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Anthem I CareMore Lung Care (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem I CareMore Lung Care (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem I CareMore Lung Care (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Anthem I CareMore Lung Care (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in San Bernardino County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Anthem I CareMore Lung Care (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Anthem I CareMore Lung Care (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem I CareMore Lung Care (HMO-POS C-SNP).
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 Lung Care (HMO-POS C-SNP), 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 $150.00 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 $800.00 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 Lung Care (HMO-POS C-SNP) plan features an Enhanced Alternative drug benefit with a $150 annual prescription drug deductible. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through standard mail, while Tier 2 standard generics require a $45 copay. For Tier 5 specialty drugs, this plan offers no copay across preferred, standard, and standard mail pharmacies. For higher-tier medications, you will pay a coinsurance of 30% for Tier 3 preferred brands and 31% for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescriptions. Additionally, individuals who qualify for the Low-Income Subsidy will have their Part D premium reduced to $0.
Additional Benefits
The Anthem I CareMore Lung Care (HMO-POS C-SNP) plan offers comprehensive medical coverage with many essential services requiring no copay and no coinsurance. Members enjoy no copay for primary care visits, specialist consultations, outpatient hospital services, and urgent care. For inpatient hospital stays, there is a $25 daily copay for days 1 through 10 and no copay for subsequent days, while emergency room visits require a $120 copay. Routine dental, vision, and hearing services are also covered with no copay and no coinsurance, subject to generous annual benefit limits. The plan includes up to 70 annual one-way transportation trips to approved locations and an $80 quarterly over-the-counter allowance with no copay. While home health care and diabetic supplies have no copay, services like dialysis and therapeutic radiology require a 20 percent coinsurance.
Inpatient Hospital See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) partially covers inpatient acute and psychiatric hospital stays, requiring a $25 daily copay for days 1 through 10, no copay for days 11 and beyond, and no coinsurance. Prior authorization is required, and upgrades as well as non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers outpatient hospital, observation, ambulatory surgical center, and blood services with no copay and no coinsurance. Outpatient substance abuse services, including individual and group sessions, are also covered with a $30 copay and no coinsurance.
Partial Hospitalization See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers partial hospitalization services with a $30 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Anthem I CareMore Lung Care (HMO-POS C-SNP), as transportation to any health-related location is not covered. Ground and air ambulance services require a $195 copay and no coinsurance, while up to 70 annual one-way trips to plan-approved locations are available with no copay and no coinsurance.
Emergency Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers emergency services with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $100,000 with a $120 copay and no coinsurance per service.
Primary Care See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers primary care, specialist visits, therapies, mental health, psychiatry, podiatry, and telehealth services with no copay and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance, though routine chiropractic care is not covered. Other health professionals and opioid treatment require copays up to $20 and $30 respectively, with no coinsurance.
Preventive Services See details
Preventive services are partially covered by Anthem I CareMore Lung Care (HMO-POS C-SNP) with no copays or coinsurance for covered options like annual physical exams, glaucoma screenings, and kidney disease education. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge 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 counseling, enhanced disease management, telemonitoring, and counseling services.
Hearing Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers hearing exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $3,000 annual limit, but inner ear, outer ear, and over the ear models are not covered. Prior authorization is required for these services, which also feature a $300 annual limit for OTC hearing aids.
Vision Services See details
Vision services are partially covered by Anthem I CareMore Lung Care (HMO-POS C-SNP), offering routine eye exams and eyewear with no copay, no coinsurance, and no deductible. Covered eyewear is subject to a combined annual limit of $300, though eyewear upgrades are not covered.
Dental Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) features partially covered dental services with no copays and no coinsurance, up to a maximum annual benefit of $3,000. Covered benefits include preventive care, oral exams, and restorative services, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers home infusion bundled services with prior authorization, including Medicare Part B insulin drugs for a $35 copay and no coinsurance. Other covered Part B chemotherapy, radiation, and clinical drugs require no copay, with coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers durable medical equipment and prosthetics with no copay and a coinsurance ranging from no coinsurance to 20%. Diabetic supplies and therapeutic shoes or inserts are also covered under this plan with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) covers diagnostic and radiological services, though prior authorization is required. Diagnostic procedures, lab services, and diagnostic radiological services are fully covered with no copay and no coinsurance, while outpatient X-rays feature no copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Anthem I CareMore Lung Care (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Anthem I CareMore Lung Care (HMO-POS C-SNP) with prior authorization required; while some services are covered, in practice Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) partially covers Skilled Nursing Facility (SNF) services with prior authorization, though additional days beyond the Medicare-covered limit are not covered. Covered stays require no coinsurance, featuring no copay for days 1 through 20 and a $100 daily copay for days 21 through 100.
Other Services See details
Anthem I CareMore Lung Care (HMO-POS C-SNP) partially covers other services, providing over-the-counter items with an $80 quarterly limit, chronic illness meal benefits, and Medicare community resource support with no copay or coinsurance. Acupuncture and dual eligible SNPs with highly integrated services are not covered under this benefit.
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