Anthem Blue Cross Emphasizes Better Health through New Medicare Advantage Plans in California, Provider Collaboration, Extra Benefits

Business Wire

WOODLAND HILLS, Calif.--(BUSINESS WIRE)-- As Medicare’s primary sales season gets under way, Anthem Blue Cross (Anthem) is emphasizing better health in California through provider collaboration agreements and new Medicare Advantage plans with extra benefits.

This includes provider collaboration plans in all Anthem Medicare Advantage Prescription Drug (MAPD) plan service areas, as well as expanding Dual-Eligible Special Needs Plans (DSNPs) for people eligible for both Medicare and Medi-Cal, and traditional HMOs for the general population. Anthem MAPD plans continue to offer significant benefits not available in Original Medicare, including $0 copays for preventive dental, vision and hearing benefits, $0 copays for online doctor’s visits and a free fitness program.

“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 Josh Martin, president of the company’s Medicare west region.

Following are some specifics on Anthem’s 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 Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, Ventura and Yolo counties. Plans are effective Jan. 1, 2016.

New and expansion plans. Anthem is launching a new $0 premium HMO product in San Bernardino and Riverside counties called Anthem MediBlue Select (HMO) featuring closer alliances with high-quality, local health care providers to coordinate care, as well as lower copays and out-of-pocket costs. This product, which already exists in Los Angeles and Orange counties, features $0 copays for primary care doctor visits, specialist visits and hospitalizations, plus transportation to doctor’s appointments.

Additionally, Anthem is expanding its $0 premium Dual-Eligible Special Needs Plan (DSNP) called Anthem MediBlue Dual Advantage (HMO SNP) to Sacramento County to serve those beneficiaries eligible for both Medicare and Medi-Cal. These plans coordinate the separate programs, while providing enhanced benefits. Like existing Anthem special needs plans in Fresno, Kern, San Francisco and Ventura counties, this plan is available for a $0 premium and includes dental, vision and hearing benefits, an allowance for eyewear and hearing aids, transportation to doctor’s appointments and a free fitness program, all at no extra cost to the member. 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.

A traditional HMO, called Anthem MediBlue Plus (HMO), is being launched in Sacramento, Yolo and San Diego counties, while an HMO plan (HMO) called Anthem MediBlue Coordination Plus (HMO), which emphasizes care coordination with attractive supplemental benefits, is being introduced in Los Angeles, Orange, Riverside, San Bernardino and San Diego counties. Although the Coordination Plus plan is open to all Medicare beneficiaries, it may be an especially good fit for people who qualify for both Medicare and Medi-Cal. In fact, the premium is $0 for those people who are eligible for both.

Provider collaboration. To improve member health and lower member costs, Anthem continues to implement provider collaboration agreements. More than 20 new agreements have been implemented across the state. As a result, all of Anthem’s California HMO members now have access to a provider collaboration agreement.

Online doctor’s visits. LiveHealth Online (LHO) telehealth is being added to all Anthem HMOs in California. 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 for 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 available for a $0 copay at preferred pharmacies, including some drugs that treat high blood pressure, high cholesterol and diabetes. All Anthem MAPD plans and several Anthem PDPs will offer certain generics in the coverage gap for a $0 copay. Anthem has more than 1,500 preferred pharmacies in California, including CVS, Ralphs, Target and Wal-Mart (Sam’s Club). Additionally, Anthem has added the following pharmacies to its preferred network: Beverly Glen Pharmacy, Brent Air Pharmacy, Brentwood Plaza Pharmacy, Golden Cove Pharmacy, Medi-Rx Pharmacy, Portola Pharmacy and Sunrise Pharmacy.

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, Anthem MediBlue Access (PPO) for PPOs, Anthem MediBlue Coordination Plus (HMO) for the new coordination plan and Anthem MediBlue Select (HMO) for select plans.

In addition to MAPD plans, Anthem offers Medicare Supplement plans and standalone PDP plans across all California 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. California residents are also eligible to receive a $180 discount under certain circumstances for the first year they are enrolled in an Anthem Blue Cross Medicare Supplement. Medicare Supplement plans 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,” Martin said.

For details about Anthem Medicare plans in your area, call (855) 866-3957 or visit Anthem’s Medicare online store at www.anthem.com/ca/shop. Anthem will be holding educational events and home visits throughout AEP. Anthem-affiliated agents will be available at some locations of CVS/pharmacy and Ralphs between Oct. 15 and Dec. 7. Days and hours vary.

Anthem Blue Cross is a PPO plan, an HMO plan, and a PDP with a Medicare contract. Enrollment in Anthem Blue Cross 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

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Additional information about Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company is available at www.anthem.com. Also follow us on Twitter at www.twitter.com/AskAnthem or on Facebook at www.facebook.com/AskAnthem.