Anthem MediBlue Plus HMO
Anthem MediBlue Plus HMO is a Medicare Advantage plan with prescription drug coverage (MAPD). This plan is offered by Anthem Blue Cross Blue Shield in 4 counties in the state of Connecticut. Clients can purchase in either Fairfield, Litchfield, New Haven as well as Windham counties. Given the plan is an HMO plan, participants must use in network providers. In fact, if you use out of network providers anthem will not cover your claims. An exception to this would be when getting urgent or emergency care which allows of of network services.
The plan has a monthly premium of $37 a month. This would be in addition to the part B premium of $121.80. This plan does not require a referral. Copays for a primary doctor are $15 and $40 for a specialist. The plan has an annual out of pocket max of $6,700 per year. Annual max indicates the most the insured would need to pay in medical claims for the year. It does not include prescription drug out of pocket costs. You can add dental coverage to this plan for an additional premium. They include Silver Sneakers in the $37 monthly premium and they pay a local gym membership monthly fee for members. Diabetic supplies are covered at 100% when using approved diabetic supply vendors.
A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap). MAPD plans offered medical and drug benefits combined with the insurance company as the primary insurance. With a Medicare Supplement, Original Medicare is primary. The insurance company would be the secondary insurance. As a result, a Medicare Supplement plan does not have a network. In fact, members may see any provider that participates with Original Medicare. This is not the case with an Advantage plan.