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 2025, 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 Select Counties 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 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 a $350.00 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 $6760.00 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) plan has a $350 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For generic drugs, you can expect to pay a $5-$10 copay at preferred and standard pharmacies, and no copay for standard mail order. For preferred brand drugs, you will pay 25% coinsurance. Specialty drugs have no copay.
Additional Benefits
The Anthem Select (HMO-POS) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the service. Emergency, primary care, and preventive services are covered, often with no copay, and the plan also includes coverage for hearing, vision, and dental care, with some services having no copay. Additional benefits of this plan include ambulance and transportation services, and coverage for home health and skilled nursing facilities. The plan also covers medical equipment, diagnostic and radiological services, and offers coverage for home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For the first 5 days, the copay is $395 per admission, and there is no copay for days 6-90. Additional days for both acute and psychiatric care are covered with no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Outpatient hospital services have a copay between $0 and $395, observation services have a $395 copay, Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $40 copay for individual and group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Select (HMO-POS) plan with a $40 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Select (HMO-POS) plan. Ground ambulance services have a $280 copay, while air ambulance services have a 20% coinsurance. Transportation Services have no copay, and also include rideshare services, bus/subway, van, and medical transport to a plan-approved health-related location, up to 60 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Anthem Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay, while Urgently Needed Services have a $45 copay, and there is no coinsurance for any of these services.
Primary Care See details
The Anthem Select (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a $30 copay, mental health specialty services with a $35 copay, podiatry services with a $30 copay, other health care professional services with no copay, psychiatric services with a $35 copay, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits with no copay, and opioid treatment program services with a $40 copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include Medicare-covered zero dollar preventive services, an annual physical exam with no copay, and additional preventive services including fitness benefits, remote access technologies, and home and bathroom safety devices. Additional services such as health education, in-home safety assessment, and several others are not covered.
Hearing Services See details
The Anthem Select (HMO-POS) plan covers hearing exams with a $30 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids have a plan-specified amount of $2500 per year, and OTC hearing aids are covered with no copay up to $300 per year. Prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include coverage for eye exams, with a copay of $0-$30, and eyewear, which includes contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, all with no copay. Eyewear has a combined maximum plan benefit coverage of $300.
Dental Services See details
The Anthem Select (HMO-POS) plan covers dental services, including oral exams, dental x-rays, and other diagnostic and preventive services with no copay, and a maximum annual benefit of $2,000. The plan also covers orthodontic services, restorative services, and more with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Anthem Select (HMO-POS) 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 Select (HMO-POS) plan. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
The Anthem Select (HMO-POS) plan covers medical equipment, including durable medical equipment (DME) with a coinsurance between 0% and 20%, and preferred vendors are required. Prosthetics/Medical Supplies are covered with no copay and a coinsurance of 20% for Medicare-covered Prosthetic Devices and Medical Supplies. Diabetic equipment is covered with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
The Anthem Select (HMO-POS) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a copay between $0 and $50, and lab services with no copay. Radiological services include diagnostic services with a copay between $25 and $395, therapeutic services with at least 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the Anthem Select (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Select (HMO-POS) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Select (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Anthem Select (HMO-POS) plan covers acupuncture with no copay, but requires prior authorization and is limited to 12 treatments per year. Over-the-counter items are covered with no copay, and have a maximum benefit coverage amount of $110 every three months. Other services, including meal benefits, are not covered.
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