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 CT. 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. Additionally, this plan comes with a Part B Premium reduction of $80.00. You must continue to pay paying your reduced 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 $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
Prescription drugs are not covered by Anthem Veteran (HMO-POS).
Additional Benefits
The Anthem Veteran (HMO-POS) plan offers comprehensive medical coverage with predictable cost-sharing, featuring no copay or coinsurance for primary care visits and routine preventive services. For specialized care, members pay a $40 copay for specialist visits, while inpatient hospital stays require a $350 daily copay for the first five days and no copay thereafter. Emergency care is covered with a $130 copay, and urgent care has a $50 copay, with no coinsurance required for either service. This plan also includes valuable supplemental benefits, such as dental coverage with no copay for preventive services and a 25% coinsurance for comprehensive care up to $2,000 annually. Additionally, members benefit from no copays for routine vision and hearing exams, which include annual allowances of $200 for eyewear and up to $1,000 for prescription hearing aids. Unlimited transportation to approved medical appointments with no copay and no-copay home health services further enhance the plan's overall value.
Inpatient Hospital See details
Anthem Veteran (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 5 and no copay for days 6 and beyond. This benefit is partially covered because upgrades and non-Medicare-covered stays are not covered, and prior authorization is required.
Outpatient Services See details
Anthem Veteran (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require prior authorization and have a copay ranging from $0 to $350 (including a $350 copay per stay for observation services), while outpatient substance abuse individual and group sessions carry a $40 copay.
Partial Hospitalization See details
Anthem Veteran (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Anthem Veteran (HMO-POS) covers ground and air ambulance services with a $325 copay and no coinsurance. Transportation services are partially covered, offering unlimited one-way rides to plan-approved health-related locations with no copay and no coinsurance, while trips to non-approved health locations are not covered.
Emergency Services See details
Anthem Veteran (HMO-POS) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency, urgent care, and emergency transportation are also covered up to a $100,000 maximum benefit with a $130 copay and no coinsurance per service.
Primary Care See details
Anthem Veteran (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits, mental health, and physical therapy require a $40 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services under Anthem Veteran (HMO-POS) are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and select screenings. However, additional preventive benefits are only partially covered, as services such as health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, home modifications, and counseling are not covered.
Hearing Services See details
Anthem Veteran (HMO-POS) hearing services include Medicare-covered exams for a $40 copay and no coinsurance, plus annual routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 annually and OTC hearing aids up to $300 annually with no copays and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Anthem Veteran (HMO-POS) with no deductibles, no coinsurance, and no copays for covered services. This includes one annual routine eye exam and up to $200 yearly for eyewear like contacts and eyeglasses, while other eye exam services and upgrades are not covered.
Dental Services See details
Anthem Veteran (HMO-POS) dental services are partially covered up to a $2,000 yearly maximum, with no copay and no coinsurance for preventive care, and no copay and 25% coinsurance for covered comprehensive services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Anthem Veteran (HMO-POS) with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin requires 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 durable medical equipment (DME) with no copay and a coinsurance ranging from 0% to 20%. Prosthetics and medical supplies are covered with no copay and a 20% coinsurance, while diabetic equipment, supplies, and therapeutic shoes feature no copays and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Veteran (HMO-POS) covers diagnostic and radiological services with prior authorization required, offering no coinsurance for diagnostic services and no copay for lab services or outpatient X-rays. Other diagnostic procedures carry a copay between $0 and $90, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Anthem Veteran (HMO-POS) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Anthem Veteran (HMO-POS) with no coinsurance, but prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copays ranging from $15 to $30.
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 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) partially covers other services, offering acupuncture for a $15 copay and no coinsurance, as well as over-the-counter items, chronic illness meals, and Medicare community resource support with no copay and no coinsurance. Other miscellaneous services under this benefit are not covered.
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