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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 San Francisco County. 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 $7550.00 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. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will pay a $7 copay at a preferred pharmacy, and $12 at a standard pharmacy. For standard mail order, you will have no copay. The plan also has a catastrophic coverage phase where you pay nothing for covered drugs after your yearly out-of-pocket drug costs reach $2000.00.
Additional Benefits
The Anthem Select (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and ambulatory surgical centers may have no copay. You can expect copays for services like primary care visits, specialist visits, and mental health services, as well as for emergency and urgent care. The plan includes coverage for hearing and vision services, with copays for exams and no copays for some hearing aids and eyewear. Dental services include coverage for exams and cleanings, and home health services are available with no copay. There is also coverage for skilled nursing facilities with a copay, and ambulance services with a copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you will pay a copay of $360 for days 1-4, and no copay for days 5-90, while Inpatient Hospital Psychiatric has a copay of $330 for days 1-4, and no copay for days 5-90. Additional days for both Acute and Psychiatric are covered with no copay.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $350, observation services have a $350 copay, and ambulatory surgical center services have no copay. Outpatient substance abuse services have a $40 copay for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Anthem Select (HMO-POS) plan, with a $40 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a $300 copay, while air ambulance services have a 20% coinsurance. Transportation services to health-related locations are 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 have a $90 copay, Urgently Needed Services have a $35 copay, and Worldwide Emergency Services have a $90 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with a $5 copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $35 copay, Physician Specialist Services with a $20 copay, and Mental Health Specialty Services with a $40 copay for individual and group sessions. Additionally, Podiatry Services have a $0-$20 copay, Other Health Care Professional services have a $0-$5 copay, Psychiatric Services have a $40 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services have a $35 copay, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have a $40 copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional preventive services like Medicare-covered glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs after a welcome visit, all with no copay. Other services like health education, in-home safety assessments, medical nutrition therapy, and more 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 have a $20 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay, with 1 visit covered per year for each. Prescription hearing aids (all types) have no copay, with a maximum benefit of $3,000 every year, and prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered. OTC hearing aids have no copay, with a maximum benefit of $300 every year.
Vision Services See details
Vision services include coverage for eye exams with a copay between $0 and $20, and eyewear, which includes contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, all with no copay, and a combined maximum benefit of $175 per year; upgrades are not covered. Routine eye exams have no copay and are covered once per year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $20 copay, and Oral Exams and Prophylaxis (Cleaning) with no copay, but does not cover Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, or Orthodontics. Dental X-Rays and Fluoride Treatment are offered as optional supplemental benefits.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered under the Anthem Select (HMO-POS) plan. The plan has a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered under the Anthem Select (HMO-POS) plan. You will pay 20% coinsurance for these services.
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 20% coinsurance, and Medical Supplies with no copay and 20% coinsurance. Diabetic Equipment is covered, including Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, both with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay between $0 and $120, and lab services with no copay. Radiological Services are covered, with a copay of at most $165 for diagnostic services, a coinsurance of at least 20% for therapeutic services, and no copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered under the Anthem Select (HMO-POS) plan with no copay and no coinsurance, but 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. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Select (HMO-POS) plan, with prior authorization required. There is no copay for days 1-20, and a $140 copay for days 21-100.
Other Services See details
Other Services includes acupuncture and Medicare Community Resource Support. Acupuncture has no copay, while Medicare Community Resource Support has no copay. Over-the-Counter (OTC) Items, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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