A non-government entity
Anthem Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Select (HMO-POS) in 2026, please refer to our full plan details page.
Anthem Select (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Orange and Los Angeles Counties. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Anthem Select (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 Select (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 Select (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 $200.00 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
Anthem Select (HMO-POS) offers an Enhanced Alternative drug benefit with a yearly prescription drug deductible of $200. During the initial coverage phase, Tier 1 preferred generic drugs have no copay at preferred pharmacies and standard mail-order, but require a $10 copay at standard pharmacies. Tier 2 standard generic drugs require a 25% coinsurance, while Tier 3 preferred brand and Tier 4 non-preferred drugs require a 30% coinsurance. These cost-sharing rates apply until your total drug costs reach $2,100. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, qualifying for the low-income subsidy can reduce your Part D premium to nothing.
Additional Benefits
The Anthem Select (HMO-POS) plan offers comprehensive coverage with no copays and no coinsurance for many essential services, including inpatient hospital stays, preventive care, primary care visits, specialist consultations, and routine diagnostic tests. For outpatient services and emergency care, members can expect predictable costs, such as a $150 copay for emergency room visits (waived if admitted) and a $200 copay for covered ambulance services. Skilled nursing facility care is also highly affordable, featuring no copay for the first 20 days of a stay. In addition to core medical care, this plan provides valuable supplemental benefits to support overall wellness, including routine dental, vision, and hearing services with no copays for preventive care. Members benefit from a $300 annual allowance for over-the-counter hearing aids, a $75 annual eyewear allowance, and diagnostic dental services with no copay, while comprehensive dental services require a 25% coinsurance. Other notable perks include a $54 quarterly over-the-counter drug allowance and up to 24 acupuncture treatments per year with no copay.
Inpatient Hospital See details
Anthem Select (HMO-POS) partially covers inpatient hospital benefits, offering Medicare-covered acute and psychiatric stays with no copay and no coinsurance, as well as unlimited additional days. Prior authorization is required, and upgrades or non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Select (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for outpatient hospital, observation, ambulatory surgical center, and blood services. Patients will pay a $30 copay per session for outpatient substance abuse individual and group services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Anthem Select (HMO-POS) with no copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Anthem Select (HMO-POS), as transportation to any health-related location is not covered. Covered ground and air ambulance services require a $200 copay and no coinsurance, while up to two one-way trips per year to plan-approved locations are covered with no copay and no coinsurance.
Emergency Services See details
Anthem Select (HMO-POS) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 maximum with a $150 copay and no coinsurance.
Primary Care See details
Anthem Select (HMO-POS) offers primary care benefits with no copay and no coinsurance for primary care visits, specialist services, physical and occupational therapy, and routine chiropractic and podiatry care. Psychiatric, mental health specialty, and opioid treatment services require a $30 copay and no coinsurance.
Preventive Services See details
Anthem Select (HMO-POS) partially covers preventive services with no copays and no coinsurance for covered benefits like annual physical exams, kidney disease education, and personal emergency response systems (PERS). However, several supplemental benefits, including fitness programs, health education, and weight management, are not covered.
Hearing Services See details
Anthem Select (HMO-POS) covers hearing exams and OTC hearing aids with no copay and no coinsurance, offering up to a $300 annual limit for OTC devices. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $3,000 yearly limit, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Anthem Select (HMO-POS) vision services are partially covered, offering no copay and no coinsurance for routine eye exams and eyewear, though eyewear upgrades are not covered. Covered benefits include one routine eye exam per year and a combined annual eyewear allowance of up to $75.
Dental Services See details
Anthem Select (HMO-POS) offers dental services that are partially covered, with no coverage for maxillofacial prosthetics, implant services, and orthodontics. Diagnostic and preventive dental services feature no copay and no coinsurance, while covered comprehensive services require a 25% coinsurance and no copay, up to a $500 annual maximum.
Home Infusion bundled Services See details
Anthem Select (HMO-POS) covers home infusion bundled services, which require prior authorization and step therapy. 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 0% to 20%.
Dialysis Services See details
Anthem Select (HMO-POS) covers dialysis services with 20% coinsurance and no copay.
Medical Equipment See details
Anthem Select (HMO-POS) covers medical equipment, offering durable medical equipment (DME) with no copay and 0% to 20% coinsurance. Prosthetics and medical supplies require no copay and 20% coinsurance, while diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Select (HMO-POS) covers diagnostic tests, lab services, diagnostic radiology, and outpatient X-rays with no copay and no coinsurance. Therapeutic radiological services are covered with a 20% coinsurance, and all of these services require prior authorization and a doctor referral.
Home Health Services See details
Home health services are covered by Anthem Select (HMO-POS) with no copay and no coinsurance, though prior authorization and a doctor referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Select (HMO-POS) plan, as all associated sub-services—including cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Anthem Select (HMO-POS) with no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance. Prior authorization is required for these services, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem Select (HMO-POS) partially covers other services with no copay and no coinsurance, which includes up to 24 acupuncture treatments per year, a $54 quarterly over-the-counter drug allowance, chronic illness meal benefits, and community resource support. Dual Eligible SNPs with Highly Integrated Services are not covered.
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