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Anthem Veteran (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Veteran (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Veteran (Regional PPO) in 2025, please refer to our full plan details page.
Anthem Veteran (Regional PPO) is a Regional PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Ohio. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Anthem Veteran (Regional 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 (Regional 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 (Regional 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.
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.
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 $4900.00 (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 $4900.00 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 (Regional PPO).
Additional Benefits
The Anthem Veteran (Regional PPO) plan offers a range of benefits with varying cost-sharing. Hospital stays have a copay for the first few days, and outpatient services often have copays, such as for specialist visits and mental health. Preventive services, including an annual physical, and many diagnostic services are available with no copay. The plan also provides coverage for hearing, vision, and dental services, often with no copay. Additionally, it covers home health services and skilled nursing facilities with no copay for a limited time. However, certain services like cardiac rehabilitation and some transportation options are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the Anthem Veteran (Regional PPO) plan. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $255 copay for days 1-8, and no copay for days 9-90; additionally, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $255, observation services with a $255 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a copay of $35 for both individual and group sessions. Outpatient blood services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Veteran (Regional PPO) plan, with a $40 copay. Prior authorization is required for coverage.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Veteran (Regional PPO) plan. Ground and Air Ambulance Services have a copay of $275, with no coinsurance, while 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 Veteran (Regional PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services have a $25 copay; there is no coinsurance for any of these services.
Primary Care See details
The Anthem Veteran (Regional PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a $35 copay. The plan also covers physician specialist services with a $35 copay, mental health specialty services with a $35 copay for individual and group sessions, and podiatry services with a copay that ranges from $0 to $35. Other health care professional services have a copay that ranges from $0 to $20, and psychiatric services have a $35 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $35 copay, additional telehealth benefits have no copay, and opioid treatment program services have a $35 copay.
Preventive Services See details
The Anthem Veteran (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Additionally, it covers Personal Emergency Response Systems, Remote Access Technologies, and Fitness Benefits with no copay. Other preventive services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
The Anthem Veteran (Regional PPO) plan covers hearing exams with a $35 copay, routine hearing exams and fitting/evaluation for hearing aids with no copay, and OTC hearing aids with no copay. Prescription hearing aids (inner ear, outer ear, and over the ear) are not covered, but prescription hearing aids (all types) are covered with a maximum benefit of $3,000 per year.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay between $0 and $35, with a maximum plan benefit of $69 every year, and routine eye exams have no copay. Eyewear has no copay, and a combined maximum benefit of $275 every year, but upgrades are not covered.
Dental Services See details
The Anthem Veteran (Regional PPO) plan covers dental services with no copay, and a maximum benefit of $2,000 per year. Covered services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, and more, all with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Anthem Veteran (Regional PPO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0% to 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment benefits include Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, and radiological services, are covered by the Anthem Veteran (Regional PPO) plan. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay between $50 and $255, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a copay of $50.
Home Health Services See details
Home Health Services are covered by the Anthem Veteran (Regional PPO) plan with no copay and no coinsurance, though 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 (Regional PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Veteran (Regional PPO) plan. There is no copay for days 1-20, and a $214 copay for days 21-100, however, additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Anthem Veteran (Regional PPO) plan covers over-the-counter (OTC) items with no copay, up to a maximum of $70 every three months. However, acupuncture, meal benefits, 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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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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