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Anthem Veteran (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Veteran (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Veteran (PPO) in 2025, please refer to our full plan details page.
Anthem Veteran (PPO) is a PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in NH. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Anthem Veteran (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem Veteran (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 Veteran (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. Additionally, this plan comes with a Part B Premium reduction of $90.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (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 $8950.00 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:
Sign up for Anthem Veteran (PPO)
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Drug Coverage
Prescription drugs are not covered by Anthem Veteran (PPO).
Additional Benefits
The Anthem Veteran (PPO) plan offers a wide array of benefits with varying costs. Inpatient hospital stays have a $350 copay for days 1-5, but no copay for the remaining days, and outpatient services have copays ranging from $0 to $350. Emergency services have a $125 copay, and primary care and preventive services have no copay, though specialist visits incur a $40 copay. The plan also includes coverage for hearing, vision, and dental services. Hearing exams have a $40 copay, and prescription hearing aids are covered up to $1000 per year. Vision services have copays for eye exams, and no copay for eyewear. Dental services are covered with no copay, up to a maximum of $2000 per year.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered by the Anthem Veteran (PPO) plan. For days 1-5, there is a $350 copay, and for days 6-90, there is no copay. Additional days for both Acute and 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 include all outpatient hospital services with a copay between $0 and $350, observation services with a $350 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $40 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Veteran (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with all ambulance services requiring prior authorization. Ground and air ambulance services have a $290 copay, while transportation services to a plan-approved health-related location have no copay. 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 Veteran (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $55 copay, and Worldwide Urgent Coverage and Worldwide Emergency Transportation each have a $125 copay.
Primary Care See details
The Anthem Veteran (PPO) plan covers primary care services with no copay, and covers physician specialist services with a $40 copay. Mental health specialty services and psychiatric services each have a $40 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $40 copay, while additional telehealth benefits have no copay.
Preventive Services See details
The Anthem Veteran (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services include Fitness Benefit and Remote Access Technologies, with no copay. Some preventive services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $40 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, prescription hearing aids (all types) with no copay, and OTC hearing aids with no copay, though specific types of prescription hearing aids such as inner ear, outer ear, and over the ear are not covered. The plan has a maximum benefit of $59 per year for hearing exams, and $1000 per year for prescription hearing aids, and $300 per year for OTC hearing aids.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay between $0 and $40, and eyewear has no copay; however, upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, and other diagnostic services with no copay; other services such as restorative services, endodontics, and orthodontics are also covered with no copay, and a maximum benefit of $2000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Anthem Veteran (PPO), including Medicare Part B insulin drugs with a $35 copay. Other Medicare Part B drugs and Medicare Part B chemotherapy/radiation drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Anthem Veteran (PPO) plan with a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0% to 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment, including supplies and therapeutic shoes/inserts, with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay between $0 and $90, lab services with no copay, and outpatient X-ray services with no copay. Therapeutic Radiological Services have a coinsurance of at least 20%, while diagnostic radiological services may have a copay up to $350.
Home Health Services See details
Home Health Services are covered under the Anthem Veteran (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Veteran (PPO) plan. Prior authorization is required for this service.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Veteran (PPO) plan. You will have no copay for days 1-20, and a $214 copay per day for days 21-100; there is no coinsurance.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a $40 copay per visit, and is limited to 24 treatments per year. OTC items have no copay, and a maximum benefit of $45 every three months. The plan also offers a meal benefit with no copay.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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