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Anthem Veteran (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Veteran (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Veteran (PPO) in 2026, please refer to our full plan details page.
Anthem Veteran (PPO) is a PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Indiana. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Anthem Veteran (PPO) 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 (PPO).
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 (PPO), 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 combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 (PPO).
Additional Benefits
The Anthem Veteran (PPO) plan offers robust coverage for core medical needs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $45 copay, while emergency room services carry a $115 copay with no coinsurance. Inpatient hospital stays require a daily copay for the first five days with no copays for subsequent days, and outpatient services generally feature no coinsurance. This Medicare Advantage plan also provides comprehensive additional benefits, including routine dental, vision, and hearing exams with no copay or coinsurance. Members benefit from a $2,000 annual allowance for dental care with a 25% coinsurance, a $2,000 allowance for prescription hearing aids, and a $200 allowance for eyewear. Additionally, the plan covers diabetic equipment and supplies with no copay and provides a quarterly $30 allowance for over-the-counter items.
Inpatient Hospital See details
Anthem Veteran (PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $445 for days 1 to 5 of an acute stay and $415 for days 1 to 5 of a psychiatric stay, with no copay for subsequent days. The benefit is partially covered, as upgrades and non-Medicare-covered stays are not covered, and prior authorization is required.
Outpatient Services See details
Anthem Veteran (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $445 (with a $445 copay per stay for observation services), and outpatient substance abuse sessions require a $45 copay.
Partial Hospitalization See details
Anthem Veteran (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Anthem Veteran (PPO) covers ground and air ambulance services with a $290.00 copay and no coinsurance, although prior authorization is required. Transportation services are not covered under this plan.
Emergency Services See details
Anthem Veteran (PPO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $25 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance, up to a maximum benefit limit of $100,000.
Primary Care See details
Anthem Veteran (PPO) offers primary care physician visits and telehealth services with no copay and no coinsurance, while specialist and mental health services require a $45 copay and no coinsurance. Physical and occupational therapy are covered with a $35 copay and no coinsurance, but chiropractic services are not covered in practice.
Preventive Services See details
Anthem Veteran (PPO) provides preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering memory fitness and remote access technologies with no copay, while services like health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Anthem Veteran (PPO) covers Medicare-covered hearing exams for a $45 copay and no coinsurance, while routine exams, fittings, and OTC hearing aids are covered with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $2,000 annual limit, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Anthem Veteran (PPO), featuring no coinsurance for all services and no copay for annual routine eye exams, though other exams may require a copay of up to $45. Covered eyewear like contacts and eyeglasses has no copay and no coinsurance up to a $200 annual limit, but upgrades and other eye exam services are not covered.
Dental Services See details
Dental services under the Anthem Veteran (PPO) are partially covered up to a $2,000 combined annual maximum for in- and out-of-network care. Diagnostic and preventive services are available with no copay and no coinsurance, while covered comprehensive dental procedures require no copay and a 25% coinsurance. Orthodontics, implant services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Anthem Veteran (PPO) covers Home Infusion bundled Services with no copay, requiring prior authorization and step therapy. Covered Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require 0% to 20% coinsurance.
Dialysis Services See details
Anthem Veteran (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Veteran (PPO) covers medical equipment with no copays, though coinsurance and prior authorization requirements may apply. Durable medical equipment has a 0% to 20% coinsurance, prosthetics and medical supplies carry a 20% coinsurance, and diabetic equipment and supplies are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Veteran (PPO) covers diagnostic and radiological services, featuring lab services with no copay or coinsurance and diagnostic tests with a copay of $0 to $100 and no coinsurance. Diagnostic radiological services require a minimum $50 copay, outpatient X-rays carry a $90 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Anthem Veteran (PPO) 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 under the Anthem Veteran (PPO) with no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Anthem Veteran (PPO) 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, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem Veteran (PPO) partially covers other services with no copay and no coinsurance, including Medicare Community Resource Support, chronic illness meal benefits, and up to $30 every three months for over-the-counter (OTC) items. Acupuncture is not covered under this benefit.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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