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Anthem Medicare Review

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best...

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UPDATED: Nov 30, 2018

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A BlueCross Blue Shield licensee and one of the biggest names in health insurance, Anthem offers a solid range of Medicare options. Their products for Medicare-eligible customers include Advantage, Supplement, and Part D plans as well.

About Anthem

Anthem has something of a complex history and was born out of a series of acquisitions and mergers involved several companies. The company’s beginnings can be found in the creation of Mutual Hospital Insurance Inc. and Mutual Medical Insurance, Inc. in the 1940s, two companies that merged in the 1980s to form Associated Insurance Companies, Inc. That name lasted only a year and was changed to The Associated Group; this group was the parent company of BlueCross Blue Shield of Indiana.

The first appearance of the name Anthem is under the parent company American General Insurance, which was acquired by The Associated Group early on. In 1995, The Associated Group acquired Community Mutual Insurance in Ohio, followed by the creation of Anthem BlueCross Blue Shield. Finally, in 1996, The Associated Group changed its name to Anthem Insurance Company.

That was not the end of the acquisitions, however. Anthem acquired Wellpoint in 2003 and made another slight name change to Anthem, Inc. in 2015. At this point already one of the biggest health insurance companies in the nation, Anthem sought a merger with another giant, Cigna; this was shot down by the courts in 2017 amid accusations against Cigna for breaching the merger agreement.

Anthem today remains a major player in the health insurance industry and writes individual and family major medical, group health insurance, and all three of the common Medicare products. With headquarters in Indianapolis, Anthem is the biggest health insurance provider in several states and offers Medicare products in 14 states.

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Anthem Medicare Products

Anthem writes all of the three main types of Medicare insurance: Advantage, Supplement, and Part D Prescription Drug. Availability of plans does vary by state. For the purposes of this review, we looked at the plan options in California.

Medicare Advantage

There are 13 Medicare Advantage plans available in California, some of which have only slight differences. A few are condition-specific plans as well. Almost all of the plans are $0-premium (aside from your Original Medicare Part A & B premiums), with only three having an added monthly cost. Although Anthem does write PPO plans, none of the listed options are PPO. All of the plans are $0 deductible.

Value Plus HMO offers $0 copays for both primary care and specialist visits, and there is also no copay for inpatient hospital visits at in-network hospitals. There is, however, a copay of $100 for emergency room visits. This plan includes prescription drug coverage starting at $0 for Tier 1. This plan also includes hearing, vision, and dental insurance.

The Diabetes and Heart plans are similar to each other, with each focusing on a different specified illness. Both have $0 copays for most office visits and include prescription drug coverage starting at $0 for Tier 1 drugs, as well as hearing and dental. A third plan, Anthem Breathe, again has similar coverage but is focused on lung care, and finally, the ESRD plan is focused on End Stage Renal Disease needs.

There are four MediBlue plans are various levels. MediBlue Plus is a $0 premium plan with a $20 primary care copay and a $50 specialist copay. Prescription drugs start at a $7 copay, and additional dental, hearing, and vision can be added for an additional monthly premium. Select also has no premium and has $0 copays for primary care and specialists. Tier 1 drugs start at $0.

MediBlue Extra has an additional monthly premium and has $0 copays for primary care and specialist visits, and for prescription drugs. A $415 deductible applies to all tiers above one. Inpatient hospital services have a copay of $95 for the first four days.

MediBlue Coordination Plus has a 20% coinsurance amount for both primary care and specialist visits. Prescription drug coverage is the same as the Extra plan. This plan includes hearing, vision, and comprehensive dental coverage.

There are also two Connect plans; the base plan is a $0 premium with $0 copays for primary care and specialist visits. Prescription drugs start at $0, and dental, vision, and hearing are also included. The Connect Plus has 20% coinsurance for primary care and specialist visits. Prescription drugs start at a 25% coinsurance. Dental, vision, and hearing are all included.

