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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 2026, 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 2026.
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 $7200.00 (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 $7200.00 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 robust medical coverage with no copay and no coinsurance for primary care visits, routine preventive services, and home health care. Specialist visits and urgent care require a low $35 and $25 copay respectively, while emergency room visits carry a $130 copay with no coinsurance. For hospital stays, inpatient care requires a $255 daily copay for the first eight days and no copay thereafter, while outpatient hospital services range from no copay up to a $255 copay. This plan features strong supplemental benefits, including no copay for routine dental, vision, and hearing exams, alongside a $1,750 annual dental limit and a $3,000 hearing aid allowance. Durable medical equipment and dialysis services are covered with no copay and a coinsurance of up to 20 percent. Additionally, members receive a $70 quarterly allowance for over-the-counter health items with no copay or coinsurance.
Inpatient Hospital See details
Anthem Veteran (Regional PPO) partially covers inpatient hospital and psychiatric services with no coinsurance, requiring a $255 daily copay for days 1 through 8 and no copay for days 9 and beyond. Prior authorization is required, and upgrades as well as non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Veteran (Regional PPO) covers outpatient services with no coinsurance, offering outpatient hospital and observation services with copays ranging from $0 to $255, and substance abuse sessions for a $35 copay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for most services.
Partial Hospitalization See details
Partial hospitalization is covered under the Anthem Veteran (Regional PPO) plan with a $40 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Anthem Veteran (Regional PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Anthem Veteran (Regional PPO) with a $130 copay and no coinsurance, and urgently needed services are covered with a $25 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum limit with a $130 copay and no coinsurance.
Primary Care See details
Anthem Veteran (Regional PPO) features primary care and telehealth services with no copay and no coinsurance, while specialist visits, mental health sessions, and physical therapies require a $35 copay and no coinsurance. Podiatry services have a $0 to $35 copay and no coinsurance, but chiropractic services are not covered because routine and other chiropractic sub-services are excluded.
Preventive Services See details
Anthem Veteran (Regional PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual physicals, kidney disease education, and fitness benefits. Sub-services that are not covered include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, home and bathroom safety modifications, and counseling services.
Hearing Services See details
Hearing services are covered by Anthem Veteran (Regional PPO) with no coinsurance, featuring a $35 copay for Medicare-covered exams and no copay for annual routine exams, fittings, and over-the-counter hearing aids. Prescription hearing aids are covered with no copay or coinsurance up to $3,000 annually, but are only partially covered as inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by Anthem Veteran (Regional PPO), featuring no copay or coinsurance for routine eye exams and eyewear. Routine exams are covered up to $69 annually (one visit per year) and eyewear has a combined yearly limit of $275, while upgrades and other eye exam services are not covered.
Dental Services See details
Dental Services are partially covered by the Anthem Veteran (Regional PPO) up to a $1,750 yearly maximum, featuring no copay and no coinsurance for preventive care, and no copay with a 25% coinsurance for covered comprehensive services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Veteran (Regional PPO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this plan, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Anthem Veteran (Regional PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Veteran (Regional PPO) covers durable medical equipment (DME) with no copay and 0% to 20% coinsurance, alongside prosthetics and medical supplies which require no copay and 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes or inserts are also covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Veteran (Regional PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with copays ranging from $0 to $150, while radiological services require copays starting at $50 for diagnostic imaging, a $90 copay for X-rays, and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home Health Services are covered by Anthem Veteran (Regional PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Anthem Veteran (Regional PPO) with no coinsurance, though some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered. Prior authorization is required, and these uncovered services require copays ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Anthem Veteran (Regional PPO) with no coinsurance and no prior 3-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, while days 21 through 100 require a $218 daily copay, and additional days beyond the 100-day limit are not covered.
Other Services See details
Anthem Veteran (Regional PPO) partially covers other services, featuring over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $70 every three months. Acupuncture, meal benefits, and dual eligible SNPs with highly integrated services are not covered under this benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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