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 San Diego 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 $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:
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Drug Coverage
The Anthem Select (HMO-POS) plan has a $0 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. For example, in the initial coverage phase, you'll pay $3 for a preferred generic drug at a preferred pharmacy, while a standard mail order generic drug has no copay. You will pay coinsurance for standard generic, preferred brand, and non-preferred drugs.
Additional Benefits
The Anthem Select (HMO-POS) plan provides a range of benefits, including inpatient and outpatient hospital services, with varying copays. Emergency services have a copay, while primary care, preventive services, and many vision and dental services have no copay. Hearing services include exams and hearing aids with no copay, and prescription hearing aids are covered up to a maximum. This plan also offers coverage for ambulance services with a copay or coinsurance, and partial hospitalization services with a copay. Additionally, the plan covers medical equipment, home health services, and skilled nursing facility services with copays or coinsurance. Other notable benefits include coverage for home infusion services, dialysis, and diagnostic and radiological services, with varying costs.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered under the Anthem Select (HMO-POS) plan. For days 1-7, there is a $150 copay, and for days 8-90, there is no copay. Additional days for both acute and psychiatric care are covered with no copay. 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, including all outpatient hospital services, are covered by Anthem Select (HMO-POS). Outpatient Hospital Services have a copay between $0 and $225, Observation Services have a $225 copay, Ambulatory Surgical Center (ASC) Services have no copay, Outpatient Substance Abuse Services have a $25 copay for both individual and group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Select (HMO-POS) plan, with a $25 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Select (HMO-POS) plan, with prior authorization required for all ambulance services. Ground Ambulance Services have a $250 copay, while Air Ambulance Services have a 20% coinsurance; Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Anthem Select (HMO-POS). Emergency Services and Worldwide Emergency Coverage have a $90 copay, Urgently Needed Services has a $35 copay, and there is no coinsurance for any of these services.
Primary Care See details
The Anthem Select (HMO-POS) plan offers primary care services with no copay. Chiropractic services have a $5 copay, and require prior authorization and a doctor referral. Occupational therapy services have a $25 copay, and require prior authorization and a doctor referral. Physician specialist services have a $10 copay, and require prior authorization and a doctor referral. Mental health specialty services, including individual and group sessions, have a $25 copay, and require prior authorization and a doctor referral. Podiatry services have a $0-$10 copay, and require prior authorization and a doctor referral. Other health care professional services have a $0-$20 copay, and require prior authorization and a doctor referral. Psychiatric services, including individual and group sessions, have a $25 copay, and require prior authorization and a doctor referral. Physical therapy and speech-language pathology services have a $25 copay, and require prior authorization and a doctor referral. Additional telehealth benefits are covered with no copay. Opioid Treatment Program Services have a $25 copay and require prior authorization and a doctor referral.
Preventive Services See details
Preventive services include Medicare-covered zero-dollar preventive services, annual physical exams with no copay, and additional preventive services. Additional preventive services like health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and more are not covered. Other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit are covered with no copay.
Hearing Services See details
Hearing services with Anthem Select (HMO-POS) include hearing exams with a $10 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, and OTC hearing aids with no copay. Prescription hearing aids are covered up to a maximum of $3000 per year, while inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
The Anthem Select (HMO-POS) plan covers vision services including eye exams with a copay between $0 and $10. Eyewear is covered with no copay, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames have no copay, and upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics, all with no copay; Medicare Dental Services have a $10 copay. The plan has a $1,500 maximum benefit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Anthem Select (HMO-POS) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with all diagnostic services requiring prior authorization and a doctor referral. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $10.00, and Therapeutic Radiological Services have a coinsurance of at least 20%. 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. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by Anthem Select (HMO-POS). This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
The Anthem Select (HMO-POS) plan covers Skilled Nursing Facility (SNF) services with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $100.
Other Services See details
Under "Other Services," Anthem Select (HMO-POS) covers over-the-counter items with no copay, up to a maximum of $15.00 every three months. Other services such as acupuncture, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and more are not covered.
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