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Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem I Carelon Chronic Care 2 (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 I Carelon Chronic Care 2 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
Anthem I Carelon Chronic Care 2 (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 San Bernardino. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Anthem I Carelon Chronic Care 2 (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 I Carelon Chronic Care 2 (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 I Carelon Chronic Care 2 (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 I Carelon Chronic Care 2 (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 $800.00 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 I Carelon Chronic Care 2 (HMO-POS C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay varying costs depending on the drug tier and pharmacy. For example, preferred generic drugs have a $9.50 copay at a preferred pharmacy and a $0 copay through standard mail order. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including outpatient services, partial hospitalization, preventive services, hearing exams, vision services, dental services, home health services, and OTC items. Emergency Services and Worldwide Emergency Coverage have a $120 copay, while inpatient hospital stays have a $25 copay for days 1-10, and no copay for the remaining days. This plan provides additional benefits such as ambulance services with a $150 copay, and transportation services to health-related locations with no copay. Primary care, including specialist visits, typically have no copay, while chiropractic services have a $20 copay. The plan also covers prescription hearing aids up to $3,000 annually, and dental services up to $2,500 per year.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $25 copay for days 1-10, and no copay for days 11-90. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric have 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, including all outpatient hospital services, observation services, and ambulatory surgical center services, are covered with no copay. Outpatient substance abuse services, including individual and group sessions, have a copay of $25.00. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) with prior authorization. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $150 copay. Transportation Services to a plan-approved health-related location are covered with no copay, offering 10 one-way trips per year via rideshare services, bus/subway, van, or medical transport; 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. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $120 copay. Urgently Needed Services has no copay.
Primary Care See details
The Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, physician specialist services, physical therapy, speech-language pathology services, and additional telehealth benefits have no copay, while chiropractic services have a $20 copay, mental health specialty services and psychiatric services have a copay between $0 and $25, other health care professionals have a copay between $0 and $20, and opioid treatment program services have a $30 copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams with no copay, and additional preventive services with varying copays. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit are also covered with no copay. Some services, such as Health Education, In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, and others, are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids have no copay. Prescription hearing aids (all types) have no copay, but the plan covers up to $3,000 every year.
Vision Services See details
Vision services include eye exams, eyewear, and contact lenses. Eye exams and eyewear have no copay. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses have no copay, but upgrades are not covered.
Dental Services See details
The Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) plan covers dental services, including oral exams, dental x-rays, and other diagnostic and preventive services, with no copay. Other services like restorative services, endodontics, and orthodontics are covered with no copay, and a maximum plan benefit of $2,500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with no 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 I Carelon Chronic Care 2 (HMO-POS C-SNP) plan. The coinsurance for this benefit is 20%.
Medical Equipment See details
Medical equipment includes Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and a coinsurance of 0-20%, while DME for use outside of the home is not covered. Prosthetic Devices have a coinsurance of 0-20%, and Medical Supplies have a coinsurance of 0-20%. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services have a copay up to $150.00, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Anthem I Carelon Chronic Care 2 (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 covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) plan, with a $0 copay for days 1-20, and a $50 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
The Anthem I Carelon Chronic Care 2 (HMO-POS C-SNP) plan covers Over-the-Counter (OTC) Items with no copay, and a meal benefit with no copay, but requires prior authorization. Other services such as acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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