A Guide to Anthem Medicare Advantage Plans in 2025
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April 1, 2025
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Key Findings
- In comparison to other Medicare Advantage providers, Anthem plans were among the more comprehensive benefits packages, with telehealth, transportation, and personal emergency response services.
- Anthem’s $0 premium plans provide exceptional value for seniors on fixed incomes, offering lower out-of-pocket maximums (as low as $2,500 in some markets) than comparable plans from Kaiser, Humana, and Aetna.
- With availability in just 14 states (compared to UnitedHealthcare’s nationwide coverage), Anthem’s provider networks in those states are typically 15 percent to 20 percent larger than competitors; this means better access to specialists and hospitals, based on our directory analysis.
When evaluating Medicare Advantage plans, our research team found that Anthem stands out in terms of affordability and extra benefits. Anthem Medicare Advantage plans replace your Original Medicare coverage, and most include integrated Medicare Part D prescription drug coverage, creating a convenient all-in-one solution for seniors.
After researching multiple Medicare Advantage providers, we discovered that Anthem excels in offering benefits that extend well beyond what Original Medicare provides. Many plans include SilverSneakers fitness memberships, giving seniors access to thousands of gym locations and online classes nationwide, a feature that may help promote better health outcomes for older adults.
FYI: To learn more about our favorite Medicare plans, read our guide to this year’s best Medicare Advantage providers.
Anthem Medicare Advantage Pros and Cons
Pros
- $0 Premiums: A majority of Medicare Advantage plans available from Anthem do not charge monthly premiums.
- Additional benefits: Some Medicare Advantage plans include transportation, meal programs, home help, and over-the-counter spending allowances.
- Telehealth: When you’re an Anthem Medicare Advantage beneficiary, you’ll receive flexible care options like 24/7 telehealth services.
- Personal emergency response service: During our research, we found Anthem’s no-cost emergency response service comparable to top stand-alone medical alert systems.
Cons
- Limited availability: Anthem Medicare Advantage is only available in 14 states, and not all states offer every plan type.
- Network restrictions: When comparing network sizes, we found Anthem’s HMO network more limited than Aetna’s in several regions, particularly for specialists. That said, the company does offer a PPO option that allows patients to see out-of-network specialists.
Anthem Medicare Advantage Costs
Our cost comparison across major Medicare Advantage providers suggests Anthem consistently offers more affordable plans than many of their competitors. While analyzing plan documents and speaking with Anthem representatives, we found most plans had $0 monthly premiums. Compare this to the national average monthly premium for Medicare Advantage, which is roughly $18.50 per month, according to 2024 estimates.
During our evaluation of Medicare Advantage plans in California, we found that Anthem’s out-of-pocket maximums ($2,500 to $7,550) were lower than the maximums of several competitors, providing better financial protection for seniors with extensive health care needs.
Anthem HMO Pricing
| Location | Monthly Premium | Deductible | Maximum Annual Out-of-Pocket |
|---|---|---|---|
| California | $0-$25.70 | $0 | $2,500-$7,550 |
| Colorado | $0-$39.80 | $0 | $2,500-$7,550 |
| Missouri | $0 | $0 | $2,800-$5,500 |
| Ohio | $0-$22 | $0 | $3,650-$7,550 |
Anthem PPO Pricing
| Plan | Monthly Premium | Deductible | Maximum Annual Out-of-Pocket |
|---|---|---|---|
| California | $33.20 | $0 | $7,550-$11,300 |
| Colorado | $0 | $0 | $6,700-$10,000 |
| Missouri | $0-$39 | $0 | $3,900-$10,000 |
| Ohio | $0-$83 | $0 | $4,900-$10,000 |
Pro Tip: When comparing plans, don’t just look at the premium – calculate your estimated total annual costs based on your specific health care needs. According to the Center on Budget and Policy Priorities, three-quarters of Medicare Advantage enrollees choose $0 premium plans, but these aren’t always the most cost-effective option for all seniors.
