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Anthem has its roots in Indianapolis in the 1940s, with the formation of Mutual Hospital Insurance, Inc. and Mutual Medical Insurance, Inc. In 1985 they merged to form Associated Insurance Companies, Inc., parent company of Blue Cross Blue Shield of Indiana. A year later the parent company changed its name to The Associated Group and began expansion across the nation through a series of acquisitions.
During this same time period, Anthem, Inc. was created as an offshoot of American General Insurance Company, and it was one of the early acquisitions of The Associated Group. In 1995, The Associated Group acquired Community Mutual Insurance in Ohio and created Anthem Blue Cross Blue Shield. The following year the company changed the name from The Associated Group to Anthem Insurance Company. The company shifted its focus exclusively to healthcare at that time.
In 2003, Anthem acquired Wellpoint Health Networks, previously known as Blue Cross of California. The merger between the two resulting in ongoing growth, with the final change to Anthem, Inc. taking place in 2014. The announcement of an intended merger with Cigna in 2015 places Anthem in a position to become a giant in the insurance industry. As of the time of this review, the fate of this merger remains in the hands of the courts.
Anthem’s headquarters is still in Indianapolis, although they serve a much wider region and are one of the biggest Medicare providers in several states. They are the largest Blue Cross Blue Shield licensed insurance company in the country.
Anthem writes all three Medicare plans: Medicare Advantage, Medicare Supplement, and Part D Prescription Drug. Plans are not available in all areas and vary from state to state. Coverage area will likely change if the previously mentioned Cigna merger goes through.
Anthem’s Medicare Advantage plans include HMO and PPO options, as well as a Special Needs plan that combines Medicare and Medicaid. All of the Medicare Advantage plans include Part D prescription drug coverage.
When comparing plans in our Southern California sample area, we found three available HMO plans. No PPO plans were listed for this area, although they are available in other states.
Of the three MediBlue plans, two are zero-premium, meaning there is no cost beyond your regular Medicare premium. These are Plus and Select. The Select Plan has a low out-of-pocket maximum with no co pay for most services including office visits, hospital stays, and lab services. Prescription drugs are covered starting at a $4 co pay for Tier 1 from a preferred pharmacy. Basic dental, hearing, and vision are included, and for an added premium, increased dental and vision coverage can be added.
The Plus Plan has a $20 co pay for office visits, with a $50 co pay for specialists. There is a $325 per day hospital co pay for the first 5 days, with no cost thereafter. Emergency care has a $75 co pay and Urgent Care a $45 co pay. As with the Select plan, dental and vision as well as hearing are included, with supplemental benefits available at an additional premium. Part D drug coverage starts at a $5 co pay for Tier 1 drugs at a preferred pharmacy.
The third plan is the Coordination Plus HMO. This plan features a 20% coinsurance for most services, with other coinsurance rates set by Medicare. Dental, vision, and hearing are included with the 20% coinsurance – this plan does not offer supplemental benefits. Tier 1 prescription drugs at preferred pharmacies are covered with no co pay, higher tiers start at $10.
In our comparison of the plans, we found it difficult to see what difference there was between the Select and Plus plans to justify paying higher co pays, given that both have no extra premium beyond your Original Medicare payments. The Select plan appears to offer excellent value.
Anthem offers three of the lettered Medicare Supplement plans in our sample area. They are the most popular and common plan levels: A, N, and F. Plan A is offered by all Medicare Supplement companies and is a basic plan that pays for all of the coinsurance for medical, hospital, and hospice, as well as three pints of blood each year.
Plan F offers the highest level of coverage, covering all out of pocket costs, while Plan N is a popular middle-of-the-road option with a good balance of coverage and premium cost. While these are the most popular plans, we expect to see at least a few more options offered by such a large insurance company. It was particularly surprising to see that they do not offer the high-deductible Plan F, which provides the same coverage at a lower monthly rate with a deductible.
Anthem also offers their dental and vision coverage options to their Medicare Supplement customers. This is a nice additional option not offered by all insurance companies.
