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 Alameda 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 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) Medicare plan offers an Enhanced Alternative drug benefit with no prescription drug deductible, meaning your coverage begins right away. During the initial coverage phase, there is no copay for Tier 1 preferred generic drugs at preferred, standard, or standard mail pharmacies. For Tier 2 standard generic drugs, you will pay a $42 copay at preferred or standard mail pharmacies, and a $47 copay at standard pharmacies. For higher-tier medications, you will pay a 25% coinsurance for Tier 3 preferred brand drugs and a 33% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs. This structured plan offers clear, cost-effective options for managing your annual prescription medication expenses.
Additional Benefits
Anthem Select (HMO-POS) offers comprehensive medical coverage with predictable costs, featuring no copay for primary care telehealth, routine preventive services, and home health care. For in-person doctor visits, you will pay a low $15 copay for primary care and a $45 copay for specialists, with no coinsurance. Inpatient hospital stays require a daily copay of $315 for the first six days of acute care, while outpatient services range from no copay up to a $315 copay. This plan also provides robust supplemental benefits, including annual routine dental, vision, and hearing exams with no copay or coinsurance. Prescription hearing aids are covered up to $3,000 annually and routine eyewear is covered up to $225 per year, both with no copay. Additionally, diagnostic lab work, diabetic supplies, and over-the-counter items are available with no copay, while durable medical equipment requires up to 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Anthem Select (HMO-POS) with no coinsurance, requiring a daily copay of $315 for days 1 through 6 of acute care and $311 for days 1 through 6 of psychiatric care, followed by no copay for days 7 through 90. Non-Medicare-covered stays and hospital upgrades are not covered, and prior authorization is required.
Outpatient Services See details
Anthem Select (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $315 copay for outpatient hospital services, a $315 copay per stay for observation services, and a $40 copay for substance abuse sessions. Ambulatory surgical center and blood services have no copay, though most of these outpatient services require prior authorization and a doctor referral.
Partial Hospitalization See details
Anthem Select (HMO-POS) covers partial hospitalization services with a $40 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Anthem Select (HMO-POS), with ground and air ambulance services requiring prior authorization, a $275 copay, and no coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Anthem Select (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $35 copay and no coinsurance, while worldwide emergency, urgent, and transportation benefits are covered up to a $100,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
Anthem Select (HMO-POS) covers primary care visits for a $15 copay and specialist visits for a $45 copay, with no coinsurance. Other services like therapy, mental health, and psychiatric sessions require copays ranging from $25 to $40 with no coinsurance, telehealth features no copay, and chiropractic services are partially covered since routine chiropractic care is not covered.
Preventive Services See details
Anthem Select (HMO-POS) partially covers preventive services with no copays or coinsurance for covered care, including annual physical exams, kidney disease education, and remote access technologies. Several supplemental services, such as fitness benefits, weight management programs, and in-home safety assessments, are not covered.
Hearing Services See details
Anthem Select (HMO-POS) covers routine hearing exams and fittings with no copay or coinsurance, while Medicare-covered exams require a $45 copay. Prescription hearing aids are partially covered up to $3,000 annually with no copay or coinsurance—excluding inner ear, outer ear, and over-the-ear types—and OTC hearing aids are covered up to $300 yearly with no copay or coinsurance.
Vision Services See details
Anthem Select (HMO-POS) offers partially covered vision services, which exclude eyewear upgrades. Covered benefits feature no deductible and no coinsurance, with no copay for annual routine eye exams and eyewear (up to a $225 yearly limit), and a copay of up to $45 for other eye exams.
Dental Services See details
Anthem Select (HMO-POS) offers partially covered dental services, featuring Medicare-covered dental care for a $45 copay and no coinsurance, and annual oral exams and cleanings with no copay and no coinsurance. Dental x-rays and fluoride are available as optional supplemental benefits, while restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Anthem Select (HMO-POS) and require prior authorization. Under this plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Anthem Select (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Select (HMO-POS) covers medical equipment, featuring durable medical equipment with 0% to 20% coinsurance and prosthetic devices or medical supplies with 20% coinsurance, both with no copays. Diabetic supplies and therapeutic shoes or 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 with prior authorization and doctor referrals. Diagnostic procedures carry a $0 to $75 copay and lab services have no copay, both with no coinsurance, while radiological services require either a $10 to $150 copay (no coinsurance) or 20% coinsurance (no copay) depending on the service.
Home Health Services See details
Anthem Select (HMO-POS) covers Home Health Services with no copay and no coinsurance, though a doctor referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Anthem Select (HMO-POS), but in practice, some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered. Since these services are not covered by the plan, there are no copays or coinsurance.
Skilled Nursing Facility (SNF) See details
Anthem Select (HMO-POS) covers Skilled Nursing Facility (SNF) services with prior authorization, featuring no copay and no coinsurance for days 1 through 20, and a $218 copay with no coinsurance for days 21 through 100. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Anthem Select (HMO-POS) partially covers Other Services, providing 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.
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