A non-government entity
Anthem Medicare Advantage 2 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Medicare Advantage 2 (HMO). 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) in 2025, please refer to our full plan details page.
Anthem Medicare Advantage 2 (HMO) is a HMO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in New Hampshire. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Anthem Medicare Advantage 2 (HMO) 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).
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), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.40. 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 $590.00 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 $8300.00 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) plan has an enhanced alternative drug benefit. The plan includes a deductible of $590.00. During the initial coverage phase, after the deductible is met, you will pay 25% coinsurance for most drugs at standard pharmacies. Specialty tier drugs have no copay. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Anthem Medicare Advantage 2 (HMO) plan offers a range of benefits with varying cost-sharing. You'll have a $35 copay for primary care visits, and a $50 copay for specialist visits, but many services have no copay, including preventive services like annual physicals, routine hearing exams, and routine eye exams. Many services have coinsurance, including outpatient and emergency services, dental, hearing, and vision services. Additional benefits include coverage for prescription hearing aids up to $1500 per year, and up to $300 per year for OTC hearing aids, as well as coverage for OTC items and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the Anthem Medicare Advantage 2 (HMO) plan, but additional days for inpatient hospital and non-Medicare-covered stays are not covered. Prior authorization is required, and coinsurance applies for covered services, but more details on the coinsurance are not provided.
Outpatient Services See details
Outpatient services are covered by the Anthem Medicare Advantage 2 (HMO) plan, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while individual and group outpatient substance abuse sessions have a 20% coinsurance. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Medicare Advantage 2 (HMO) plan. You will pay a $55 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with 20% coinsurance for ground and air ambulance services, and no copay for transportation services to plan-approved health-related locations. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Anthem Medicare Advantage 2 (HMO) plan. Emergency Services have a $110 copay, Urgently Needed Services have a $45 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The Anthem Medicare Advantage 2 (HMO) plan covers primary care physician services with a $35 copay, chiropractic services with 20% coinsurance, occupational therapy with 20% coinsurance, physician specialist services with a $50 copay, mental health specialty services with 20% coinsurance, other health care professional services with 20% coinsurance and a $35 copay, psychiatric services with 20% coinsurance, physical therapy and speech-language pathology services with 20% coinsurance, additional telehealth benefits with no copay, and opioid treatment program services with 20% coinsurance. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Anthem Medicare Advantage 2 (HMO) plan covers preventive services, including annual physical exams with no copay. Additional preventive services, like Glaucoma Screening, Diabetes Self-Management Training, and others, are covered with a 20% coinsurance.
Hearing Services See details
Hearing Services include hearing exams with a $50 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to a maximum of $1500 per year, and OTC hearing aids are covered with no copay up to $300 per year.
Vision Services See details
The Anthem Medicare Advantage 2 (HMO) plan covers vision services, including eye exams with a $50 copay and 20% coinsurance, and eyewear with a 20% coinsurance. Routine eye exams have no copay, while contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames have no copay.
Dental Services See details
Dental services are covered, with a $50 copay for Medicare Dental Services. Other dental services include 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. There is a $2,500 maximum plan benefit coverage per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Anthem Medicare Advantage 2 (HMO) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Anthem Medicare Advantage 2 (HMO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with 0-20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Anthem Medicare Advantage 2 (HMO) plan. All diagnostic and radiological services have no copay, and the coinsurance is at most 20% for diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Anthem Medicare Advantage 2 (HMO) 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 (HMO). This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Anthem Medicare Advantage 2 (HMO) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. The plan requires prior authorization and the coinsurance details are provided separately.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay, while acupuncture is not covered. The plan offers up to $150 every three months for OTC items, and the benefit amount carries over if unused. Some other services, such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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