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 Riverside and San Bernardino 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 $100.00 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 $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:
Sign up for Anthem Select (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Anthem Select (HMO-POS) Medicare plan features an Enhanced Alternative drug benefit with a $100 prescription drug deductible. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies and standard mail, or a $10 copay at standard pharmacies. For other tiers, cost-sharing is structured as coinsurance, requiring 25% for Tier 2 standard generics, 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 Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy, or Extra Help, will pay $0 for their Part D costs.
Additional Benefits
The Anthem Select (HMO-POS) plan offers robust coverage with no copays or coinsurance for many essential services, including acute inpatient hospital stays, primary care and specialist doctor visits, physical therapy, and home health care. Members also enjoy no copays or coinsurance for routine preventive services, preventive dental care up to a $500 annual limit, routine eye exams, and hearing tests. Outpatient services are highly affordable, featuring no copays for ambulatory surgical centers and lab work, while emergency room visits carry a $150 copay that is waived if you are admitted. For specialized care, the plan features a 20% coinsurance for dialysis and durable medical equipment, though diabetic supplies are covered with no copay or coinsurance. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. It is important to note that certain services require prior authorization, and some benefits like cardiac rehabilitation and meal programs are not covered under this plan.
Inpatient Hospital See details
Anthem Select (HMO-POS) partially covers inpatient hospital benefits, offering acute stays with no copay or coinsurance and psychiatric stays for a $900 copay per stay and no coinsurance. Prior authorization is required, and non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Anthem Select (HMO-POS) with no coinsurance, offering no copay for ambulatory surgical center and blood services. Copays for other covered services range from $0 to $100 for outpatient hospital services, $100 per stay for observation services, and $25 per session for substance abuse services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Anthem Select (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Anthem Select (HMO-POS) covers ambulance and transportation services, though transportation is only partially covered as trips to any health-related location are not covered. Ground and air ambulance services require a $250 copay with no coinsurance, while up to 20 one-way trips to plan-approved locations are provided 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 require a $25 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
Primary care benefits are covered by Anthem Select (HMO-POS) with no copay and no coinsurance for primary care visits, specialist services, physical therapy, occupational therapy, and telehealth. A $25 copay and no coinsurance apply to mental health, psychiatric, and opioid treatment services, with several services requiring prior authorization and referrals.
Preventive Services See details
Preventive services are partially covered under Anthem Select (HMO-POS) with no copay and no coinsurance for covered benefits like annual physicals, remote access, and kidney education. However, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, fitness, disease management, telemonitoring, bathroom safety, and counseling are not covered.
Hearing Services See details
Anthem Select (HMO-POS) covers hearing exams and OTC hearing aids with no copay or coinsurance, providing up to $300 annually for OTC devices. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 annual limit, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Anthem Select (HMO-POS) provides partially covered vision services, offering annual routine eye exams and eyewear with no copay and no coinsurance up to a $100 annual limit. Eyewear upgrades are not covered under this plan.
Dental Services See details
Dental services are partially covered by Anthem Select (HMO-POS), featuring Medicare dental and preventive care with no copay and no coinsurance up to a $500 annual maximum, as well as comprehensive services with no copay and a 25% coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Select (HMO-POS) covers home infusion bundled services with prior authorization, requiring a $35 copay and no coinsurance for Medicare Part B insulin. Other Part B drugs, including chemotherapy and radiation, have no copay and a coinsurance ranging from no coinsurance up 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, with durable medical equipment and prosthetics requiring prior authorization and carrying up to a 20% coinsurance and no copay. Diabetic supplies and therapeutic shoes or inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Select (HMO-POS) covers diagnostic and radiological services, offering no copays for diagnostic procedures, lab services, and outpatient X-rays. Diagnostic radiological services require a copay of up to $50, while therapeutic radiological services carry a 20% coinsurance; prior authorization and doctor referrals are required for all services.
Home Health Services See details
Anthem Select (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Select (HMO-POS) plan. This non-coverage applies to all related sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Anthem Select (HMO-POS) partially covers Skilled Nursing Facility (SNF) services, which require prior authorization but exclude additional days beyond the Medicare-covered limit. For covered stays, there is no copay and no coinsurance for days 1 through 20, and a $218 daily copay with no coinsurance for days 21 through 100.
Other Services See details
Anthem Select (HMO-POS) partially covers Other Services, offering acupuncture, over-the-counter items, and community resource support with no copay and no coinsurance. Meal benefits and Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved