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Anthem Select (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Select (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Select (PPO) in 2025, please refer to our full plan details page.
Anthem Select (PPO) is a PPO 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 4 out of 5 stars in 2025.
It's important to know that Anthem Select (PPO) 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 (PPO).
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 (PPO), 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 has a $750.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $395.00 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 combined Maximum Out-Of-Pocket cost of $12000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $12000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $395.00. In the initial coverage phase, after the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, preferred generic drugs have a $7.00 copay at a preferred pharmacy or a $0 copay through standard mail order. After your total drug costs reach $2000.00, you will enter the next coverage phase.
Additional Benefits
The Anthem Select (PPO) plan offers a wide variety of benefits, including coverage for inpatient and outpatient services, with varying copays. You'll find no copays for many services such as primary care, preventive services, hearing and vision exams, and dental services. The plan also provides coverage for emergency services, ambulance, home health, and skilled nursing facilities. This plan includes coverage for prescription hearing aids, and eyewear. Diagnostic and radiological services are covered, and include copays and/or coinsurance. Be aware that some services require prior authorization, and there are some exclusions for services like cardiac rehabilitation and additional hours of care.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you will pay a $415 copay for days 1-5, and no copay for days 6-90, while for Inpatient Hospital Psychiatric, you will pay a $415 copay for days 1-4, and no copay for days 5-90. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $415, observation services with a $415 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $40 copay for individual and group sessions, and outpatient blood services with no copay. Prior authorization is required for most of these services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Anthem Select (PPO) plan, but requires prior authorization. You will have a $40 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Select (PPO) plan. Medicare-covered ground and air ambulance services have a copay of $345, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Anthem Select (PPO) plan. Emergency Services and Worldwide Emergency Coverage each have a $110 copay, while Urgently Needed Services have a $45 copay; there is no coinsurance for any of these services.
Primary Care See details
The Anthem Select (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, physician specialist services with a $45 copay, mental health specialty services with a $40 copay for individual and group sessions, other health care professional services with a $0-$20 copay, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with no copay, and opioid treatment program services with a $40 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Anthem Select (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services are also covered, with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit. The plan does not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services includes coverage for hearing exams with a $45 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription Hearing Aids (all types) are covered with no copay, and OTC hearing aids are covered with no copay. Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
The Anthem Select (PPO) plan covers vision services including eye exams and eyewear. Eye exams have a copay of $0-$45, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, has no copay, but upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, and other diagnostic and preventive services with no copay. Other services, such as restorative services, endodontics, and orthodontics, are also covered with no copay, and are subject to a $2,000 annual maximum benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Anthem Select (PPO) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay. 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 by the Anthem Select (PPO) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay, and a coinsurance between 0% and 20%, and DME for use outside the home is not covered. Prosthetic devices and medical supplies have no copay, and a coinsurance of 20% for both. Diabetic supplies and diabetic therapeutic shoes/inserts have no copay, and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests and Lab Services, are covered by the Anthem Select (PPO) plan. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $140, while Lab Services have no copay. Radiological services are also covered, with Diagnostic Radiological Services having a copay between $50 and $415, Therapeutic Radiological Services having a 20% coinsurance, and Outpatient X-Ray Services having a $50 copay.
Home Health Services See details
Home Health Services are covered under the Anthem Select (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Select (PPO) plan. Specifically, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Anthem Select (PPO), with a $0 copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Anthem Select (PPO) plan covers over-the-counter items with no copay. Acupuncture, meal benefits, dual eligible SNPs with highly integrated services, 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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