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Anthem I CareMore Lung 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 CareMore Lung 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 CareMore Lung Care 2 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Anthem I CareMore Lung 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 Los Angeles, Orange. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Anthem I CareMore Lung 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 CareMore Lung 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 CareMore Lung 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 CareMore Lung 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 $499.00 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 CareMore Lung Care 2 (HMO-POS C-SNP) offers an enhanced alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs at preferred pharmacies and through standard mail, as well as no copay for Tier 5 specialty drugs. For other medications, Tier 2 standard generics carry a 20% to 25% coinsurance, while Tier 1 drugs at standard pharmacies require a $10 copay. Tier 3 preferred brands and Tier 4 non-preferred drugs require 30% and 33% coinsurance respectively. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescription drugs. Furthermore, individuals who qualify for the low-income subsidy will pay nothing for their Part D premium.
Additional Benefits
The Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) plan offers robust coverage with no copays and no coinsurance for many essential medical services. Members enjoy no copays for inpatient hospital stays, primary care and specialist visits, routine diagnostic tests, and home health services. For urgent care, there is no copay, while emergency room visits require a $90 copay and ambulance services carry a $150 copay. Supplemental benefits are also highly affordable, featuring no copays or coinsurance for routine dental, vision, and hearing services. The plan provides generous annual allowances, including up to $4,000 for preventive and restorative dental care and $275 for eyewear. While many services have no cost-sharing, members should expect a 20% coinsurance for dialysis and up to 20% coinsurance for durable medical equipment and home infusion drugs.
Inpatient Hospital See details
Inpatient hospital acute and psychiatric services are partially covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no copay and no coinsurance for Medicare-covered stays. Prior authorization is required, and non-Medicare-covered stays and upgrades for acute care are not covered.
Outpatient Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) covers outpatient services with no coinsurance. There is no copay for outpatient hospital, observation, ambulatory surgical center, and blood services, while outpatient substance abuse sessions require a $25 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with a $150 copay and no coinsurance for both ground and air ambulance services. Transportation benefits are partially covered, offering up to 22 one-way trips per year with no copay and no coinsurance to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) covers emergency services with a $90 copay and no coinsurance, and urgently needed services with no copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit limit with a $90 copay and no coinsurance.
Primary Care See details
Primary care benefits under Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) are generally covered with no coinsurance, featuring no copays for primary care, specialist, therapy, podiatry, and telehealth services. Chiropractic services are partially covered because routine chiropractic care is not covered, while mental health, psychiatric, and opioid treatment services require copays up to $25 with no coinsurance.
Preventive Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams and kidney disease education. Additional preventive services are partially covered; memory fitness, remote access, and home safety modifications are covered with no copay or coinsurance, but services like health education, weight management, and alternative therapies are not covered.
Hearing Services See details
Hearing services are covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no copays or coinsurance for routine exams, fitting evaluations, and OTC hearing aids up to $300 annually. Prescription hearing aids are partially covered with no copay or coinsurance up to a $3,000 annual limit, but inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Vision services are partially covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no copay, no deductible, and no coinsurance, although prior authorization is required. The plan covers one routine eye exam per year and provides up to $275 annually for eyewear, including contact lenses and eyeglasses, but eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no copay and no coinsurance for covered services, up to a maximum annual benefit of $4,000. While preventive and restorative treatments are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) covers home infusion bundled services with prior authorization, requiring a $35 copay for Part B insulin and ranging from no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Part B drugs.
Dialysis Services See details
Dialysis services are covered under the Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) plan with a 20% coinsurance and no copay.
Medical Equipment See details
Medical equipment is covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP), with prior authorization required for services. Durable medical equipment requires no copay and 0% to 20% coinsurance, while prosthetics, medical supplies, and diabetic equipment are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) with no coinsurance, though prior authorization is required. Members pay no copay for diagnostic procedures, lab services, diagnostic radiological services, and outpatient X-rays, while therapeutic radiological services require a $60 copay.
Home Health Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) does not cover Cardiac Rehabilitation Services. This means there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, or SET for PAD rehabilitation sub-services.
Skilled Nursing Facility (SNF) See details
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization and offering no copay for days 1 through 31, a $50 daily copay for days 32 through 100, and no coinsurance. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Anthem I CareMore Lung Care 2 (HMO-POS C-SNP), as acupuncture and dual eligible SNPs with highly integrated services are not covered. Covered services—including over-the-counter items, meal benefits, and Medicare community resource support—are available to members with no copay and no coinsurance.
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