Blue Cross and Blue Shield
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov. To learn more about this plan, visit the Anthem Blue Cross and Blue Shield Medicare website.
Additional Medicare Plan Options in Ashtabula County
Are you eligible for a Ashtabula County, OH Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- UnitedHealthcare Nursing Home Plan 2 (Local PPO), for Institutional beneficiaries
- Anthem MediBlue Dual Advantage (Local HMO), for Dual-Eligible beneficiaries
- Allwell Dual Medicare (Local HMO), for Dual-Eligible beneficiaries
- UnitedHealthcare Dual Complete LP1 (Local HMO), for Dual-Eligible beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- HumanaChoice R5495-001 (PPO)
- HumanaChoice R5495-002 (PPO)
- SummaCare Medicare Ruby (HMO)
- AARP Medicare Advantage Plan 1 (HMO)
- Anthem MediBlue Access Core (PPO)