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 San Diego County. 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 $2500.00 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) plan features an Enhanced Alternative drug benefit with a $200 prescription drug deductible. After meeting this deductible, you will enter the initial coverage phase where Tier 1 preferred generic drugs have no copay at preferred pharmacies and standard mail order, or a $10 copay at standard pharmacies. For other tiers, you will pay a 25% coinsurance for Tier 2 standard generics, and a 30% coinsurance for both Tier 3 preferred brands and 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 prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy, also known as Extra Help, will pay $0 for their Part D coverage.
Additional Benefits
Anthem Select (HMO-POS) provides robust medical coverage with affordable cost-sharing, featuring no copay for primary care visits, telehealth, and preventive services. For hospital care, inpatient stays require a $150 daily copay for days 1 through 7 followed by no copay, while outpatient services range from no copay to a $225 copay. Emergency room visits carry a $150 copay, and urgent care is available for a $35 copay, with no coinsurance required for either service. The plan also covers routine wellness benefits, offering dental cleanings, routine hearing exams, and home health services with no copay. Vision exams feature no copay or a low $10 copay, while hearing aids and eyewear are covered up to generous annual limits with no copay. Additionally, diagnostic labs and diabetic supplies require no copay, helping members manage their ongoing health needs with minimal out-of-pocket expenses.
Inpatient Hospital See details
Anthem Select (HMO-POS) partially covers inpatient hospital benefits, as upgrades and non-Medicare-covered stays are not covered. Covered acute and psychiatric inpatient stays require prior authorization and have a copay of $150 per day for days 1 through 7, no copay for days 8 through 90, and no coinsurance.
Outpatient Services See details
Anthem Select (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services, a $25 copay for outpatient substance abuse sessions, and copays ranging from $0 to $225 for outpatient hospital and observation services. Most of these covered services require a doctor referral and prior authorization.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Anthem Select (HMO-POS) with a $25.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Anthem Select (HMO-POS), which features a $275 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered with no copay or coinsurance for up to 2 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Anthem Select (HMO-POS) covers emergency services with a $150 copay and no coinsurance, and urgently needed care with a $35 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum limit, requiring a $150 copay and no coinsurance.
Primary Care See details
Anthem Select (HMO-POS) primary care benefits are partially covered with no coinsurance, featuring no copay for primary care provider visits and telehealth services, and copays ranging from $5 to $25 for therapy, specialist, and mental health services. Routine chiropractic care is not covered under this plan.
Preventive Services See details
Anthem Select (HMO-POS) covers preventive services, including annual physical exams, remote access technologies, and kidney disease education, with no copay and no coinsurance. However, many supplemental benefits under this category, such as fitness programs, health education, and nutrition therapy, are not covered.
Hearing Services See details
Anthem Select (HMO-POS) covers hearing exams with a $10 copay and no coinsurance, while routine hearing exams and fitting evaluations have no copay or coinsurance. Hearing aids are partially covered with no copay or coinsurance, offering up to $3,000 annually for prescription hearing aids and $300 for OTC hearing aids, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Anthem Select (HMO-POS) because eyewear upgrades are not covered. Covered eye exams require a $0 to $10 copay and no coinsurance, while eligible eyewear has no copay and no coinsurance up to a $250 annual limit.
Dental Services See details
Anthem Select (HMO-POS) offers partially covered dental services up to a $1,500 annual limit, though maxillofacial prosthetics, implant services, and orthodontics are not covered. Preventive services like cleanings and exams have no copay and no coinsurance, while Medicare dental services require a $10 copay (no coinsurance) and comprehensive treatments have a 25% coinsurance with no copay.
Home Infusion bundled Services See details
Anthem Select (HMO-POS) covers home infusion bundled services, which require prior authorization and step therapy for certain drugs. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while Part B chemotherapy and other Part B drugs feature no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Anthem Select (HMO-POS) with a 20% coinsurance and no copay.
Medical Equipment See details
Anthem Select (HMO-POS) covers medical equipment, featuring durable medical equipment with 0% to 20% coinsurance and no copay, and prosthetic devices and medical supplies with 20% coinsurance and no copay. Diabetic supplies, therapeutic shoes, and inserts are also covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Select (HMO-POS) covers diagnostic and radiological services, requiring prior authorization and doctor referrals for all services. Diagnostic procedures, lab services, and outpatient X-rays feature no copay, while diagnostic radiological services carry a copay of up to $10, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Anthem Select (HMO-POS) covers home health services 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 none of the sub-services, including cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) rehabilitation, are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is 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, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Anthem Select (HMO-POS), offering Over-the-Counter (OTC) items up to $15 every three months and Medicare Community Resource Support with no copay and no coinsurance. Acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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