A non-government entity
Anthem Kidney Care (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Kidney Care (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 Kidney Care (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Anthem Kidney Care (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 Select Counties in GA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Anthem Kidney Care (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 Kidney Care (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 Kidney Care (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 Kidney Care (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 $5900.00 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 Kidney Care (HMO-POS C-SNP) plan features a $0 drug deductible, allowing your prescription coverage to begin immediately. You will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs at preferred pharmacies, standard pharmacies, and standard mail order. Tier 2 generic medications also feature no copay at preferred pharmacies and standard mail order, while standard pharmacies require a $10 copay for a one-month supply. For Tier 3 preferred brand drugs, the plan features a 15% coinsurance at preferred pharmacies and standard mail order, which increases to a 20% coinsurance at standard pharmacies. Tier 4 non-preferred drugs carry a 30% coinsurance across all standard and preferred pharmacy options. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
Anthem Kidney Care (HMO-POS C-SNP) offers robust coverage with many services featuring no coinsurance and no copay, including primary care visits, preventive services, dialysis, and home health care. For specialized care, specialist visits and outpatient services generally carry low copayments ranging from $0 to $40, while inpatient hospital stays require a $325 daily copay for the first five days. Emergency care is accessible with a $130 copay, and urgent care costs $50, both with no coinsurance. The plan also includes valuable supplemental benefits such as dental, routine vision, and routine hearing services with no copays or coinsurance, subject to specific annual coverage limits. While durable medical equipment and prosthetics may require coinsurance up to 20%, diabetic supplies and over-the-counter items are covered with no copay. This comprehensive plan is designed to minimize out-of-pocket costs for essential kidney care and daily health needs.
Inpatient Hospital See details
Anthem Kidney Care (HMO-POS C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 5 and no copay for days 6 and beyond. Unlimited additional days are covered with no copay, though upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring a copay of $0 to $325 for outpatient hospital services, a $325 copay per stay for observation services, and a $40 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are also covered with no copay and no coinsurance.
Partial Hospitalization See details
Anthem Kidney Care (HMO-POS C-SNP) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Anthem Kidney Care (HMO-POS C-SNP), as transportation to any health-related location is not covered. Ground and air ambulance services require prior authorization and carry a $220 copay with no coinsurance, while unlimited one-way trips to plan-approved locations are provided with no copay and no coinsurance.
Emergency Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit with a $130 copay and no coinsurance.
Primary Care See details
Anthem Kidney Care (HMO-POS C-SNP) covers primary care physician visits and telehealth services with no copay and no coinsurance. Other covered services, including specialists, physical therapy, mental health, and podiatry, require copays ranging from $0 to $40 and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes training. Additional preventive benefits are partially covered with no copay or coinsurance for fitness, remote access, and home safety modifications. Sub-services not covered include health education, personal emergency response systems, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling.
Hearing Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers hearing services with no coinsurance, offering annual routine hearing exams and fitting evaluations with no copay, while Medicare-covered exams require a $40 copay. Prescription hearing aids are partially covered with no copay up to a $2,000 annual limit, excluding inner ear, outer ear, and over the ear models, and OTC hearing aids are covered with no copay up to a $300 annual limit.
Vision Services See details
Anthem Kidney Care (HMO-POS C-SNP) partially covers vision services, featuring no copay and no coinsurance for annual routine eye exams and eyewear up to a $275 yearly limit. Other eye exams require a copay of $0 to $40 and no coinsurance, while upgrades and other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Anthem Kidney Care (HMO-POS C-SNP) with no copay and no coinsurance for covered services, up to a $2,000 annual maximum. While preventive and comprehensive treatments like cleanings and fillings are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Anthem Kidney Care (HMO-POS C-SNP) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy and other drugs require 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 Kidney Care (HMO-POS C-SNP) with no copay and no coinsurance.
Medical Equipment See details
Anthem Kidney Care (HMO-POS C-SNP) covers medical equipment with no copays, featuring 0% to 20% coinsurance for durable medical equipment and 20% coinsurance for prosthetics and medical supplies. Diabetic equipment and supplies are covered with no copay and no coinsurance, though prior authorization and manufacturer limitations may apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Anthem Kidney Care (HMO-POS C-SNP) with prior authorization required. Lab services have no copay or coinsurance, diagnostic tests range from a $0 to $175 copay with no coinsurance, and radiological services require either a copay starting at $50 or a minimum 20% coinsurance.
Home Health Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Anthem Kidney Care (HMO-POS C-SNP) with no coinsurance and require prior authorization. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice, carrying copays ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Anthem Kidney Care (HMO-POS C-SNP) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. This benefit is partially covered as prior authorization is required and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Anthem Kidney Care (HMO-POS C-SNP), featuring Over-the-Counter (OTC) items and Medicare Community Resource Support with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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