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 2026, 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 2026.
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 $9250.00 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) Medicare plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copays for primary care visits, telehealth, and home health services. Inpatient hospital stays require a $400 daily copay for the first five days with no copay thereafter, while specialist visits and urgent care carry a $35 and $40 copay, respectively. Emergency care is covered with a $115 copay, and skilled nursing facility stays feature no copay for the first 20 days. This plan also includes valuable supplemental benefits with no deductibles, including preventive dental, routine vision, and routine hearing services with no copays. Members benefit from a $1,600 annual dental limit, up to $200 yearly for eyewear, and up to 60 one-way transportation trips to approved locations with no copay. Additionally, the plan provides a $75 quarterly over-the-counter item allowance and zero-cost fitness benefits to support daily wellness.
Inpatient Hospital See details
Anthem Veteran (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $400 daily copay for days 1 through 5 and no copay for days 6 and beyond. This benefit is partially covered as prior authorization is required, and upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Veteran (HMO-POS) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require no copay to a $400 copay (with a $400 copay for observation services) and no coinsurance, while outpatient substance abuse sessions carry a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Anthem Veteran (HMO-POS) with a $40.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Anthem Veteran (HMO-POS) covers ambulance services with a $275 copay and no coinsurance per ground or air trip, which requires prior authorization. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Anthem Veteran (HMO-POS) covers emergency services with a $115 copay and urgently needed services with a $40 copay, with no coinsurance required for either service. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit with a $115 copay and no coinsurance.
Primary Care See details
Anthem Veteran (HMO-POS) provides primary care physician and telehealth services with no copay and no coinsurance, while specialist, physical therapy, and mental health visits require a $35 copay and no coinsurance. Other services like podiatry range from a $0 to $35 copay with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Anthem Veteran (HMO-POS) features partially covered preventive services with no copays and no coinsurance for covered care, including annual physicals, kidney disease education, and glaucoma screenings. While fitness benefits, remote access technologies, and home safety devices (up to $500 annually) are covered at no cost, several supplemental services such as health education, personal emergency response systems, and in-home support are not covered.
Hearing Services See details
Anthem Veteran (HMO-POS) hearing services feature no copay and no coinsurance for routine exams, fitting evaluations, and OTC hearing aids up to $300 annually, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are partially covered up to $1,000 annually with no copay and no coinsurance, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Anthem Veteran (HMO-POS) provides partially covered vision services with no deductibles and no coinsurance, including one annual routine eye exam and eyewear like contacts and glasses with no copay up to a $200 yearly limit. Eye exams have a copay of $0 to $35, while other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Anthem Veteran (HMO-POS) dental services are partially covered up to a $1,600 annual limit, offering preventive care with no copay and no coinsurance. Comprehensive dental treatments are covered with no copay and a 25% coinsurance, though prior authorization is required, and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Veteran (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Anthem Veteran (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Veteran (HMO-POS) covers medical equipment with no copay and 0% to 20% coinsurance for durable medical equipment, and no copay with 20% coinsurance for prosthetic devices and medical supplies. Diabetic equipment, supplies, and therapeutic shoes or inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Veteran (HMO-POS) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a copay of $0 to $175. Covered radiological services require prior authorization and include a $50 copay plus coinsurance for outpatient X-rays, a minimum $50 copay for diagnostic radiological services, and a minimum 20% coinsurance plus a copay for therapeutic radiological services.
Home Health Services See details
The Anthem Veteran (HMO-POS) plan covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Anthem Veteran (HMO-POS) plan, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all listed as not covered.
Skilled Nursing Facility (SNF) See details
Anthem Veteran (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Anthem Veteran (HMO-POS) provides select other services with no copay and no coinsurance, including a quarterly $75 over-the-counter item allowance, chronic illness meal benefits, and community resource support. Acupuncture and other additional services are not covered.
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