Anthem Medicare Preferred PPO 2015

Open Enrollment for Medicare Advantage & Part D plans is October 15 through December 7 for a January 1 2015 effective date.  This is a great time to find the best 2015 Medicare Advantage plan for yourself and family.  Call me if you need a little help finding the right plan.

2015 Anthem Medicare Advantage Plans for all the Anthem States are a complete medical plan which also includes the Medicare Part D Rx plan at no additional cost.  The new Anthem Medicare Preferred PPO plan is available in certain counties (Scroll down this page to view the new plan benefits and the States and counties where it is available.

California    Missouri    Nevada    Ohio

The Anthem Medicare Preferred PPO plan is a Medicare Advantage Preferred Provider Organization (PPO) plan, which offers flexibility to see any physician, specialist or hospital, and provides comprehensive medical coverage, along with the Anthem Medicare Part D prescription Rx plan at no additional cost for Medicare beneficiaries.

Enroll Today …

  • Complete the enrollment form for your State and County (I will forward the appropriate forms).  When finished either fax, email or mail the forms back to me for processing.
  • If you are in a County which does not offer the Medicare Preferred PPO plan, please call me and I’ll be able to see what companies and plans are available in your area.

The Anthem Medicare Preferred Standard PPO plan which includes the Anthem Medicare Part D Rx plan.  You will have to satisfy co-payments and deductibles as part of your plan benefits when you see a physician or hospital.

Open Enrollment … October 15 through December 7 … The 2014 “Open-Enrollment” period October 15th through December 7th 2013.  If you would like to enroll in an Anthem plan during the next open enrollment, your new coverage will start January 1, 2014.  The enrollment process is very quick although it may take a week or two for Anthem to send your new ID cards and policy in the mail.

When you use the Anthem Medicare Preferred plan, you will have out of pocket expenses such as; copayments, and deductibles.  Throughout the year if you add up your “out of pocket” costs, the most you would have to pay is your “out of pocket maximum.”  Once you have paid this amount, Anthem Blue Cross will pick up the balance of your medical charges for the rest of the year, whether you see an “In-network” or “Out-of network” provider.  So don’t worry if your favorite physician is not part of the Anthem Blue Cross provider network.  Your out of pocket maximum will be the same as an in-network doctor.

Dental & Vision Optional Packages:

Option 1 – Preventive Dental Package  ($12 / month)

  • 2 oral exams per year ($0 copay) which include cleanings every six months, and up to 1 dental X-ray per year.
  • $0 co-pay for preventive dental benefits.
  • $500 plan benefit limit per year.

Option 2 – Comprehensive Dental & Vision Package  ($31 / month)

  • 2 oral exams per year which include cleanings every six months, and one set of X-rays per year.
  • $0 co-pay for preventive dental benefits.
  • 20% of the cost for covered restorative dental services (amalgam restoration).
  • 50% of the cost for covered endodontic, periodontic and oral surgery dental services.
  • $1,000 plan benefit coverage limit for dental benefits per year.
  • Vision:
  • $0 co-pay for 1 routine eye exam every year.
  • $0 co-pay for one pair of glasses every year.
  • $0 co-pay for contact lenses every year.

Option 3 – Combination Package  ($36 / month)

  • Dental (Preventive & Comprehensive)  Vision (Eye Exams & Eye wear)  Chiropractic Services  &  Acupuncture.
  • Comprehensive Dental package – same as above.
  • Vision package – same as above.
  • Acupuncture Services:
  • Benefit amount of $60 per chiropractic visit.
  • Up to 10 routine acupuncture visits each year.
  • $20 co-pay per visit.
  • Chiropractic Services:
  • Benefit amount of $60 per chiropractic visit.
  • Up to 10 routine chiropractic visits each year.
  • $20 co-pay per visit.

Is your Medicare Advantage plan Changing Benefits? … Some insurance companies have decided to cancel or drastically change certain Medicare Advantage plans for the 2013 year.  This means that many Medicare beneficiaries that are currently enrolled will need to change their plan by enrolling in a new Medicare Advantage or Medicare Supplement plan during the open enrollment period.  You may enroll in another plan with that same company or choose a plan from one of the other companies in your area.  If your plan has been dropped, Medicare gives you additional time to select a Medicare Advantage like the Anthem Medicare Preferred PPO plan.  The “Annual Open Enrollment” period each year is from; October 15th through December 31st

Who is Eligible?  If you are currently on Medicare Parts A and B you can enroll in the Anthem Freedom Blue Plan during the Annual Election Period (AEP) which is every year from November 15th through December 31st.  Or, if you are currently on Medicare A and new to Part B (within three months), or, if you are loosing your employer based health insurance and currently on Medicare A and B.

