Anthem health insurance guide

Anthem is a health insurance company based in the U.S., with a presence in 14 states. They offer many plan choices, including HMO, PPO, and Medicare Advantage options. Anthem plans are more competitively priced than some competitors, and members have access to extra benefits and unique member resources. There are currently more than 42 million Anthem members, with many more switching to the provider each year because of their competitive rates. However, Anthem has a mediocre customer service reputation, and they consistently have a high rate of claim denials.

Anthem Health Insurance Guide

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Anthem Health Insurance Plans

Anthem is one of the most popular health insurance companies because of its large network and extensive offerings. They have various plan options for individuals, families, businesses, and those with existing Medicare or Medicaid coverage. Anthem offers HMO and PPO plans, with the opportunity to add fitness, vision, or dental coverage. 

HMO Plans

Anthem MediBlue HMO is the provider’s Medicare Advantage option, which combines the benefits of Medicare Parts A and B into one policy. These plans offer extras including benefits for hearing aids and prescription medications. Members who enroll in an HMO plan choose a primary care provider who provides most of their care but can refer them to a specialist if needed. HMO plans are generally more affordable than PPO options. 

PPO Plans

Anthem’s suite of PPO options offers more flexibility than HMO plans, but they often come with a higher monthly premium. Members must still name a primary care physician, but they do not need to get a referral to see a specialist. PPO plan participants can see medical providers outside of Anthem’s network by paying an extra fee. The lender currently offers more than 1,200 PPO plans, the majority of which come with prescription drug coverage.  PPO plans without prescription drug coverage are also available. 

Special Needs Plans

Anthem offers two types of Special Needs Plan, one option for Medicare enrollees who also get Medicaid and one for those with chronic health conditions or specific health needs. These options come with Medicare Advantage benefits while offering additional services, including additional prescription drug coverage. 

Prescription Drug Plans

Anthem offers several options for those looking for stand-alone prescription drug plans, which provide benefits for drugs that fall into the Medicare coverage gap. These plans must be used in tandem with Medicare Parts A and B or Medicare Supplement Insurance plans. Anthem works with nearly 70,000 pharmacies in 14 states to fill prescriptions for members. 


Anthem administers Medicaid coverage for members who meet specific qualifications such as a low income and a documented disability. Medicaid coverage is only available in six states, so ensure you check your state regulations before enrolling in a plan. Most members who register for Medicaid through the U.S. government can transfer their existing coverage to Anthem.

Member Benefits

Anthem plans often come with extra benefits that allow members to access services and programs for less money. While these benefits vary depending on the plan, these are some of the benefits Anthem members enjoy: 

Anthem Health Plan Availability

Anthem health insurance plans are widely available in Midwest, Northeast, and Pacific U.S. states. Not every Anthem plan is available in every state. Particular coverage and prescription drug availability also vary depending on the member’s geographic location. 

Policies are offered to people residing in the following areas:

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