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 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 Riverside and San Bernardino 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 $1800.00 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 a $0 deductible for prescription drugs. During the initial coverage phase, you will pay varying coinsurance amounts depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay, while standard generic drugs have a 15% or 20% coinsurance depending on the pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Anthem Select (HMO-POS) plan offers a wide range of benefits with varying costs. Many services have no copay, including inpatient hospital stays (acute), primary care, vision services, dental services, preventive services, hearing services, and home health services. The plan includes copays for some services, such as outpatient services, emergency services, and mental health services. Ambulance services have a $200 copay. Additional benefits include coverage for medical equipment, and home infusion.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute with no copay for a Medicare-covered stay, and Inpatient Hospital Psychiatric with a $900 copay for a Medicare-covered stay; both require prior authorization. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $100, Observation Services have a $100 copay, Ambulatory Surgical Center Services and Outpatient Blood Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse have a copay of $25.
Partial Hospitalization See details
Partial Hospitalization is covered under the Anthem Select (HMO-POS) plan, with prior authorization required. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Anthem Select (HMO-POS), including both ground and air ambulance services with a $200 copay, and transportation services with no copay. Transportation services to any health-related location are also covered, up to 20 one-way trips per year.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, have a copay of $120, while Urgently Needed Services have a copay of $25; there is no coinsurance for any of these services. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a copay of $120.
Primary Care See details
The Anthem Select (HMO-POS) plan offers primary care, chiropractic, occupational therapy, specialist, mental health, podiatry, other health care professional, psychiatric, physical therapy, speech-language pathology, additional telehealth, and opioid treatment program services. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay. Individual and Group Sessions for Mental Health and Psychiatric Services, and Opioid Treatment Program Services have a $25 copay.
Preventive Services See details
Preventive Services includes coverage for Medicare-covered preventive services, Annual Physical Exams with no copay, and additional preventive services. Additional preventive services include a Fitness Benefit and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), with no copay.
Hearing Services See details
The Anthem Select (HMO-POS) plan covers hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids with no copay. Prescription hearing aids (all types) are covered with no copay, but Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The Anthem Select (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay. Eyewear has a combined maximum benefit of $150.00 every year.
Dental Services See details
The Anthem Select (HMO-POS) plan covers various dental services, including oral exams, dental X-rays, and other diagnostic services, with no copay. Other covered services include prophylaxis (cleaning), fluoride treatment, and other preventive services, all with no copay. The plan also covers orthodontic services, restorative services, and more, all with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, 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 under the Anthem Select (HMO-POS) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, Prosthetic Devices with no copay and a 20% coinsurance, and Medical Supplies with a 20% coinsurance and no copay. Diabetic Equipment is covered, including Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic and radiological services, are covered. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a copay of at most $50, while Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Anthem Select (HMO-POS) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Select (HMO-POS) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Select (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $50 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Anthem Select (HMO-POS) plan covers acupuncture with no copay, and over-the-counter items with no copay and a maximum coverage amount of $15 every three months. Other services such as Meal Benefit, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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