Anthem Veteran (PPO) 2025 Plan Details for Perry County, Indiana Residents
Anthem Veteran (PPO) 2025 Plan Details for Perry County, Indiana Residents
When selecting a Medicare Advantage plan in Perry County for 2025, it's important to compare all your options. Anthem Veteran (PPO) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Anthem Veteran Overview
Plan ID H7093-001-0 Overview | |
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Health Plan ID: | H7093-001-0 |
Medicare Advantage Plan Type: | Local PPO |
Plan Year: | 2024 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $6,700 |
Part B Give Back: | $70.00/mo |
Part D Drug Plan Benefit: | Not Included |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | Perry County, IN |
Insured By: | Anthem Blue Cross and Blue Shield |
Why Consider Anthem Veteran?
Anthem Veteran is a Medicare Advantage Preferred Provider Organization (PPO) plan that offers comprehensive and flexible healthcare coverage. With a monthly premium of $0.00, this plan includes all the benefits of Medicare Part A and Part B, ensuring you have access to essential medical care. As a PPO plan, Anthem Veteran gives you the freedom to choose any Medicare-approved provider, with the added benefit of lower costs when you stay within the plan’s network.
Note that Anthem Veteran does not include Part D prescription drug coverage. For prescription drug needs, explore Medicare drug plans available separately. A key benefit of Anthem Veteran is its financial protection through an annual maximum out-of-pocket (MOOP) limit of $6,700. Once you reach this limit, the plan covers 100% of your in-network healthcare costs for the remainder of the year. This makes Anthem Veteran an ideal choice for those who seek both flexibility and comprehensive healthcare coverage.
We're Here to Help You Enroll |
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Out-of-Pocket Expenses
Anthem Veteran includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H7093-001-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $45 Copay Prior Authorization Required |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $45 Copay Prior Authorization Required |
Routine Foot Care: | $0 Copay Prior Authorization Required |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $90 Copay |
Urgent care: | $25 Copay |
Ground ambulance: | $290 Copay |
Inpatient hospital care: | $350.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital care: | $245 Copay Prior Authorization Required |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $40 Copay |
Outpatient group therapy: | $40 Copay |
Inpatient psychiatric hospital care: | $295.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient group therapy: | $40 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $40 Copay Prior Authorization Required |
Occupational therapy: | $40 Copay Prior Authorization Required |
Medical Equipment and Supplies (In-Network) | |
Diabetes supplies: | $0 Copay |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging (In-Network) | |
Diagnostic radiology services: | $275 Copay Prior Authorization Required |
Lab services: | $50 Copay Prior Authorization Required |
Outpatient x-rays: | $110 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $100 Copay Prior Authorization Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Most preventive services are covered 100% by Anthem Veteran as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that Anthem Blue Cross and Blue Shield offers with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | $0 Copay Prior Authorization Required |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay Prior Authorization Required |
Vision | Maximum vision benefit: | $200.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay Prior Authorization Required |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
CMS Measure | Star Rating |
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2024 Overall 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 |
Eligibility Requirements for Anthem Veteran
You are eligible to enroll in Anthem Veteran if you meet the following conditions:
- You qualify for Medicare Part A and Part B.
- You live in the plan’s service area.
- You do not have End-Stage Renal Disease (ESRD), with some exceptions.
If these criteria describe your situation, you’re eligible to sign up for Anthem Veteran and take advantage of its full range of benefits.
When Can I Enroll in Anthem Veteran?
To ensure you don’t miss your chance to enroll in Anthem Veteran, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) to get assistance from a licensed insurance agent.
Steps to Enroll in Anthem Veteran
Joining Anthem Veteran is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Anthem Veteran.
- Direct Enrollment: You can also choose to enroll directly with Anthem Veteran. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Contact Anthem Blue Cross and Blue Shield
Website: | https://shop.anthem.com/medicare |
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Formulary: | https://www.anthem.com |
Pharmacy: | Anthem Blue Cross and Blue Shield Pharmacy Page |
New Members: | (855)593-0907 |
TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
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