A non-government entity
Anthem Veteran (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Veteran (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Veteran (HMO-POS) in 2025, please refer to our full plan details page.
Anthem Veteran (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in Georgia. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Anthem Veteran (HMO-POS) 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 (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 Veteran (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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7550.00 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
Prescription drugs are not covered by Anthem Veteran (HMO-POS).
Additional Benefits
The Anthem Veteran (HMO-POS) plan offers comprehensive coverage, including inpatient hospital stays with a copay for the first few days and no copay thereafter. Outpatient services have varying copays, with no copays for some services, while emergency and urgent care services have copays. Primary care visits have no copay, and preventive services are covered with no copay for many services. This plan includes coverage for hearing, vision, and dental services, often with no copays. It also covers home infusion, dialysis, and medical equipment with varying cost-sharing structures. Additional benefits include transportation, over-the-counter items, and meal benefits, all with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered by the Anthem Veteran (HMO-POS) plan. For days 1-6, there is a $275 copay, and for days 7-90, there is no copay. Additional days for inpatient hospital acute and psychiatric are covered with no copay, while non-Medicare covered stays and upgrades for inpatient hospital acute and psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $275, while Observation Services have a $275 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a $35 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Anthem Veteran (HMO-POS) plan, with a $40 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, each with a $275 copay, and transportation services to plan-approved health-related locations with no copay for up to 60 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered under the Anthem Veteran (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services has a $45 copay, and Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $110 copay.
Primary Care See details
The Anthem Veteran (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $15 copay, and occupational therapy services have a $35 copay. Physician specialist services have a $35 copay, and individual and group mental health and psychiatric sessions have a $35 copay. Podiatry services have a copay between $0 and $35, other health care professional services have a copay between $0 and $20, and physical therapy and speech-language pathology services have a $35 copay. Additional telehealth benefits have no copay, and opioid treatment program services have a $35 copay.
Preventive Services See details
Preventive services include Medicare-covered services and an annual physical exam with no copay, as well as additional preventive services, kidney disease education, and other preventive services with no copay for some services. Health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, 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, and telemonitoring services are not covered.
Hearing Services See details
The Anthem Veteran (HMO-POS) plan covers hearing exams with a $35 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $1,000 per year with no copay for all types, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are covered with no copay up to $300 per year.
Vision Services See details
The Anthem Veteran (HMO-POS) plan covers vision services, including eye exams with a copay of $0-$35, and eyewear such as contact lenses, eyeglasses, and eyeglass lenses with no copay, and eyeglass frames and upgrades with no copay, up to a combined maximum of $250 per year. Routine eye exams are covered with no copay.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Other services like restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are covered with no copay, and there is a $2,000 maximum plan benefit coverage per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Anthem Veteran (HMO-POS) plan. Medicare Part B Insulin Drugs have a $35 copay, while 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 Veteran (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetics/Medical Supplies with no copay and 20% coinsurance, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. 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 and tests with a copay between $0 and $175, and lab services with no copay. Diagnostic radiological services have a copay between $50 and $275, while therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-ray services have a $50 copay.
Home Health Services See details
Home Health Services are covered by the Anthem Veteran (HMO-POS) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Veteran (HMO-POS) plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Veteran (HMO-POS) plan. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Anthem Veteran (HMO-POS) plan covers Over-the-Counter (OTC) Items with no copay and a maximum benefit of $75.00 every three months, and Meal Benefits with no copay. Acupuncture and several other services are not covered by this plan.
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