Anthem Mediblue Preferred (HMO)

Anthem MediBlue Preferred (HMO) received an overall four-star rating — out of a possible five stars — from the U.S. Centers for Medicare & Medicaid Services in 2022.

CMS rates Medicare Advantage plans based on several factors for both the plans health coverage and prescription drug coverage. One star represents poor performance while five stars represents excellent performance.

Star ratings are just one of the ways you should compare Medicare Advantage plans when reviewing your coverage.

The Anthem MediBlue Preferred (HMO) health plan received 4½ stars out of a possible five.

Beneficiaries rated the health plan based on 33 different criteria. It received its highest marks — five stars — for 14 of the criteria used.

The plan did not receive any one-star ratings. It received its lowest ratings — two stars — in five criteria.

The Anthem MediBlue Preferred (HMO) prescription drug plan received 4 stars out of a possible five.

The drug plan rating is based on 16 criteria.

The Anthem MediBlue Preferred (HMO) prescription drug plan received five-star ratings on six criteria.

There were no one-star ratings for any criteria used in rating the drug plan. Its lowest ratings — two stars — consisted of just two items: accuracy in drug pricing information for Medicare’s Plan Finder website and members’ rating of the drug plan.

Anthem MediBlue Preferred (HMO) is a no-premium Medicare Advantage plan. That means you pay no monthly premium for it. However, you are still responsible for the monthly Medicare Part B premium — $164.90 in 2023.

Medicare Advantage plans are not available in all counties in the United States. You should check with your plan administrator to determine if the Anthem MediBlue Preferred (HMO) plan is available where you live.

As a Medicare Advantage plan, it is required to cover everything Original Medicare — Medicare Part A and Part B — but it may also include other benefits. Anthem MediBlue Preferred (HMO) also includes a Medicare Part D prescription drug plan.

Anthem MediBlue Preferred (HMO) has a network of hospitals, doctors, durable medical equipment suppliers and other health care providers who accept its coverage. Using providers in this network means lower out-of-pocket costs for plan members.

Going to a provider out-of-network may require you to pay significantly more for the provider’s services. Check with your plan’s administrator to understand exactly what your costs will be.

While Original Medicare does not cover routine dental, vision and hearing services, the Anthem MediBlue Preferred (HMO) does cover some of these services.

The Anthem MediBlue Preferred (HMO) plan includes a Medicare Part D prescription drug plan. You have to use in-network pharmacies to get the full coverage and lowest costs. Using an out-of-network pharmacy may result in higher out-of-pocket costs for you.

You should also check the plans formulary — or list of covered drugs — to see if prescription medications you take are covered by the plan.

In addition, this plan covers certain over-the-counter (non-prescription) drugs. There is a limit of $65 every three months — but unused benefits do not roll over into the next quarter or the next calendar year.

After you pay your deductible for the year, you have a prescription benefit up to $4,430 per year. You then move into gap coverage — until your total out-of-pocket costs reach $6,350. During this gap, you will pay 25% for generic and brand name drugs.

Once you hit the $6,350 threshold, catastrophic coverage kicks in. At this point, you will pay $3.95 or 5% — whichever is greater — for generics. You will also pay $9.85 or 5% — whichever is greater — for brand name drugs.