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Anthem Medicare Advantage 2 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Medicare Advantage 2 (HMO-POS). 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 (HMO-POS) in 2026, please refer to our full plan details page.
Anthem Medicare Advantage 2 (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Anthem Medicare Advantage 2 (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 Medicare Advantage 2 (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 Medicare Advantage 2 (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 $300.00 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 $8450.00 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 Medicare Advantage 2 (HMO-POS) plan features a drug deductible of $300. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs at preferred, standard, and standard mail-order pharmacies. Tier 2 generic drugs also have no copay at preferred pharmacies and standard mail order, though standard retail pharmacies require a small copay starting at $5 for a one-month supply. For higher-tier medications, your costs are based on a percentage of the drug cost rather than a flat copayment. You will pay a 25% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply at preferred, standard, and standard mail-order pharmacies.
Additional Benefits
The Anthem Medicare Advantage 2 (HMO-POS) plan offers comprehensive coverage for core medical needs with mostly predictable copayments and no coinsurance for many services. You will pay no copay for primary care visits, preventive physicals, and home health services, while specialist visits and diagnostic labs carry low to no copays. For more intensive care, outpatient hospital services range from no copay up to $445, and inpatient hospital stays require a $445 daily copay for the first few days with no copay for subsequent days. This plan also features essential supplemental benefits, including no copay for routine dental cleanings, annual eye exams, and routine hearing tests. Beneficiaries receive allowances for eyewear and hearing aids, alongside a quarterly allowance of up to $45 for over-the-counter items with no copay. However, some services like routine transportation and cardiac rehabilitation are not covered, and certain medical equipment or dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Anthem Medicare Advantage 2 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $445 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and upgrades as well as non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Medicare Advantage 2 (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $445, observation services have a $445 copay per stay, and outpatient substance abuse sessions carry a $45 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Anthem Medicare Advantage 2 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Anthem Medicare Advantage 2 (HMO-POS) covers ground and air ambulance services with a $325 copay and no coinsurance, subject to prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Anthem Medicare Advantage 2 (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance, up to a maximum plan benefit of $100,000.
Primary Care See details
Anthem Medicare Advantage 2 (HMO-POS) covers primary care physician services and telehealth benefits with no copay and no coinsurance. Other medical services, including specialist visits, physical therapy, and mental health services, require no coinsurance and copays ranging from $0 to $45, while chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Anthem Medicare Advantage 2 (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, and remote access technologies. This benefit is partially covered, as several supplemental services—including fitness benefits, health education, weight management, nutritional therapy, and in-home safety assessments—are not covered.
Hearing Services See details
Anthem Medicare Advantage 2 (HMO-POS) covers hearing exams and fittings with no coinsurance and no copay, except for Medicare-covered exams which require a $45 copay. Prescription hearing aids are partially covered with no copay or coinsurance up to $2,000 annually, though inner ear, outer ear, and over the ear models are not covered. OTC hearing aids are also covered with no copay or coinsurance up to a $300 annual limit, and prior authorization is required for most services.
Vision Services See details
Anthem Medicare Advantage 2 (HMO-POS) offers partially covered vision services with no deductibles and no coinsurance, featuring no copay for annual routine eye exams and eyewear up to a $125 yearly limit. Eye exam copays range from $0 to $45, though other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Anthem Medicare Advantage 2 (HMO-POS) dental services are partially covered, featuring no copay and no coinsurance for preventive care such as oral exams, cleanings, fluoride, and x-rays. However, there is no coverage for restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, orthodontics, or other diagnostic and preventive dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Anthem Medicare Advantage 2 (HMO-POS) with no copay, though prior authorization is required. Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Anthem Medicare Advantage 2 (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Medicare Advantage 2 (HMO-POS) covers durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic equipment, including supplies and therapeutic shoes, is covered with no copay and no coinsurance, though manufacturer limitations apply.
Diagnostic and Radiological Services See details
Anthem Medicare Advantage 2 (HMO-POS) covers diagnostic services with no coinsurance, offering no copay for lab work and a $0 to $90 copay for diagnostic procedures. Radiological services require prior authorization and feature a $15 copay for outpatient X-rays, a minimum $15 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Anthem Medicare Advantage 2 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Medicare Advantage 2 (HMO-POS) plan, as no coverage is provided for standard cardiac, intensive cardiac, pulmonary, or supervised exercise therapy rehabilitation services.
Skilled Nursing Facility (SNF) See details
Anthem Medicare Advantage 2 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Anthem Medicare Advantage 2 (HMO-POS) partially covers Other Services, providing no copay and no coinsurance for Medicare Community Resource Support and over-the-counter (OTC) items up to $45 every three months. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this benefit.
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