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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 2025, 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 2025 to people living in Select counties in Ohio. This plan received an overall rating of 3.5 out of 5 stars in 2025.
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 $3900.00 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) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay no copay for preferred generic drugs at preferred and standard pharmacies and for preferred mail order. For standard generic drugs, you'll pay 20% coinsurance at preferred pharmacies and mail order, and 25% coinsurance at standard pharmacies. For preferred brand drugs and non-preferred drugs, you'll pay 50% and 33% coinsurance, respectively.
Additional Benefits
The Anthem Chronic Care (HMO-POS C-SNP) plan offers comprehensive coverage with varying costs for different services. Inpatient hospital stays have a $310 copay for the first seven days, with no copay for the remaining days. Outpatient services have copays ranging from $0 to $310, while emergency services have a $140 copay. The plan provides no copay for primary care, preventive services, and many vision and dental services. Additional benefits include coverage for hearing aids up to $3,000 per year, and an allowance of $300 per year for over-the-counter hearing aids, as well as transportation services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered. For days 1-7 of an inpatient hospital stay, you will have a $310 copay, and days 8-90 have no copay.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $310, Observation Services with a $310 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse services with a $25 copay for individual and group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by Anthem Chronic Care (HMO-POS C-SNP) with a $40 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $260 copay. Transportation Services to a plan-approved health-related location has no copay and covers 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 Chronic Care (HMO-POS C-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, Urgently Needed Services has a $30 copay, and Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $140 copay.
Primary Care See details
The Anthem Chronic Care (HMO-POS C-SNP) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, and physician specialist services with a copay between $0 and $25. Mental health specialty services, psychiatric services, and opioid treatment program services have a $25 copay for individual and group sessions. The plan also covers podiatry services with a copay between $0 and $25, other health care professional services with a copay between $0 and $20, physical therapy and speech-language pathology services with a $25 copay, and additional telehealth benefits with 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 services like fitness, remote access technologies, and home and bathroom safety devices are covered, and other preventive services like glaucoma screenings, diabetes self-management training, and others, are covered with no copay. Health education, in-home safety assessments, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
The Anthem Chronic Care (HMO-POS C-SNP) plan covers hearing exams with a $25 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a maximum benefit of $3,000 per year, and OTC hearing aids are covered with no copay, up to $300 per year.
Vision Services See details
Vision services include eye exams with a copay of $0-$25, and eyewear with no copay. Eyewear has a combined maximum plan benefit coverage of $300 per year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental services are covered, with a $2,500 annual maximum benefit. There is no copay for 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. The plan covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Anthem Chronic Care (HMO-POS C-SNP) plan. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies with no copay and a 20% coinsurance. Diabetic Equipment benefits include Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, both with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic procedures/tests have a copay between $0 and $95, lab services have no copay, diagnostic radiological services have a copay between $50 and $310, therapeutic radiological services have 20% coinsurance, and outpatient X-ray services have a $50 copay.
Home Health Services See details
Home Health Services are covered by the Anthem Chronic Care (HMO-POS C-SNP) 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 generally covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and there is a copay, but the specific amount is not detailed in this summary.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for over-the-counter items and meal benefits with no copay. Over-the-counter items have a maximum benefit of $70 every three months, and the plan also covers nicotine replacement therapy and Naloxone. Acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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