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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 2025, 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 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
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 Select (HMO-POS) plan has no deductible for prescription drugs. In the initial coverage phase, you will pay varying coinsurance amounts for your prescriptions depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred and standard pharmacies, and also no copay through standard mail. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The Anthem Select (HMO-POS) plan offers comprehensive coverage with no copays for many services, including inpatient hospital stays, outpatient services, primary care, preventive services, hearing exams, vision exams and eyewear, dental, home health services, and more. Emergency services have a $90 copay, and ambulance services have a $175 copay for both ground and air. Other benefits include coverage for prescription hearing aids with no copay, and no copay for a meal benefit, and over-the-counter items with no copay up to $55 every three months. The plan also provides coverage for many other services, such as home infusion bundled services, dialysis services, medical equipment, and diagnostic and radiological services, often with coinsurance or copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with no copay for a Medicare-covered stay, and additional days are unlimited with no copay per day. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, with no copay for Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services. Individual and Group Sessions for Outpatient Substance Abuse have a copay between $30.00 and $30.00.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Select (HMO-POS) plan with no copay, but prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Anthem Select (HMO-POS), including all ambulance services with no coinsurance and a $175 copay for both ground and air ambulance services. Transportation Services to a plan-approved health-related location have no copay, with up to 72 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Anthem Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $90 copay, while Urgently Needed Services have no copay.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits and Opioid Treatment Program Services are covered under the Anthem Select (HMO-POS) plan. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Additional Telehealth Benefits, and Physical Therapy and Speech-Language Pathology Services have no copay. Individual and group mental health sessions have a $30 copay.
Preventive Services See details
The Anthem Select (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including those not usually covered by Medicare, are also covered, but may have a copay. Some services such as Health Education, In-Home Safety Assessment, Medical Nutrition Therapy, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams and routine hearing exams have no copay; fitting/evaluation for hearing aids has no copay; prescription hearing aids (all types) have no copay, and OTC hearing aids have no copay. Prescription hearing aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
The Anthem Select (HMO-POS) plan covers vision services including eye exams and eyewear. There is no copay for eye exams, routine eye exams, eyewear, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum plan benefit coverage amount of $150.
Dental Services See details
The Anthem Select (HMO-POS) plan covers dental services, including oral exams, dental x-rays, and other diagnostic, preventive, restorative, and orthodontic services, with a $0 copay for all services. Other Dental Services have a maximum benefit of $1500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Anthem Select (HMO-POS) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by Anthem Select (HMO-POS). You will pay 20% coinsurance for these services.
Medical Equipment See details
The Anthem Select (HMO-POS) plan covers medical equipment, including Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies with a 20% coinsurance; Diabetic Equipment is covered with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests and Lab Services with no copay, Diagnostic Radiological Services with no copay, and Outpatient X-Ray Services with no copay. Therapeutic Radiological Services are covered with 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Anthem Select (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Select (HMO-POS) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Select (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $75 per day; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Anthem Select (HMO-POS) plan covers acupuncture with no copay and up to 24 treatments per year, and also covers over-the-counter items with no copay, up to $55 every three months, including nicotine replacement therapy and Naloxone. The plan offers a meal benefit with no copay, and "Other 1" services with no copay, requiring a doctor's referral. However, the plan does not cover Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and several other sub-services.
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