A non-government entity
Anthem I CareMore Medicare Advantage (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem I CareMore Medicare Advantage (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem I CareMore Medicare Advantage (HMO-POS) in 2026, please refer to our full plan details page.
Anthem I CareMore Medicare Advantage (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in San Bernardino county. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Anthem I CareMore Medicare Advantage (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 I CareMore Medicare Advantage (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 I CareMore Medicare Advantage (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 $135.00 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 $1000.00 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:
Sign up for Anthem I CareMore Medicare Advantage (HMO-POS)
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Drug Coverage
The Anthem I CareMore Medicare Advantage (HMO-POS) plan features an annual prescription drug deductible of $135.00. During the initial coverage phase, tier 1 preferred generic drugs have no copay at preferred pharmacies or through standard mail, and tier 5 specialty drugs also have no copay. Other tiers require coinsurance, ranging from 25% for tier 2 standard generics to 31% for tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, beneficiaries who qualify for Extra Help or the low-income subsidy will benefit from a reduced Part D premium of $0.00.
Additional Benefits
The Anthem I CareMore Medicare Advantage (HMO-POS) plan offers comprehensive coverage with no copays or coinsurance for inpatient hospital stays, primary care, specialist visits, and home health services. Members also pay no copay for diagnostic lab services, outpatient X-rays, and routine preventive care. For urgent and emergency needs, emergency room visits require a $100 copay, which is waived upon admission, while ambulance services carry a $160 copay. Additional benefits include routine dental, vision, and hearing exams with no copay, alongside allowances for eyewear and hearing aids. While comprehensive dental care requires a 25% coinsurance and dialysis requires a 20% coinsurance, members can access unlimited transportation to plan-approved locations and over-the-counter items with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days.
Inpatient Hospital See details
Anthem I CareMore Medicare Advantage (HMO-POS) partially covers inpatient hospital services with no copay and no coinsurance for Medicare-covered acute and psychiatric stays. Prior authorization is required, and certain sub-services such as non-Medicare-covered stays and room upgrades are not covered.
Outpatient Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for outpatient hospital, observation, ambulatory surgical center, and blood services. Outpatient substance abuse individual and group sessions are covered with a $30 copay and no coinsurance, though prior authorization is required for most of these outpatient services.
Partial Hospitalization See details
Partial hospitalization is covered by Anthem I CareMore Medicare Advantage (HMO-POS) with a $30.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers ground and air ambulance services with a $160 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering unlimited one-way rides to plan-approved locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by Anthem I CareMore Medicare Advantage (HMO-POS) with a $100 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $100 copay and no coinsurance.
Primary Care See details
Anthem I CareMore Medicare Advantage (HMO-POS) offers primary care, specialist, psychiatric, mental health, and telehealth services with no copayments or coinsurance. Other covered services feature copayments ranging from $0 to $30 with no coinsurance, though chiropractic services are only partially covered as routine chiropractic care is not covered.
Preventive Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) partially covers preventive services, offering covered benefits like annual physical exams, select screenings, memory fitness, and remote access technologies with no copay and no coinsurance. Sub-services not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $3,000 annual limit, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are also covered with no copay and no coinsurance up to a $300 yearly limit.
Vision Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers routine eye exams and eyewear with no copay and no coinsurance, though prior authorization is required. Eyewear is partially covered with a combined $200 annual limit, but eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Anthem I CareMore Medicare Advantage (HMO-POS) up to a $2,000 annual maximum, though maxillofacial prosthetics, implant services, and orthodontics are not covered. Diagnostic and preventive care require no copay and no coinsurance, while covered comprehensive services require a 25% coinsurance and no copay.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Anthem I CareMore Medicare Advantage (HMO-POS) with prior authorization required. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs are covered with no copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers dialysis services with a 20% coinsurance and no copay. This plan ensures you have access to vital dialysis treatments with clear and predictable cost-sharing.
Medical Equipment See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers medical equipment, including durable medical equipment and prosthetics, with no copay and no coinsurance to 20% coinsurance. Diabetic supplies are covered with no copay and a 20% coinsurance, while diabetic therapeutic shoes and inserts require a $25 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Anthem I CareMore Medicare Advantage (HMO-POS) with no coinsurance, though prior authorization is required. Members pay no copay for lab services, diagnostic procedures, diagnostic radiological services, and outpatient X-rays, while therapeutic radiological services require a $50 copay.
Home Health Services See details
Home health services are covered by Anthem I CareMore Medicare Advantage (HMO-POS) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem I CareMore Medicare Advantage (HMO-POS) plan, as all related sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered in practice.
Skilled Nursing Facility (SNF) See details
Anthem I CareMore Medicare Advantage (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay for days 1 to 20 and a $100 daily copay for days 21 to 100, with no coinsurance required. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem I CareMore Medicare Advantage (HMO-POS) partially covers other services, providing over-the-counter items, meal benefits, and community resource support with no copays and no coinsurance. Acupuncture and dual eligible SNPs with highly integrated services are not covered under this benefit.
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