Anthem Blue Cross and Blue Shield Emphasizes Better Health through Medicare Advantage Plans in Maine, Provider Collaboration, Extra Benefits

Business Wire

SOUTH PORTLAND, Maine--(BUSINESS WIRE)-- As Medicare’s primary sales season gets under way, Anthem Blue Cross and Blue Shield (Anthem) is emphasizing better health in Maine through provider collaboration agreements and Medicare Advantage plans with extra benefits.

This includes provider collaboration plans in some areas as well as expanding Dual-Eligible Special Needs Plans (DSNPs) for people eligible for both Medicare and Medicaid. Anthem Medicare Advantage Prescription Drug plans (MAPD) continue to offer significant benefits not available in Original Medicare, including dental and vision coverage and online doctor’s visits.

“Even with the Medicare reimbursement environment changing, we think it’s critical to structure our plans to provide our members with real value over Original Medicare, including extra benefits and strong local alliances,” said John Caby, president of Anthem’s Medicare east region.

Following are some specifics on Anthem MAPD plans that will be available for the Annual Election Period, or AEP, which begins Oct. 15 and continues through Dec. 7. Anthem offers MAPD plans in all but one Maine county (Aroostook). Plans are effective Jan. 1, 2016.

Expansion plans. Anthem is expanding its $0 premium MAPD Dual-Eligible Special Needs plan called Anthem MediBlue Dual Advantage (HMO SNP) and a traditional $0 premium HMO plan called Anthem MediBlue Plus (HMO) to Knox County for 2016. Like existing Anthem special needs plans in the state, the DSNP includes dental and vision coverage, some transportation to doctor’s appointments, some over-the-counter drug costs and a fitness program, all at no extra cost. Unlike most plans, people who qualify for a DSNP have a continuous Special Election Period, which means they can elect to join a new plan at any time throughout the year.

Provider collaboration. To improve member health and lower member costs, Anthem continues to implement provider collaboration agreements.

Online doctor’s visits. LiveHealth Online (LHO) telehealth will continue to be available in Anthem’s Maine MAPD plans. LHO allows members to access board-certified doctors through their computer or mobile device, and will include a behavioral health benefit effective Jan. 1, 2016. With this additional benefit, members can generally choose a qualified mental health expert and schedule a counseling session in advance to be held during available hours. (Those in crisis should call 911). Both seeing a doctor and counseling visits are available at a $0 copay to eligible members.

More $0 generics. Anthem is enhancing its Medicare pharmacy benefits in 2016. Both Prescription Drug Plans (PDP) and MAPD plans will feature a “Select Tier” with selected generic drugs for a $0 copay at preferred pharmacies, including some drugs that treat high blood pressure, high cholesterol and diabetes. Anthem also has several PDP plans that offer certain generics in the coverage gap for a $0 copay. Anthem has more than 100 preferred pharmacies in Maine, including CVS/pharmacy, Hannaford, Target and Wal-Mart (Sam’s Club).

New Plan Names. As part of its initiative of being easier to do business with, Anthem has introduced a standard nomenclature nationwide to its individual MAPD plans. This includes Anthem MediBlue Dual Advantage (HMO SNP) for DSNPs, Anthem MediBlue Plus (HMO) for HMOs, and Anthem MediBlue Access (PPO) for PPOs.

In addition to MAPD plans, Anthem offers Medicare Supplement plans and standalone PDP plans across all Maine counties. Medicare Supplement plans help cover costs Original Medicare doesn’t, such as copayments, coinsurance and deductibles. These plans offer access to any doctor or medical facility that accepts Medicare, generally for a higher premium than an MAPD. They are generally paired with a PDP.

“We pride ourselves in being one of the nation’s only insurers that can offer a full continuum of Medicare products, including something for every budget and lifestyle,” Caby said.

For details about Anthem Medicare plans in your area, call (855) 866-4320 or visit Anthem’s Medicare online store at www.anthem.com/shop. Anthem will be holding educational events and home visits throughout AEP.

Anthem is a PPO plan, an HMO plan and a PDP with a Medicare contract. Enrollment in Anthem depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on Jan. 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

You must continue to pay your Medicare Part B premium.

This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

About Anthem Blue Cross and Blue Shield

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine, Inc., and an independent licensee of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Maine is available at www.anthem.com. Also follow us on Twitter at www.twitter.com/AskAnthem or on Facebook at www.facebook.com/AskAnthem.