What Anthem Blue Cross Offers for Medicare

Anthem Blue Cross is a major health insurance company that offers Medicare Advantage plans and Medigap policies in many states. If you are turning 65 or already on Medicare, Anthem is one of the insurers you may see when you compare plans during open enrollment. The plans available to you depend on where you live — Anthem operates in some states but not others, and coverage areas shift year to year.

Anthem Blue Cross is not the same as Original Medicare (the federal program run by Centers for Medicare & Medicaid Services). Instead, Anthem is a private insurance company that contracts with Medicare to offer alternatives to Original Medicare. Understanding the difference between what Anthem offers and what Medicare itself provides will help you decide whether an Anthem plan fits your needs.

Key Takeaways

  • Anthem Blue Cross offers Medicare Advantage plans and Medigap policies, but availability depends on your state and ZIP code.
  • Medicare Advantage plans through Anthem replace Original Medicare and often include prescription drug coverage, but have networks and out-of-pocket limits.
  • Medigap policies from Anthem work alongside Original Medicare to cover costs that Medicare does not pay.
  • You can compare Anthem plans with other insurers on Medicare.gov during the annual open enrollment period from October 15 to December 7.
  • Anthem's customer service and plan details are available by phone, online, or through a local agent in your area.

Medicare Advantage Plans Through Anthem Blue Cross

A Medicare Advantage plan is a way to get your Medicare coverage through a private insurance company instead of using Original Medicare directly. Anthem offers these plans in select areas. When you enroll in an Anthem Medicare Advantage plan, you are choosing Anthem as your Medicare insurer for that year.

Medicare Advantage plans typically include hospital, medical, and prescription drug coverage all in one plan. Many Anthem Medicare Advantage plans also cover dental, vision, or hearing services — benefits that Original Medicare does not cover. However, these plans use networks, meaning you usually pay less if you see doctors and use hospitals that are in Anthem's network. Out-of-pocket costs are capped each year, so you know the maximum you will spend.

The trade-off is that you may need referrals to see specialists, and some services may require prior approval from Anthem before you receive them. If you travel outside your plan's service area, you may not have coverage except in emergencies. Review the specific plan details before you enroll to understand what doctors and hospitals are in the network where you live.

Medigap Policies From Anthem Blue Cross

Medigap is supplemental insurance that works with Original Medicare. If you choose Original Medicare instead of Medicare Advantage, you can buy a Medigap policy from Anthem to help pay for costs that Medicare does not cover — such as copayments, coinsurance, and deductibles.

Anthem offers several Medigap plans, labeled A through G and a few others. Each plan type covers a different set of costs. For example, Plan G covers most of what Original Medicare does not, while Plan A covers less but costs less per month. You choose which Medigap plan fits your budget and health needs.

Unlike Medicare Advantage, a Medigap policy does not restrict you to a network. You can see any doctor or hospital that accepts Medicare, anywhere in the country. You will still use your Original Medicare card for claims, and Anthem pays its share of the costs you owe. Medigap does not cover prescription drugs, so if you want drug coverage, you must also enroll in a separate Medicare Part D plan.

How to learn about Anthem Serves Your Area

Anthem Blue Cross does not operate in every state. Even in states where Anthem does business, not all ZIP codes may have Anthem plans available. The easiest way to check is to visit Medicare.gov and use the plan finder tool. Enter your ZIP code, and the tool will show you which insurers, including Anthem if available, offer plans in your area.

You can also call Anthem directly at the number on your current insurance card or search for "Anthem Blue Cross Medicare" plus your state name online to reach the local Anthem office. A representative can tell you which plans are available where you live and answer questions about coverage, costs, and networks.

Availability changes each year. A plan that was available last year may not be offered this year, or new plans may become available. Check every year during open enrollment to see the current options.

Comparing Anthem Plans With Other Insurers

During the Medicare open enrollment period — October 15 through December 7 each year — you can compare Anthem plans with plans from other insurers. Medicare.gov's plan finder lets you see the monthly premium, deductible, copayments, and which doctors and pharmacies are in each plan's network.

When you compare, look at the total cost, not just the monthly premium. A plan with a low premium might have high copayments or a smaller network. Consider which doctors you see regularly and whether they are in the plan's network. If you take prescription medications, check whether they are covered and at what cost tier.

You can also speak with a licensed insurance agent who represents multiple insurers. These agents can help you compare Anthem plans with competitors and answer questions about how each plan works. Many agents offer this service at no cost to you.

Enrollment Periods and important date

If you are new to Medicare, you have a seven-month window around your 65th birthday to enroll in an Anthem plan without penalty. This is called your Initial Enrollment Period. If you miss this window, you may face a permanent penalty on your premiums.

If you are already on Medicare, you can change to an Anthem plan during the annual open enrollment period from October 15 to December 7. Changes take effect January 1 of the following year. You can also switch plans if you have a may have access to life event, such as moving to a new state or losing other health coverage.

Some Anthem plans may have their own enrollment important date or special enrollment periods. Check the plan documents or call Anthem to confirm the exact dates that explore to the plan you are considering.

Questions to Ask Anthem Before You Enroll

Before you choose an Anthem plan, gather information that will help you make the right decision. Ask about the monthly premium, annual deductible, and out-of-pocket maximum. Find out whether your current doctors and hospitals are in the network and what the copayments are for office visits and specialist care.

If you take medications, ask Anthem for the formulary — the list of covered drugs — and what tier your medications are on. Tier 1 drugs usually cost less than Tier 4 drugs. Ask whether you need prior approval for any services or referrals to see specialists. Request a summary of benefits and coverage document, which outlines what the plan covers and what it does not.

Ask how to reach customer service and whether Anthem offers support in your preferred language. Find out how to file a complaint if you have a problem with the plan. Having these answers before you enroll will help you understand what to expect.

Frequently Asked Questions

Is Anthem Blue Cross the same as Medicare?

No. Anthem Blue Cross is a private insurance company. Medicare is a federal health insurance program. Anthem offers plans that work with or instead of Original Medicare, but Anthem itself is not Medicare. You enroll in Medicare through the federal government, and you enroll in Anthem plans through Anthem or during Medicare's open enrollment period.

Can I use my Anthem plan if I move to another state?

It depends on the type of plan. Medicare Advantage plans are usually limited to a specific service area, so if you move out of state, your plan may end and you will need to choose a new plan in your new state. Medigap policies are portable — you can use them in any state as long as the doctor or hospital accepts Medicare. Check your plan documents or call Anthem to understand the rules for your specific plan.

Does Anthem Medicare cover prescription drugs?

Most Anthem Medicare Advantage plans include prescription drug coverage. If you choose a Medigap policy instead, you must enroll in a separate Medicare Part D plan for drug coverage. Part D plans are offered by many insurers, including Anthem. You can enroll in Part D during the same open enrollment period as your Medigap plan.

What happens if I do not enroll in an Anthem plan during open enrollment?

If you miss the annual open enrollment period and do not have a may have access to life event, you cannot change plans until the next October 15. If you are new to Medicare and miss your Initial Enrollment Period, you may face a permanent penalty on your premiums when you do enroll. Contact Anthem or Medicare to understand the rules that explore to your situation.

How do I switch from an Anthem plan to a different insurer?

You can switch during the annual open enrollment period from October 15 to December 7. Use Medicare.gov's plan finder to compare other insurers' plans, and enroll in the plan you choose. Your new coverage will start January 1. If you have a may have access to life event, such as moving or losing coverage, you may be able to switch at other times of the year.