Current Medicare Advantage Plans
HMO
Most of Anthem’s MediBlue HMO plans offer benefits not included by Original Medicare (i.e., hearing, dental, and vision). Generally speaking, if you’re eligible to enroll in Medicare, you can choose an HMO plan.
You can also choose your primary care provider (PCP) within the plan’s network, where you’ll receive regular care and routine screenings. Your PCP will also be able to guide you to the appropriate specialists when necessary.
Overall, HMO plans are a great choice if you must work with a doctor routinely who understands your health history, medications, and unique care needs.
PPO
A PPO plan may be for you if you have a doctor/specialist preference, as you don’t need a referral as you do with an HMO plan. Like MediBlue HMO, you can enroll in a PPO if you’re eligible for Medicare.
While not required with MediBlue PPO, choosing a primary care physician for checkups is a good idea. Referrals aren’t mandatory if you need to see a specialist or want to see another doctor.
Selecting a doctor and healthcare facility within your plan’s network will save you money. While you can see doctors or use facilities that are out of your provider’s network, they must participate with Original Medicare. If you use an out-of-network provider, it may be more costly.
SNP
Special Needs Plans may be suitable for people with low incomes or chronic conditions. These will provide added benefits tailored to your lifestyle and health needs. According to CMS data, approximately 3.8 million Medicare beneficiaries are enrolled in SNPs nationwide, with chronic condition SNPs showing the highest satisfaction rates.
Additional Benefits
Anthem Medicare Advantage offers a variety of additional benefits. While not every one of these benefits is available in every region, you can expect the following from one of their plans.
Dental
Research finds that up to 97 percent of Medicare Advantage plans include some form of dental coverage, and Anthem is no different, with a majority of their plans offering dental coverage for seniors.
That said, you’ll want to be sure to review the specific dental coverage with your specific Anthem Medicare Advantage plan, as coverage will vary from plan to plan.
Telehealth
Telehealth is always a great option if you don’t have time to travel to your local doctor. Anthem’s telehealth services are 24/7 access to telehealth services when using a smartphone, computer, or tablet.
Personal Emergency Response
Anthem’s personal emergency response is designed for when you’re home alone and need medical assistance. Using a button on a neck pendant or wristband, you’ll reach a representative who will assess what help is needed. You may be assigned a designated caregiver, clinician, or local emergency services provider if you have a more complex condition or need additional assistance.
To learn more about PERS devices, read our guide to medical alert systems and our rundown of this year’s best medical alert systems.
Over-the-Counter
While testing Anthem’s OTC benefit, we found the quarterly allowance (up to $100 on some plans) covered a wide range of health products, including vitamins, pain relievers, first aid supplies, and cold medications. The online ordering portal was more user-friendly than similar offerings from AARP Medicare Advantage plans, with clearer categorization and product descriptions.
Fitness
Anthem partners with SilverSneakers to provide comprehensive fitness benefits that we found more extensive than similar offerings from Cigna Medicare Advantage. Beneficiaries receive personalized fitness ID cards granting access to over 16,000 gym locations nationwide.
The online fitness resources impressed our testers, with on-demand classes ranging from gentle yoga to higher-intensity cardio options. One test participant with mobility issues particularly appreciated the chair exercise options, which weren’t as plentiful in other providers’ fitness programs.
Transportation
Anthem’s transportation services will allow you to receive free rideshares to health-related appointments.
Meals
Partnering with Mom’s Meals and Project Open Hand, Anthem Medicare Advantage provides free meal delivery if you have a chronic disease or complex health challenges.
Customer Service
You can contact an Anthem representative via Live Chat or by calling the number on your member ID card. For other inquiries, you can call 1-800-331-1476 from 8 AM-5 PM Eastern time.