Enrolling is Easy …  Print the application and either fax, mail or email back to me.  I will make sure the application is processed quickly and accurately, with no delays.  I will also keep you updated through out the application process.

Traveling abroad for Vacation? – Vacation Insurance

Please feel free to call or email or leave a comment below.

John Conner

Questions & Comments:

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82 thoughts on “Anthem Medicare Preferred PPO 2015

  1. John Post author

    Hi Donna, here is the Humana-Walmart Medicare Part D Rx plan link, which you may want to review:

    Also, what is your zip code, I’m not sure which state your Anthem PPO is in. The Anthem PPO’s are only available with the Medicare Part D plan attached. If you are with a Medicare Supplement you will be able to mix-n-match Part D plans.

    Hope that helps. And feel free to contact me anytime with questions.

    Thanks … John

  2. donna babbitt

    Just found your site while meandering through the morasse of supplementary ins. information. I have two questions.

    1. I would like to change my part D from Anthem to something else to avoid the continuing late fee I must pay. I only have two monthly prescriptions and would like a plan that would be accepted by Target or Walmart.

    2. Is Anthem the only medicare supplementary with the PPO option? We are with Anthem so that we can select the Dr.s and the Hospital. I now handle all our ins. etc. and it is mind boggling. I appreciate your expertise.

    Thankyou, Donna M Babbitt

  3. PAtricia Berman

    How do I get a list of hospitals and doctors for Los Angeles area?

  4. john Post author

    Hi Tuan, the only time you can cancel a Medicare Supplement and enroll in a Medicare Advantage plan is during the Annual Open enrollment period, which is typically during November and December of each year, for a January 1 effective date. At this time you are past the open enrollment period. So, you have a couple options. First keep your Med Supp through this year (2012) and enroll in a Med Advantage plan for a January 1 effective date. Another option is to drop your Medicare Supplement (I don’t recommend this) and revert to Original Medicare only and keep your Medicare Part D Rx plan.

    If you have questions, please contact me anytime.

    Thanks .. John Conner

  5. tuan

    Dear John,

    I am under medicare part A and B also I am in Medigap. I was just wondering if I could cancel my Medigap to join the Anthem Medicare Preferred PPO plan? Could that cause any problems?

    Thank you,

  6. john Post author

    Hi Jessica, yes the Anthem Medicare PPO is the only Medicare PPO plan in Santa Clara county. Also, if she enrolls in the Anthem Medicare PPO plan she will have to stay with the Anthem Part D rx plan, she cannot enroll in a different Part D plan.

    Hope that helps. Feel free to call anytime with questions.

    Thanks .. John

  7. Jessica Berman

    Thank you for all the information. My mom lives in Santa Clara County in California, has Medicare Advantage and Anthem Blue Cross Freedom which is turning into Anthem Medicare Preferred Standard PPO. Is this the ONLY PPO offered to Advantage members in Santa Clara County?

    Also, it says online that this plan comes with Part D prescription Rx plan. Does she have to take Part D through Anthem or if not, should I research other Part D plans and see if there is one that covers more for her medications?


  8. john Post author

    Bill, email a few of the doctors names to me and I’ll look at the Anthem directory for you.

    Thanks … John

  9. Bill

    Hi John,
    I have called New Patient’s customer service and have been told that the doctors do not take Anthem Medicare Preferred PPO. They only take original medicare with supplement. So the hospital may take the PPO, but not the doctors. This whole process, of trying to change to Medicare PPO so that we could go to City of Hope, has been very frustrating!!
    Thanks for your help,

  10. john Post author

    Hi Bill, City of Hope Cancer center in Duarte is an “In-Network” facility for the 2012 Anthem Medicare Preferred PPO plan.

    Bill, if you have any questions, please let me know.

    Thanks .. John

  11. Bill

    I have tried to find out if City of Hope in Duarte,CA will take this new 2012 Anthem Medicare PPO as out-of-network provider, but have gotten different answers when I’ve called New Patient and Billing!! I really need to know this as this is where I want to go. Can you help? I seem to not get any definite answer. Thank you for your time and expertise.

  12. john Post author

    Hi Bill, the only PPO plan in San Bernardino County is the Anthem Medicare PPO. With a HMO/POS you can self refer to a specialist, although you must stay within the same medical group as you primary-care-physician.

    Here is the Anthem Doctor search link:

    If you would like the enrollment form or have questions please feel free to contact me anytime.

