08/12/2023

Secure Epic

Health Secure Epic

Review of the New Anthem Medicare PPO

Review of the New Anthem Medicare PPO

Anthem Blue Cross released a new plan in California called Anthem Medicare Preferred Standard PPO. This plan is a revamp of the old Freedom Blue that thousands of Medicare beneficiaries were enrolled in. On September 16, Agents and Brokers were notified to cease and desist the marketing of that product until further notice. About 2 weeks later, we received notice of the Anthem Medicare Preferred or AMP plan.

The biggest difference is that is now a Local PPO as opposed to a Regional PPO, which means many people were cut off. The plan used to cover the entire state of California and now only a handful of counties will be able to have access to Medicare Advantage PPO network. In addition. only 3 of the counties will continue to receive the “Zero Cost” option; Los Angeles, San Diego and Ventura. All other counties will now have a monthly premium for this plan ranging from $40-131/mo. For some this is no problem but for many Medicare beneficiaries who are dependent upon Social Security or on a fixed income, this raises huge issues.

Other Medicare beneficiaries were not so lucky if they live in rural parts of California. Many of the central counties in the state have very little to no options for any Medicare Advantage plans. This means they will have to either go back to Original Medicare and just carry a Part D (prescription plan) or pay higher premiums for a Medicare Supplement plan.

As for the Anthem Medicare Preferred plan, it is expected to perform well in the available counties but has no official rating from CMS (Center for Medicare Services) just yet. It continues to offer the Anthem PPO network of Doctors and Hospitals, one of the largest in the state. The plan has a $300 deductible which applies towards Outpatient type services and does apply towards the Maximum out-of-pocket expenses. The $3,400 maximum out of-pocket-expense is the most you will have to spend in the calendar year, including co-pays and deductibles, which is one of the lowest amounts compared to most other Medicare Advantage plans.

Anthem Medicare Preferred has an included Part D plan with reasonable co-pays for a 30 day supply and even lower for 90 day mail-order. In addition, you will have access to Silver Sneakers, which allows a monthly gym or fitness center membership for free at participating locations. There is also optional Dental and Vision benefits for an additional premium of course.

So for those of you seeking a low cost flexible plan that will allow you to keep your physicians and not have to worry about asking for referrals, the Anthem Medicare Advantage Standard PPO plan is a great value. Make sure you get more information on specific co-pays for your county as they do differ from one county to the next. Also be sure to complete the correct application as those are also different and you need to use the appropriate one per your county.