A non-government entity
Anthem Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Select (HMO-POS) in 2025, please refer to our full plan details page.
Anthem Select (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in Connecticut. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Anthem Select (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem Select (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 Select (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.
This plan has a $275.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7300.00 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 Select (HMO-POS) plan has a $275 deductible for prescription drugs. After meeting your deductible, you'll pay a copay or coinsurance for your medications depending on the drug tier and pharmacy used. For preferred generics, you'll pay a $4 copay at preferred pharmacies and a $9 copay at standard pharmacies. Standard mail orders have no copay for preferred generics. For specialty tier drugs, there is no copay at any pharmacy.
Additional Benefits
The Anthem Select (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $400 copay for days 1-5, and then no copay. Outpatient services have a mix of copays and coinsurance, with some services like primary care and preventive services having a $5 copay or no copay. The plan also covers a variety of other services including hearing, vision, and dental, with some services such as hearing exams and eye exams having copays. Other services such as home health and durable medical equipment are covered with no copay. There are some services that are not covered, such as cardiac rehabilitation services.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a $400 copay for days 1-5 and no copay for days 6-90. Additional days for inpatient hospital are covered with no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services for the Anthem Select (HMO-POS) plan include coverage for Outpatient Hospital Services with a 30% coinsurance and no copay, Observation Services with a 30% coinsurance, and Ambulatory Surgical Center (ASC) Services with a 15% coinsurance and no copay. The plan also covers Individual and Group Sessions for Outpatient Substance Abuse, each with a $40 copay, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Select (HMO-POS) plan. This benefit has a $40 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Anthem Select (HMO-POS). Ground ambulance services have a $290 copay, while air ambulance services have a 20% coinsurance. 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 by the Anthem Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services has a $45 copay.
Primary Care See details
The Anthem Select (HMO-POS) plan covers primary care physician services with a $5 copay and chiropractic services with a $15 copay, but routine chiropractic care is not covered. Occupational therapy services have a $35 copay, and physician specialist services have a $45 copay. Mental health specialty services, psychiatric services, and opioid treatment program services have a $40 copay for individual and group sessions, while physical therapy and speech-language pathology services have a $40 copay. Additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services, including Medicare-covered preventive services, are covered by the Anthem Select (HMO-POS) plan. The plan offers an annual physical exam with no copay, and covers additional preventive services, including Medicare-covered Glaucoma Screening, Medicare-covered Diabetes Self-Management Training, Medicare-covered Barium Enemas, Medicare-covered Digital Rectal Exams, and Medicare-covered EKG following Welcome Visit, all with no copay. Some services, such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others, are not covered.
Hearing Services See details
Hearing exams require a $45 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered up to a maximum of $2000 per year, with no copay for all types of hearing aids except for prescription hearing aids - inner ear, outer ear, and over the ear which are not covered. OTC hearing aids have no copay and are covered up to $300 per year.
Vision Services See details
The Anthem Select (HMO-POS) plan covers vision services, including eye exams with a copay between $0 and $45, and eyewear with a combined maximum benefit of $175 per year. Routine eye exams, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses have no copay, while upgrades are not covered.
Dental Services See details
Dental services include Medicare dental services with no copay, oral exams and prophylaxis (cleaning) with no copay, and dental x-rays and fluoride treatment as optional supplemental benefits. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 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 Select (HMO-POS) plan, with a coinsurance between 20% and 20%.
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. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Anthem Select (HMO-POS). Diagnostic Procedures/Tests have a copay between $0 and $70, and Lab Services have no copay. Diagnostic Radiological Services have a copay between $25 and $100, while Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the Anthem Select (HMO-POS) 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 not covered by the Anthem Select (HMO-POS) plan. 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.
Skilled Nursing Facility (SNF) See details
The Anthem Select (HMO-POS) plan covers Skilled Nursing Facility (SNF) services, but requires prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items with no copay, up to a maximum of $60 every three months, and Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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