    Thanks .. John Conner

  13. john Post author

    Hi Anthony, there are several factors attributing to the differences in premium amount between the different counties. The size of the member pool is one, although one of the larger factors is the re-imbursement rate the doctors groups and hospital groups negotiate for. Medicare PPO plans pay a higher fee to the doctors and hospitals than Medicare, and in some areas the medical groups demand a higher fee schedule than other areas, thus the higher premium. Now this is only one factor, others are “claims frequencies” and “loss ratios” etc.

    I wish I had a better answer for you.

    Please feel free to contact me anytime with questions.

    Thanks .. John Conner

  14. Anthony

    John: What accounts for the vast differens in plan cost. The only possible reason I can think of is the size of the enrolled base?) 0$ in Los Angles and $131 in Sacramento, me. Thanks

  15. Bill

    I would like to change from my HMO to a Medicare Advantage PPO. I live in the San Bernardino area and was wondering what options I have. I have seen Anthem Medicare Preferred Standard PPO, but are there other PPOs in my area? I also have seen Humana Gold HMO/POS. How do the PPO and POS differ and is one easier to go out-of- network? What websites do I go to to see the providers in the San bernardino area in these two plans? Thank you for your time.

  16. john Post author

    Hi Marty, Anthem is introducing a new Medicare PPO plan in LA county, it is really the same plan as the Freedom Blue plan but with a new name.
    Here is the information:

    If you would like to enroll in the new plan, you will need the new enrollment form. Let me know and I can email it to you.

    Please call anytime.

    Thanks .. John Conner

  17. Marty

    I’ve been with Blue Cross since I was 20 years old. I’m now 68! When I became eligible for Medicare I switched over to Anthem Freedom Blue Plan 1 (Regional PPO). I live in Los Angeles. I was very happy with this plan and am sorry it is being phased out. All I use the plan for is a twice yearly physical and routine blood test and for a prescription of a generic that gets filled once a month for $7. I don’t want to move to another plan and I don’t want to pay premiums or enroll in a drug plan that costs money since I am very healthy and do not take prescribed drugs. At least not now! Help!!

  18. Dorothy Peterson

    I need the Anthem drug formulary for 2012. I am a member of Freedom Blue PPO 2011, Can you please e-mail me the new formualry.


  19. john Post author

    Hi Penny, I wish I had a good answer for you. PPO plans generally pay higher fees to doctors and hospitals than Original Medicare, and in some counties the Dr’s and Hospital groups demand much higher fee schedules. This is only one of the reasons for the premium hikes. I’m sure insurance company profitability is also part of their reasoning.

    Penny, please feel free to call if you have any questions.

    Thanks .. John Conner

  20. Penny Hunter

    Question: WHY the big change? We are seniors living in Santa Clara County.. essentially on social security … we cannot afford $131 per month per person. And WHY the big difference in California Counties?

  21. john Post author

    Hi Johanna, I just emailed the Anthem Formulary drug list to you.

    If you need more info, please let me know.

    Thanks … John

  22. Johanna

    I forgot to ask where I can find out the list of drugs covered…and the applicable copay for the Anthem 2012 program.


  23. john Post author

    Hi Doug, Anthem is introducing a new Medicare PPO plan in San Diego County ($0 / month).
    I’ll email the info to you.

    Please call if you have questions.

    John Conner … 800-700-1246

  24. Doug

    Hi John,
    My mother has Anthem Freedom Blue Plan 1(RegionalPPO)here in San Diego. Since Anthem/Blue Cross is ending her coverage as of 12-31-2011, I was wondering what other Medicare Advantage PPO programs are available in San Diego?



  25. john Post author

    Renate, I’ll send the Health Net info over. Re; the United Health, it’s an HMO, are you also looking into HMO’s?

    Thanks .. John

  26. Renate Hare

    Thanks John,
    I would appreciate the info concerning Health Net.
    Also, what do you know about Medicare Complete through UnitedHealthcare.

  27. john Post author

    Hi Renate, yes the folks in Sacramento county along with many other areas are certainly affected by this change.

    Health Net has a $0 premium Medicare PPO plan for Sacramento county. I you would like info please let me know. All the other Sacramento plans are HMO’s

    Thanks … John Conner

  28. Renate Hare

    Hi John,
    I’ve been a member of the Anthem Freedom Blue Plan 1(RegionalPPO) since 2007 here in Sacramento. It’s disappointing to find out that Anthem/Blue Cross is leaving that program and in turn ending my coverage as of !2.31.2011.
    I was satisfied with the coverage and especially liked the $0 monthly premium.
    The new Anthem Medicare Preferred PPO with the $131.00 monthly premium is not an option.
    What would you recommend?
    Thank you,

  29. john Post author

    The $15 Part D plan is through Humana. It is currently very popular. It does have the $320 annual drug deductible.

    Thanks .. John

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