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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 Kentucky. 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 a $50.00 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 $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) prescription drug plan features a low $50 annual deductible and offers significant savings on generic medications. You will pay no copay for Tier 1 preferred generics and Tier 2 generics when using a preferred pharmacy or standard mail order. Additionally, Tier 6 select care drugs are available with no copay across all standard and preferred pharmacy options. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brands require a 25% coinsurance, Tier 4 non-preferred drugs require a 30% coinsurance, and Tier 5 specialty drugs carry a 32% coinsurance for a one-month supply. These coinsurance rates apply consistently whether you fill your prescriptions at a preferred pharmacy, a standard pharmacy, or through standard mail order.
Additional Benefits
The Anthem Kidney Care (HMO-POS C-SNP) plan offers comprehensive medical coverage with a strong focus on affordable routine care, featuring no copays for primary care visits, telehealth, dialysis services, and preventive care. For emergency and urgent care, members can expect predictable copays of $130 and $50, respectively, with no coinsurance. Inpatient hospital stays require a $325 daily copay for the first five days, after which there is no copay. This plan also includes valuable supplemental benefits designed to lower out-of-pocket costs, such as dental and hearing coverage with no copays up to a $2,000 annual limit each, alongside a $300 annual eyewear allowance. Additionally, members benefit from no copays on unlimited health-related transportation, home health services, and select over-the-counter items. Diagnostic lab work and cardiac rehabilitation are also covered with no copays, helping you manage your health budget efficiently.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Anthem Kidney Care (HMO-POS C-SNP) with no coinsurance and a $325 daily copay for days 1 through 5, followed by no copay for days 6 and beyond for both acute and psychiatric stays. Prior authorization is required, and upgrades as well as 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 $0 to $325 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical and outpatient blood services are available with no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Anthem Kidney Care (HMO-POS C-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Anthem Kidney Care (HMO-POS C-SNP), with ground and air ambulance services requiring a $245 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 transportation to any health-related location is not covered.
Emergency Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, while urgently needed services require a $50 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $130 copay and no coinsurance, up to a maximum benefit limit of $100,000.
Primary Care See details
Anthem Kidney Care (HMO-POS C-SNP) offers primary care physician and telehealth services with no copay and no coinsurance. Specialist visits, therapy services, mental health sessions, and podiatry are covered with copays ranging from $0 to $40 and no coinsurance, though routine and other chiropractic services are not covered in practice.
Preventive Services See details
Anthem Kidney Care (HMO-POS C-SNP) provides preventive services with no copays and no coinsurance, including annual physical exams, kidney disease education, and select screenings. Additional preventive benefits are partially covered, excluding health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, extra smoking cessation, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers hearing services, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Hearing aids are partially covered with no copay or coinsurance up to a $2,000 annual limit for prescription aids and $300 for OTC aids, 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 Kidney Care (HMO-POS C-SNP) with no deductible and no coinsurance. Eye exams have a $0 to $40 copay, which includes one routine exam per year with no copay, though other eye exam services are not covered. Eyewear is covered with no copay up to a $300 annual limit, but upgrades are not covered.
Dental Services See details
Anthem Kidney Care (HMO-POS C-SNP) offers partially covered dental services with no copay and no coinsurance up to a $2,000 annual maximum. While preventive care, restorative services, and oral surgery are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and a 0% to 20% 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, though coinsurance and prior authorization requirements vary. Durable medical equipment has a 0% to 20% coinsurance, prosthetic devices and medical supplies require a 20% coinsurance, and diabetic equipment and therapeutic shoes are covered with no coinsurance.
Diagnostic and Radiological Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay or coinsurance and diagnostic tests with a $0 to $175 copay and no coinsurance. Diagnostic radiological services and outpatient X-rays require a copay starting at $50, while therapeutic radiological services carry 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Anthem Kidney Care (HMO-POS C-SNP) covers cardiac rehabilitation services with no copay and no coinsurance, subject to prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Anthem Kidney Care (HMO-POS C-SNP) covers skilled nursing facility (SNF) care with no coinsurance and requires no prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem Kidney Care (HMO-POS C-SNP) partially covers other services, offering select 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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