In our test area, Anthem offers three Part D Prescription Drug coverage plans. The Anthem Blue Cross MedicareRx plans have three levels: Select, Plus, and Gold.
The Select plan is the most affordable and has a $400 deductible. Tier 1 drugs have a $1 co pay, Tier 2 a $5 co pay, and Tier 3 a $32 co pay. Tier 4 has a 40% coinsurance and Tier 5 a 25% coinsurance. Rates are higher at non-preferred pharmacies.
The Plus plan has a higher premium in return for no deductible. Co pays are a little different on this plan, starting at the same $1 level for Tier 1, but with $3 for Tier 2 and $40 for Tier 3. Tier 4 is covered at 39% and Tier 5 at 33%.
The most expensive plan is the Gold level, which has no deductible and lower co pays overall. Tier 1 has a $0 co pay at preferred pharmacies. Tier 3 has a $3 co pay and Tier 3 a $25 co pay. Tiers 4 and 5 are at 35% and 33% respectively.
The coverage offered by these plans is in line with what we have seen elsewhere, although the difference between Plus and Gold in terms of lower co pays isn’t as big as we would have expected.
Anthem makes it easy to obtain rate quotes with very little requirement for personal information.
MediBlue Select and Plus both are $0 premium plans, while the Coordination Plus plan is $36.30 a month. These rates are, as with all Advantage plans, in addition to the regular premium paid for Original Medicare. These are all very good rates for the coverage, particularly with two $0 premium plans to choose from which is unusual.
The Medicare Supplement plans were quoted based on a female with a birthdate of 01/01/1950. Plan A came back at $136.58, Plan N at $141.14, and Plan F at $180.06. These rates are surprisingly high, particularly for the basic Plan A, which we have seen elsewhere for as much as 40% lower. The difference between the Plan A and Plan F premiums is not as wide a gap as we usually see considering how much more coverage is included with Plan F.
Anthem’s Standard Part D plan has a premium of $68.20 a month, Plus $106.00 and Gold $159.80 based on our sample. These rates are generally in line with what we have seen at similar companies, if a little on the high side. The plans do offer relatively low co pays on the lower end tiers, although the difference between the Plus and Gold plans doesn’t quite add up to such an increase in premium, making the Plus seem like a better value.
Ratings and Reviews
Getting a clear picture of Anthem’s rating by the Better Business Bureau is difficult due to the many branches. Anthem, Inc., the parent company of the Anthem Blue Cross Blue Shield companies, rates at a dismal D- with the BBB, although this enormous company has only 43 complaints in the last three years and 14 in the past 12 months. The BBB reports that they failed to respond to 20 complaints, resulting in the low rating.
Of course, this is at odds with other BBB ratings for Anthem BCBS companies across the country. In Ohio the company rates an A-, while the company we used for our sample rating and review, Anthem Blue Cross of California, carries an A+ rating. Overall, it appears that the various Anthem insurance companies rate fairly highly with the BBB in spite of the fact that the parent company is rated much lower. Since most people are likely to complaint about their local insurance company directly rather than the parent or holding company, these ratings carry more weight.
There are 48 reviews of Anthem on Pissed Consumer that seem to range across the various companies, with reviews from a variety of states. Overall, the company rated at 1.3 out of 5, with most negative reviews.
Consumer Affairs has 301 reviews of Anthem. Only 48 of those left a star rating, resulting in an overall one-star score. Complaints even included comments from a physician about the difficulty of getting customer service from the company. Again, complaints here seemed to cover all of the areas served by Anthem.
Overall, the number of complaints isn’t particularly high for a huge insurance company, although the scattering of complaints across the various Anthem companies does make it harder to get a clear view of the company’s reputation with its customers.
The Bottom Line
Anthem is a big company poised to become even bigger if the merger with Cigna is approved and goes through. While they have a decent selection of plans, some are overpriced for the coverage compared to other companies, and the pending merger leaves us with concerns regarding what will happen to those plans and premiums in the future. As a result, it’s difficult to recommend Anthem until the smoke surrounding the potential merger clears and we see how it affects new and existing policyholders.
For a list of companies that we recommend, visit our Best Insurance Companies page.