A non-government entity
Anthem Chronic Care (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Chronic Care (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Chronic Care (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Anthem Chronic Care (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 to people living in Select counties in MO. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Anthem Chronic Care (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Anthem Chronic Care (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem Chronic Care (HMO-POS C-SNP).
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 Chronic Care (HMO-POS C-SNP), 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 $3500.00 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 Chronic Care (HMO-POS C-SNP) Medicare plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately with no upfront deductible costs. You will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs at preferred pharmacies, standard pharmacies, and standard mail-order services. Additionally, Tier 2 generic medications have no copay when filled at preferred pharmacies or through standard mail order, while standard pharmacies require a copay starting at $10. For higher-tier medications, your costs are based on a percentage of the drug cost rather than a flat copayment. Tier 3 preferred brand drugs require a 20% coinsurance at preferred pharmacies and standard mail order, rising to 25% at standard pharmacies. Non-preferred drugs in Tier 4 carry a 30% coinsurance, while Tier 5 specialty drugs require a 33% coinsurance for a one-month supply across all available pharmacy networks.
Additional Benefits
The Anthem Chronic Care (HMO-POS C-SNP) plan offers comprehensive medical coverage with many opportunities for cost savings. Primary care visits, home health services, and preventive care are available with no copay, while specialist visits require a copay of up to $30. Inpatient hospital stays require a $295 daily copay for the first seven days, with no copay for subsequent days. Supplemental benefits include up to $3,000 in annual coverage for both dental services and prescription hearing aids with no copay or coinsurance. Members also benefit from a $400 annual eyewear allowance and up to 26 free one-way transportation trips to approved locations per year. Additionally, the plan features a $40 monthly over-the-counter item allowance and no copay for routine vision and hearing exams.
Inpatient Hospital See details
Anthem Chronic Care (HMO-POS C-SNP) covers unlimited inpatient acute and psychiatric hospital stays with no coinsurance, requiring a daily copay of $295 for days 1 through 7 and no copay for days 8 and beyond. Prior authorization is required for these services, which are partially covered as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Chronic Care (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $295 copay for outpatient hospital services and a $295 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions require a $20 copay and no coinsurance.
Partial Hospitalization See details
Anthem Chronic Care (HMO-POS C-SNP) covers partial hospitalization services with a $30.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Anthem Chronic Care (HMO-POS C-SNP) covers ambulance services with a $244 copay and no coinsurance for ground and air transport, which require prior authorization. Transportation benefits are partially covered with no copay or coinsurance, providing up to 26 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Anthem Chronic Care (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, and urgently needed services with a $45 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $150 copay and no coinsurance, up to a maximum plan benefit of $100,000.
Primary Care See details
Primary care benefits under Anthem Chronic Care (HMO-POS C-SNP) are covered with no copay and no coinsurance for primary care visits and telehealth, while specialists and podiatry services require a $0 to $30 copay with no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies require a $20 copay with no coinsurance, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive Services under the Anthem Chronic Care (HMO-POS C-SNP) plan are generally covered with no copay and no coinsurance, including an annual physical exam, kidney disease education, and diabetes self-management training. While memory fitness benefits and remote access technologies are also covered at no cost, many other additional services, such as health education, in-home safety assessments, and nutritional/dietary benefits, are not covered.
Hearing Services See details
Anthem Chronic Care (HMO-POS C-SNP) hearing services are partially covered, featuring a $30 copay and no coinsurance for Medicare-covered exams, alongside no copay and no coinsurance for routine exams and fittings. Prescription hearing aids offer up to $3,000 in annual coverage with no copay or coinsurance, though inner ear, outer ear, and over-the-ear models are not covered. Over-the-counter (OTC) hearing aids are also covered up to $300 annually with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by Anthem Chronic Care (HMO-POS C-SNP), offering no copay and no coinsurance for annual routine eye exams, though other eye exams are not covered. Eyewear is covered up to $400 annually with no deductible, featuring no copay or coinsurance for eyeglasses and frames, a 20% coinsurance and no copay for contact lenses, and no coverage for upgrades.
Dental Services See details
Anthem Chronic Care (HMO-POS C-SNP) partially covers dental services up to a $3,000 annual maximum, offering preventive and most comprehensive services with no copay and no coinsurance. Medicare-covered dental services require a $20 copay and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Anthem Chronic Care (HMO-POS C-SNP) with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Anthem Chronic Care (HMO-POS C-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Chronic Care (HMO-POS C-SNP) covers medical equipment, offering durable medical equipment with no copay and between no coinsurance and 20% coinsurance. Prosthetics and medical supplies are covered with no copay and 20% coinsurance, while diabetic equipment, supplies, and therapeutic shoes are provided with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Anthem Chronic Care (HMO-POS C-SNP), though prior authorization and referrals are required. Lab services have no copay or coinsurance, diagnostic tests range from a $0 to $65 copay with no coinsurance, and radiological services require a minimum $50 copay for diagnostic imaging, a 20% minimum coinsurance for therapeutic radiation, and a $90 copay with coinsurance for X-rays.
Home Health Services See details
Home Health Services are covered under the Anthem Chronic Care (HMO-POS C-SNP) plan with no copay and no coinsurance, although both prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Chronic Care (HMO-POS C-SNP) plan. This includes intensive cardiac, pulmonary, and supervised exercise therapy services, all of which are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Anthem Chronic Care (HMO-POS C-SNP) with no coinsurance, requiring prior authorization but no prior three-day inpatient 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 Medicare-covered limit are not covered.
Other Services See details
Anthem Chronic Care (HMO-POS C-SNP) partially covers other services with no copay and no coinsurance, which includes a $40 monthly over-the-counter item allowance, a chronic illness meal benefit, and community resource support with a referral. Acupuncture is not covered under this benefit.
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