Anthem Kidney Care (C-SNP): Costs+Coverage H4346-029-0
Anthem Kidney Care (C-SNP): Costs+Coverage H4346-029-0
Discover how Anthem Kidney Care (C-SNP HMO) stands out as a 2025 Special Needs Plan (SNP), offering tailored coverage to fit your individual needs. This page provides a comprehensive look at the plan’s benefits and costs, helping you make an informed choice.
Delivery of healthcare services and costs by Anthem Blue Cross and Blue Shield are different than Original Medicare. This private health insurance option may include additional benefits that are not provided by Medicare Part A and Part B.
Plan ID H4346-029-0 Overview | |
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Health Plan ID: | H4346-029-0 |
Medicare Advantage Plan Type: | HMO |
Plan Year: | 2024 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Enhanced $0.00 deductible |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Anthem Blue Cross and Blue Shield |
We're Here to Help You Enroll |
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Health Plan Cost Sharing & Benefits
Anthem Kidney Care is a Health Maintenance Organization (HMO) plan. As an HMO C-SNP member, you typically receive healthcare services through the plan’s local network of providers, with referrals generally required to see specialists and other providers. However, Anthem Kidney Care does cover out-of-network care for emergencies and out-of-area dialysis.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $35 Copay Prior Authorization Required |
Wellness & Preventive Programs: | |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $35 Copay Prior Authorization Required |
Routine Foot Care: | $0 |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
Routine chiropractic: | $15 Copay Prior Authorization Required |
Emergency and Urgent Care | |
Emergency room care: | $90 Copay |
Urgent care: | $35 Copay |
Ground ambulance: | $250 Copay |
Inpatient hospital care: | $289.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient hospital care: | $275 Copay Prior Authorization Required |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $196.00 per day for days 21 and beyond |
Optional supplemental benefits: | Not Covered |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $40 Copay |
Outpatient group therapy: | $40 Copay |
Inpatient psychiatric hospital care: | $325.00 per day for days 1 through 5 $0.00 per day for days 6 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: | $300 Copay Prior Authorization Required |
Lab services: | $45 Copay Prior Authorization Required |
Outpatient x-rays: | $40 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 |
Supplemental Health Plan Benefits (H4346-029-0)
The following is a summary of the supplemental benefits Anthem Blue Cross and Blue Shield includes 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 | |
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: | $100.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay |
Contact lenses (In-Network) | $0 Copay |
Additional Supplemental Benefits
None specified.
Prescription Drug Plan Costs & Benefits
Anthem Kidney Care includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $0.00 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $0.00 |
Part D Premium with Full LIS Assistance: | $0.00 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before Anthem Blue Cross and Blue Shield begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Anthem Kidney Care has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | $5.00 copay | $10.00 copay |
2 (Generic) | $8.00 copay | $13.00 copay |
3 (Preferred Brand) | $42.00 copay | $47.00 copay |
4 (Non-Preferred Drug) | $95.00 copay | $100.00 copay |
5 (Specialty Tier) | 33% | 33% |
6 (Select Care Drugs) | $0.00 copay | $0.00 copay |
5-Star Rating Marks
Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates Medicare Advantage C-SNPs across nine broad categories using a 5-star rating system. These star ratings provide insight into the quality of care and service you can expect from this Anthem Blue Cross and Blue Shield plan.
CMS Measure | Star Rating |
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2025 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 Criteria for Enrolling in Anthem Kidney Care
To enroll in Anthem Kidney Care, you must meet the following criteria:
- You are eligible for Medicare;
- You reside within the plan’s service area; and
- You have been diagnosed with one or more severe or disabling chronic conditions.
A disabling chronic condition (disease) is one that persists for one year or longer, requiring ongoing medical care and/or limiting daily activities. These conditions include:
- Autoimmune disorders
- End-stage renal disease
- Cancer
- Cardiovascular disorders
- Blood disorders (Hematologic disorders)
- HIV/AIDS
- Chronic heart failure
- Chronic lung disorders
- Neurologic disorders
- Dementia
- Diabetes
- End-stage liver disease
- Stroke
- Mental health conditions
This plan is for individuals with dialysis Services requiring dialysis (any mode of dialysis).
Medicare Special Needs Plan Enrollment Periods
After determining your eligibility for Anthem Kidney Care, it’s important to be aware of the Medicare Enrollment Periods, which determine when you can enroll in or change your plan. Depending on your circumstances, one of the following periods will apply:
- Initial Enrollment Period (IEP): The first time you can enroll in Medicare, typically around your 65th birthday.
- Annual Enrollment Period (AEP): Occurs yearly and allows you to make changes to your Medicare coverage.
- Special Enrollment Periods (SEPs): Special circumstances, such as moving or losing other coverage, may qualify you to enroll outside of the usual periods.
For more details on enrollment periods, you can learn more here and make sure you’re well-informed about your Medicare choices.
Plan Availability
Anthem Kidney Care (H4346-029-0) is available in the following locations (click to open):
Contact Anthem Blue Cross and Blue Shield
Call 1-877-388-0596 (TTY 711) to speak with a licensed HealthCompare insurance agent (Mon-Sun 8am-11pm EST) and learn more about this Special Needs Plan and other plans on this site.
You may also Enroll Online using our safe and secure online enrollment website or take advantage of the following plan resources:
Plan Website: | https://shop.anthem.com/medicare |
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Formulay Information: | https://shop.anthem.com/medicare |
Pharmacy Information: | Anthem Blue Cross and Blue Shield Pharmacy Page |
Prospective Members: | (855)679-0546 |
TTY Users: | 711 |
If you qualify for Medicare benefits 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.
Plans Offered through Medicare.org
Medicare Advantage and Part D plans and benefits offered are 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.