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 CT. 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. Additionally, this plan comes with a Part B Premium reduction of $90.00. 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 a range of benefits with varying costs. Hospital stays have a copay, while outpatient services and primary care visits may have a copay depending on the service. Emergency and urgent care services have a copay, and ambulance services also have a copay. Preventive services, routine hearing exams, and many vision and dental services are covered with no copay. The plan also includes coverage for home health services, skilled nursing facilities, and medical equipment, with varying cost-sharing. Other benefits, such as acupuncture, over-the-counter items, and a meal benefit, are available with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $350 copay for days 1-5, and no copay for days 6-90; Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $350, observation services have a $350 copay, and ambulatory surgical center services, and outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $40.
Partial Hospitalization See details
Partial Hospitalization is covered by Anthem Veteran (HMO-POS) with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Anthem Veteran (HMO-POS). Ground and air ambulance services have a $290 copay, while transportation services to a plan-approved health-related location have no copay. Transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Anthem Veteran (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $125 copay, while Urgently Needed Services has a $55 copay; all of these services have no coinsurance.
Primary Care See details
The Anthem Veteran (HMO-POS) plan covers primary care physician services and chiropractic services with no copay, while occupational therapy services have a $40 copay. Physician specialist services, physical therapy and speech-language pathology services have a $40 copay, and mental health and psychiatric services have a $40 copay for individual and group sessions. Other health care professional services have a copay between $0 and $20, and Opioid Treatment Program Services have a $40 copay. Additional telehealth benefits are covered with no copay.
Preventive Services See details
Preventive Services are covered by Anthem Veteran (HMO-POS), including an annual physical exam with no copay, and additional services like Fitness Benefit, Personal Emergency Response System (PERS), Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Health Education, In-Home Safety Assessment, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, 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 $40 copay, routine hearing exams with no copay for one visit per year, and fitting/evaluation for hearing aids with no copay for one visit per year. Prescription hearing aids are covered with a plan-specified amount of $1,000 per year, and OTC hearing aids are covered with no copay, up to $300 per year. Prescription hearing aids are not covered for inner ear or outer ear types.
Vision Services See details
Under the Anthem Veteran (HMO-POS) plan, vision services include eye exams with a copay of $0-$40 and eyewear with no copay, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, with a combined maximum benefit of $200 per year. Upgrades are not covered.
Dental Services See details
Dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics, are covered with no copay. This plan has a $2,000 annual maximum for other dental services, and orthodontics are covered under diagnostic and preventative dental services.
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 are covered with 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 includes Durable Medical Equipment (DME) with a 0-20% coinsurance and requires prior authorization, as well as Prosthetics/Medical Supplies with no copay and a coinsurance for some services. Diabetic equipment is covered with no copay for diabetic supplies and diabetic therapeutic shoes/inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic Procedures/Tests have a copay between $0 and $90, while Lab Services and Outpatient X-Ray Services have no copay. Diagnostic Radiological Services have a copay up to $350, and Therapeutic Radiological Services have 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Anthem Veteran (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 Veteran (HMO-POS) plan. The plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Veteran (HMO-POS) plan, but require prior authorization. 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 acupuncture with a $40 copay, over-the-counter items with no copay, and a meal benefit with no copay. Other services are not covered.
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