Medicare Supplement

In our sample area, Anthem offers Plans A, G, N, and the two version of Plan F. These lettered plans are standard and include the same coverage regardless of who writes them.

Plan A is the base plan that pays coinsurance amounts for Medicare Part a & B, as well as covering the first three pints of blood each year. From there, the plans add on additional coverage. Some, like Plan N, have copays that help to reduce premiums, while others, like the high deductible Plan F, bring down the monthly cost with a deductible.

Anthem offers a fairly good selection of plan options; five of the eleven total standard plans are available.

Part D

There are two Part D plans available that can be purchased to supplement the coverage under Original Medicare.

MedicareRx Plus has no pharmacy deductible. Tier 1 drugs start at $1.00. and Tier 2 at $3.00. Tier 3 has a $40 copay and the remaining two Tiers have coinsurance percentages, at 38% for Tier 4 and 33% for Tier 5.

MedicareRx Standard has a deductible of $250, although this does not apply to Tier 1 drugs, which again start at a $1.00 copay. Tier 2 is $5.00, Tier 3 $30, and Tiers 4 and 5 40% and 25% coinsurance respectively.

Rates

Rates are easy to find on the Anthem site.

For our sample area, the Part D plans have rates of $113.10 for the Plus plan and $116.90 for the Standard plan.

On the Supplement side, Plan A returned a rate of $131.29 for a sample of a 65-year-old woman in our test area. Plan F was the most expensive at $180.64.

As we mentioned previously, the majority of Anthem’s Advantage plans are $0 premium plans – you do not pay anything beyond your Original Medicare premiums.

Connect Plus returned a rate of $34.70 a month, while Coordination Plus and MediBlue Extra have the same cost at $34.80 a month. All of these plans are very reasonably priced when compared to others in the same area.

Claims

Anthem handles claims directly with providers, so in most cases, the insured will not need to get involved with the process.

As Anthem is a huge company, there are multiple customer service lines depending on the area in which you live. The toll-free member services line for your area should be able to direct you to any claims assistance you may need.

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Ratings and Consumer Reviews

Anthem, Inc. has a D- rating with the Better Business Bureau (BBB), which is incredibly poor for a huge company. Although large companies may have a lot of complaints, they are usually good at responding to them and resolving them to keep a good BBB rating. Anthem failed to respond to 28 complaints, which led to the lowered score. With only a total of 56 complaints, their volume would be considered very low for their size; they would likely have an A+ if they had responded to what amounts to more than half of the complaints against them.

Again, since Anthem is a huge company, it should be noted that there are multiple BBB files for different areas of the country. We looked at the main office BBB file, but reports may vary, and in some areas, they may have a much better rating.

There are 422 reviews of Anthem on Consumer Affairs, and their rating is just under two stars based on the 65 reviews in the past year. These reviews cover all of Anthem’s products, not only Medicare, and since they are so big the overall complaint volume is not all that high. Most of the reviews are negative, citing denial of claims and poor customer service.

All of Anthem’s Medicare Advantage plans score a 4.5 out of 5 from the government rating agency for Medicare, which is very good.

The Bottom Line

Anthem has very affordable plans across the board, particularly for Medicare Advantage plans. It is concerning that they have failed to respond to so many complaints, but on the Medicare side, they are getting very good ratings, which provides some balance. We recommend checking on the company’s ratings and reviews specific to your area when considering them as your Medicare provider.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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Review Information

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Anthem Medicare
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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

1 Comment

  1. For a month I’m a member of Anthem Medical Advantage Select in Southern California.

    I’m very dissatisfied because they didn’t inform me that basically I’m covered my Imperial Health, and not directly by them.

    What it means that all the information about medical providers on their website is not correct.

    There are basically no medical providers by Imperial Health, and it is almost impossible to find any provider within 30 mi radius.

    They claim it is approved by Medicare, but I would like to question it.

    Very dirty business.

    Reply

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