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Anthem Medicare Advantage 2 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Medicare Advantage 2 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Medicare Advantage 2 (PPO) in 2025, please refer to our full plan details page.
Anthem Medicare Advantage 2 (PPO) is a PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Indiana. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Anthem Medicare Advantage 2 (PPO) 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 Medicare Advantage 2 (PPO).
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 Medicare Advantage 2 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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 $295.00 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 combined Maximum Out-Of-Pocket cost of $6200.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $6200.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Medicare Advantage 2 (PPO) plan has a $295 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, for preferred generic drugs, you will pay a $3 copay at a preferred pharmacy, $8 at a standard pharmacy, and no copay for standard mail order. For specialty tier drugs, you will have no copay regardless of the pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Anthem Medicare Advantage 2 (PPO) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a copay, but many outpatient services have no copay, including primary care, preventive services, and dental services. The plan also covers hearing and vision services. Emergency, ambulance, and transportation services are covered, but have a copay. Home health services and durable medical equipment have no copay. However, some services like partial hospitalization and skilled nursing facilities may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $370 for days 1-5, and no copay for days 6-90. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered with no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $370, while Observation Services have a $370 copay; Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services have a $40 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Medicare Advantage 2 (PPO) plan, but requires prior authorization. The plan has a $40 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Medicare Advantage 2 (PPO) plan. Ground and air ambulance services each have a $275 copay, while transportation services to a plan-approved health-related location have no copay and are limited to 60 one-way trips per year, using rideshares, bus/subway, van, or medical transport. 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 Medicare Advantage 2 (PPO). Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services have a $35 copay; all have no coinsurance.
Primary Care See details
The Anthem Medicare Advantage 2 (PPO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay, but routine chiropractic care is not covered. Occupational therapy services have a $40 copay, and physician specialist services have a $40 copay. Individual and group mental health and psychiatric sessions have a $40 copay, and podiatry services have a $0-$40 copay. Other health care professional services have a $0-$20 copay, physical therapy and speech-language pathology services have a $40 copay, and opioid treatment program services have a $40 copay. Additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, including an annual physical exam with no copay. Additional preventive services are covered, and the plan also covers Personal Emergency Response System with no copay, and Home and Bathroom Safety Devices and Modifications with no copay. Other covered services include Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing Services include hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $3,000 per year, and OTC hearing aids are covered with no copay up to $300 per year, but prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Anthem Medicare Advantage 2 (PPO) plan covers vision services, including routine eye exams with a copay between $0 and $40, and eyewear with no copay. Eyewear coverage includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, with a combined maximum benefit of $200 every year.
Dental Services See details
The Anthem Medicare Advantage 2 (PPO) plan covers dental services including oral exams, dental x-rays, and other diagnostic and preventative services with no copay, as well as restorative services, endodontics, and more with no copay. These services are subject to a $1,000 annual maximum benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Anthem Medicare Advantage 2 (PPO) plan, 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 coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Anthem Medicare Advantage 2 (PPO) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and 0-20% coinsurance, Prosthetics/Medical Supplies have no copay and 20% coinsurance, and Diabetic Equipment has no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $160, while Lab Services have no copay. Diagnostic Radiological Services have a copay between $50 and $370, and Outpatient X-Ray Services have a $50 copay. Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Anthem Medicare Advantage 2 (PPO) 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 Medicare Advantage 2 (PPO). 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 Medicare Advantage 2 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered SNF stays, are not covered.
Other Services See details
Other Services for Anthem Medicare Advantage 2 (PPO) are not covered, with the exception of Other 1, which has no copay.
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