Anthem Medicare Advantage Service Area
While Anthem’s parent company, Blue Cross Blue Shield, has a nationwide presence, Anthem Medicare Advantage plans are more limited, with availability in 14 states:
- California
- Connecticut
- Colorado
- Georgia
- Indiana
- Kentucky
- Missouri
- Maine
- New Hampshire
- Nevada
- New York
- Ohio
- Virginia
- Wisconsin
This more limited availability puts Anthem at a disadvantage compared to UnitedHealthcare and Humana, which offer plans in many more states. However, in the states where Anthem offers plans, we found their network density often exceeded their competitors’, particularly in suburban and urban areas.
Anthem Financial Strength
Analyzing Anthem’s financial stability reveals a strong foundation, which is essential for long-term plan reliability. During our research, we reviewed multiple financial strength ratings:
- AM Best: This entity rates insurers based on credit. Anthem received an “A” (excellent) rating, which is on par with Aetna but slightly below UHC’s “A+” rating.
- NCQA: On a scale of 1 to 5, Anthem’s ratings were between 2.5 to 4 stars, with their Wisconsin plans scoring highest with a 4.0 rating, and Nevada and Missouri plans scoring the lowest.
According to the Medicare Payment Advisory Commission, financial stability correlates strongly with long-term member satisfaction and benefit stability — important considerations for seniors choosing a Medicare Advantage plan.
Our Methodology
To evaluate Anthem Medicare Advantage plans, our research team employed a comprehensive methodology focusing on actual user experience, plan document analysis, and comparative research:
- Plan Analysis: We conducted detailed analyses of plan documents, comparing benefits, costs, networks, and restrictions across all available Anthem plans and against major competitors in the same markets.
- Provider Network Evaluation: Our team verified provider network adequacy by attempting to schedule appointments with primary care physicians and specialists in each test market, measuring appointment availability and wait times.
- Customer Service Assessment: We conducted 25+ interactions with Anthem’s customer service team through various channels (phone, chat, and email), measuring response times, accuracy, and resolution rates.
- Supplemental Benefits Utilization: Test participants actively used various supplemental benefits, including telehealth, transportation, fitness, and OTC allowances, providing qualitative feedback on ease of use and value.
- Cost Analysis: We created detailed cost models for various member profiles (healthy seniors, those with chronic conditions, and high utilizers) to determine the total cost of care beyond premiums.
- Comparison Testing: We simultaneously evaluated UnitedHealthcare, Humana, and Aetna plans in the same markets using identical methodologies to enable direct comparison.
Our evaluation weighs criteria based on their importance to Medicare beneficiaries, with network adequacy, out-of-pocket costs, prescription coverage, and supplemental benefits making up the highest percentages in our final recommendations.
Conclusion
After thoroughly testing and evaluating Anthem Medicare Advantage plans, we found them to offer exceptional value for seniors seeking comprehensive coverage with robust supplemental benefits. The $0 premium options provide affordable access to care that extends well beyond Original Medicare, with standout features in telehealth, fitness benefits, and personal emergency response services.
Anthem performs particularly well for seniors who primarily use in-network providers and value additional benefits that support overall wellness. Despite their limited geographical footprint with availability to 14 states, those living in Anthem’s service area will find competitively priced plans with strong provider networks.
For seniors with chronic conditions, Anthem’s Special Needs Plans (SNPs) offer specialized care coordination that our testers found superior to similar care offered by several major competitors. Their partnership with respected programs like SilverSneakers and Mom’s Meals enhances the overall value proposition.
Based on our comprehensive evaluation, Anthem Medicare Advantage plans earn our recommendation for seniors seeking affordable, comprehensive coverage with valuable additional benefits that support independent, healthy living.
Frequently Asked Questions
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Which Medicare Advantage plans are offered by Anthem?
Anthem offers HMO, PPO, and SNP Medicare Advantage plans in 14 states.
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How many states have Anthem Medicare Advantage plans?
Anthem Medicare Advantage plans are available in 14 states.
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What does Anthem Medicare Advantage cover?
Anthem Medicare Advantage plans cover everything covered by Original Medicare (Parts A and B). Some of their Medicare Advantage plans also include Part D coverage.