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Anthem I CareMore Medicare Advantage 2 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem I CareMore Medicare Advantage 2 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem I CareMore Medicare Advantage 2 (HMO-POS) in 2026, please refer to our full plan details page.
Anthem I CareMore Medicare Advantage 2 (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Los Angeles, Orange and San Bernadino Counties. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Anthem I CareMore Medicare Advantage 2 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem I CareMore Medicare Advantage 2 (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Anthem I CareMore Medicare Advantage 2 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $85.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $1500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Anthem I CareMore Medicare Advantage 2 (HMO-POS) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $85.00. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs at preferred pharmacies and Tier 5 specialty drugs at standard and preferred pharmacies. For other drug tiers, you will pay a coinsurance ranging from 25% for standard generics to 32% for non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you will transition into the catastrophic coverage phase. During this final phase, you pay nothing for covered Medicare Part D prescription drugs. Furthermore, individuals who qualify for the low-income subsidy (LIS) can reduce their Part D premium to $0.00.
Additional Benefits
Anthem I CareMore Medicare Advantage 2 (HMO-POS) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care, specialist visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $125 for the first five days and no copay thereafter, while emergency room visits require a $120 copay. Outpatient services generally feature no coinsurance, with copays ranging from no copay up to $125 depending on the specific service. The plan provides valuable additional benefits, including routine dental, vision, and hearing services with no copays or coinsurance, alongside allowances for eyewear and hearing aids. Members also benefit from no copay for up to 22 one-way transportation trips per year and over-the-counter items. While many medical supplies and diagnostic tests require no copay, some specialized services like dialysis and durable medical equipment carry up to a 20% coinsurance.
Inpatient Hospital See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) partially covers inpatient hospital services, as upgrades and non-Medicare-covered stays are not covered. Covered acute and psychiatric stays require a $125 daily copay for days 1 through 5, no copay for days 6 and beyond, and no coinsurance.
Outpatient Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay between $0 and $125, observation services cost a $125 copay per stay, and outpatient substance abuse sessions carry a $15 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Anthem I CareMore Medicare Advantage 2 (HMO-POS) with a $15.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Anthem I CareMore Medicare Advantage 2 (HMO-POS), requiring a $100 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered, providing up to 22 one-way trips per year to plan-approved health locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by Anthem I CareMore Medicare Advantage 2 (HMO-POS) with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay and no coinsurance, while worldwide emergency coverage, urgent coverage, and emergency transportation are covered up to a $50,000 maximum with a $120 copay and no coinsurance per service.
Primary Care See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) covers primary care, specialist, therapy, and telehealth services with no copays and no coinsurance. Chiropractic services are partially covered, as routine chiropractic care is not covered, while other professional services require a $0 to $20 copay and opioid treatment has a $15 copay with no coinsurance.
Preventive Services See details
Preventive services are covered by Anthem I CareMore Medicare Advantage 2 (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, and glaucoma screenings. Additional preventive services are partially covered, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, bathroom safety, and counseling.
Hearing Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) covers routine hearing exams and OTC hearing aids with no copay or coinsurance, providing up to a $300 annual allowance for OTC devices. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,500 annual limit, though inner ear, outer ear, and over-the-ear models are not covered. Prior authorization is required for these hearing services.
Vision Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) partially covers vision services with no copay and no coinsurance for annual routine eye exams and select eyewear, which has a combined annual limit of $150. While contacts and eyeglasses are covered, eyewear upgrades are not covered under this plan.
Dental Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) partially covers dental services up to a $1,500 annual limit, offering preventive and diagnostic care with no copay and no coinsurance. Covered comprehensive services, such as restorative treatment and oral surgery, require a 25% coinsurance and no copay, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) covers home infusion bundled services, which require prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis services are covered under the Anthem I CareMore Medicare Advantage 2 (HMO-POS) plan. Members will pay a 20% coinsurance and no copay for these essential treatments.
Medical Equipment See details
Medical equipment is covered under the Anthem I CareMore Medicare Advantage 2 (HMO-POS) plan, with durable medical equipment requiring no copay and no coinsurance to 20% coinsurance, and prosthetics or medical supplies covered with no copay or coinsurance. Diabetic supplies carry a 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts require a $25 copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for diagnostic procedures, lab services, and outpatient X-rays, while diagnostic radiological services range from a $0 to $60 copay and therapeutic radiological services require a $50 copay.
Home Health Services See details
Home Health Services are covered by Anthem I CareMore Medicare Advantage 2 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services, are not covered under the Anthem I CareMore Medicare Advantage 2 (HMO-POS) plan.
Skilled Nursing Facility (SNF) See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $25 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem I CareMore Medicare Advantage 2 (HMO-POS) partially covers other services, offering over-the-counter items, meal benefits, and community resource support with no copay and no coinsurance. Acupuncture and dual-eligible SNP services are not covered under this plan benefit.
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