Anthem is a major insurance company that offers Medicare plans in many states

Anthem is one of the largest health insurance companies in the United States and sells Medicare plans — both Original Medicare supplements and Medicare Advantage plans — in dozens of states. If you see Anthem listed as an option during your Medicare enrollment period, it means the company operates in your state and is offering coverage for the coming year.

Anthem's Medicare plans vary by state and by year. The plans available to you depend on where you live, your age, and whether you already have Medicare Part A and Part B. Some states have many Anthem options; others have few or none. You can find out which Anthem plans are sold in your area by visiting Medicare.gov or calling 1-800-MEDICARE.

Key Takeaways

  • Anthem offers both Medigap (supplement) plans and Medicare Advantage plans, so you need to decide which type fits your situation before comparing Anthem to other insurers.
  • Which Anthem plans are available to you depends entirely on your state and ZIP code, so the same plan name may not exist where you live.
  • You can enroll in an Anthem Medicare plan during your Initial Enrollment Period (the three months before and after you turn 65) or during the Annual Enrollment Period (October 15 to December 7 each year).
  • Anthem plans have different costs, coverage rules, and networks of doctors and hospitals, so comparing your options side-by-side before you choose is important.

The difference between Anthem Medigap and Anthem Medicare Advantage

Anthem sells two main types of Medicare plans, and they work very differently. A Medigap plan (also called a supplement) works alongside Original Medicare — you keep your Medicare Part A and Part B, and the Anthem Medigap plan pays some of the costs that Medicare does not cover, like copayments and coinsurance. You can see any doctor or hospital that accepts Medicare.

A Medicare Advantage plan (also called Part C) replaces Original Medicare entirely. You get your coverage through Anthem instead of through Medicare, and Anthem decides which doctors and hospitals you can see, what prescriptions it covers, and how much you pay. Medicare Advantage plans often include prescription drug coverage built in, whereas Medigap plans do not.

Which type makes sense depends on your health, your budget, and whether you have preferred doctors. If you want to keep seeing your current doctors without restrictions, Medigap is usually the better choice. If you want lower monthly premiums and do not mind using Anthem's network, Medicare Advantage may cost less out of pocket.

How to find Anthem Medicare plans in your area

Start at Medicare.gov, the official government site. Click "Find Care Providers & Suppliers" or use the plan finder tool. Enter your ZIP code and the year you want coverage for. The site will show you every Medicare plan available in your area, including all Anthem options, side by side.

You can also call 1-800-MEDICARE (1-800-633-4227) and ask which Anthem plans are sold in your state. A representative can tell you the plan names, the monthly premium, and the deductible for each one. This is a free call and the line is open 24 hours a day, seven days a week.

If you already know you want to look at Anthem specifically, you can visit Anthem's own website and enter your ZIP code there. Anthem will show you the plans it sells in your area and let you compare them. You can also call Anthem directly at the phone number on your Medicare card or on the plan materials you receive in the mail.

What to compare when looking at Anthem plans

Do not choose based on the plan name alone. Two people in different states might see the same Anthem plan name but have completely different coverage and costs. Here is what to check for each plan:

  • Monthly premium: What you pay every month, regardless of whether you use the plan.
  • Deductible: The amount you pay out of pocket before the plan starts to pay.
  • Copayments and coinsurance: What you pay when you see a doctor or get a service.
  • Out-of-pocket maximum: The most you will pay in a year; after that, the plan pays 100 percent.
  • Network: For Medicare Advantage, which doctors and hospitals Anthem covers. For Medigap, this does not matter because any Medicare provider works.
  • Prescription drug coverage: Whether drugs are covered, which drugs, and what you pay for them.

Medicare.gov lets you enter your current doctors and medications and shows you which Anthem plans cover them. This is the fastest way to narrow down your choices.

When you can enroll in an Anthem Medicare plan

You have two main windows to enroll. Your Initial Enrollment Period is the three months before the month you turn 65, the month you turn 65, and the three months after. If you enroll during this window, your coverage starts on the first day of the month you turn 65 (or the first day of the following month, depending on when you enroll).

If you miss your Initial Enrollment Period, you can enroll during the Annual Enrollment Period, which runs from October 15 to December 7 each year. Coverage starts January 1 of the following year. If you enroll after December 7, you will have to wait until the next Annual Enrollment Period, unless you have a may have access to life event like losing other coverage or moving to a new state.

You can enroll online at Medicare.gov, by phone at 1-800-MEDICARE, by mail, or directly through Anthem. Enrolling online is usually the fastest.

What happens after you enroll in an Anthem plan

After you enroll, Anthem will send you a welcome packet with your member ID card, plan documents, and information about how to use your coverage. Read through the plan documents — they explain what is covered, what is not, and how to get care.

For Medicare Advantage plans, you will need to choose a primary care doctor from Anthem's network (unless the plan does not require one). For Medigap plans, you do not need to do anything special — you just use your Medicare card and your Anthem card when you see a doctor.

If you have questions about your coverage after you enroll, call the customer service number on your Anthem card. You can also log into your account on Anthem's website to check your benefits, find doctors, and manage your prescriptions.

Frequently Asked Questions

Can I switch from Anthem to another Medicare plan mid-year?

No, not usually. Once you enroll in a Medicare plan, you are locked in until the next Annual Enrollment Period (October 15 to December 7), unless you have a may have access to life event like moving, losing coverage, or becoming may be able to access for Medicaid. If you think you made a mistake, call 1-800-MEDICARE to ask whether you may have access to for an exception.

Does Anthem Medicare cover my current doctor?

For Medigap plans, yes — any doctor who accepts Medicare will work. For Medicare Advantage plans, it depends on Anthem's network in your area. Use the plan finder on Medicare.gov or Anthem's website and enter your doctor's name to check. If your doctor is not in the network, you can ask Anthem about out-of-network coverage or consider a different plan.

What is the difference between Anthem and other Medicare insurance companies?

Each company offers different plans, different networks, and different costs in each state. Anthem may be cheaper in one area and more expensive in another. The only way to know which is best for you is to compare the plans available in your ZIP code on Medicare.gov, looking at premium, deductible, copayments, and whether your doctors are included.

Do I need to pay Anthem directly, or does Medicare handle the payment?

For Medigap plans, you pay Anthem the monthly premium. Medicare pays its share directly to providers. For Medicare Advantage plans, you pay Anthem the monthly premium (if there is one), and Anthem handles all the claims. You do not pay Medicare separately once you enroll in Medicare Advantage.