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Anthem

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2.1

Overall Score

Author: Kaitlyn Short

LAST UPDATED: October 27th, 2022

Anthem is a subsidiary of BlueCross BlueShield, a well-known health insurance company. It offers combined Medicare and Medicaid plans in addition to Medicare Advantage, Prescription Drug, and Medicare Supplement plans. It also has supplemental dental and vision insurance available. This selection of plans allows health insurance shoppers to find coverage that meets their needs.

While Anthem offers a good selection of Medicare plans, it does not offer Medicare Part A or Part B. Anthem also experienced a data breach in 2015 that affected 78.8 million people. Following the breach, Anthem invested heavily in upgrading its security.

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The Good

  • Medicare Options
  • Medication Therapy Management Program
  • Supplemental Dental and Vision Insurance

Medicare Options

Anthem BlueCross BlueShield offers Dual Eligibility Medicare Special Needs (DSNP) insurance, Medicare Advantage (Part C), Prescription Drug (Part D), and Medicare Supplement Insurance (Medigap).

DSNPs offer combined Medicaid and Medicare plans for individuals who qualify for both Medicare and Medicaid services.

Anthem's Medicare Advantage plans are available with a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) network. These plans offer coverage for hospital costs and medical care.

HMO plans generally only offer coverage for in-network treatment. PPO plans offer some coverage for out-of-network services, but has even better coverage for in-network services. These network options allow Anthem members to choose a network system that best meets their needs.

While Medicare Advantage plans offer some coverage for prescriptions, Part D offers more comprehensive coverage. Because Anthem offers both Part C and Part D, people don't have to purchase two health insurance plans from separate insurers.

Medigap plans offer additional cost-sharing for out-of-pocket medical expenses from Original Medicare (Part A and Part B). It can help with copayments, coinsurance, and help cover medical care abroad. Anthem also offers SilverSneakers ® participation to all members who enroll in a Medicare supplement plan.

The SilverSneakers ® program offers access to participating gyms or a home fitness kit to help people continue to exercise and be active.

Medication Therapy Management Program

Anthem also offers a Medication Therapy Management Program to some of its members. This program helps Anthem members understand how their medications function by meeting with a pharmacist and providing a medication review every three months.

Participation in Anthem's program is optional, so eligible individuals can opt out of this complimentary service if they would like to.

To qualify for the program, Medicare beneficiaries must be enrolled in a Part D prescription drug coverage plan, have three or more chronic conditions, and take over eight daily medications. Individuals must also meet certain prescription drug expenses threshold. The threshold varies by plan.

Supplemental Dental and Vision Insurance

Medicare Advantage plans offer coverage for emergency dental and eye treatment. For preventive care, individuals will need to enroll separate dental and vision insurance plans.

Anthem offers these kinds of plans. The insurer's supplemental dental plans cover cleanings and restorative care, like fillings. Its supplemental vision plans cover eye exams, glasses, lenses, and contacts.

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The Bad

  • Insufficient Customer Insight
  • 2015 Data Breach
  • No Medicare Part A or Part B
  • Limited Availability

Insufficient Customer Insight

Anthem BlueCross BlueShield has not recieved many customer reviews on Best Company. A full recommendation based on the customer experience is not available. 

Unfortunately, Anthem's reviews are mostly negative. While inconclusive, this is not a good sign. Complaints include issues with customer service, coverage, and claims.

2015 Data Breach

Anthem experienced a data breach in 2015. This data breach affected 78.8 million Anthem members.

The settlement reached allows individuals affected by the data breach can receive help with credit monitoring and identity protection. It also provides monetary compensation for related lawsuits.

Since the breach, Anthem has upgraded its security features so that its members' information is better protected.

No Medicare Part A or Part B

Anthem does not offer Medicare Part A or Part B. However, Medicare Part C combines coverage offered by both Parts A and B. Medicare Advantage plans allow people to pay one monthly premium instead of separate monthly premiums for Part A and Part B.

Shoppers interested in purchasing Part A and Part B will need to enroll in Medicare through Social Security.

Limited Availability

Anthem Medicare plans are only available in 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia, and Wisconsin.

If you do not live in one of these states, Anthem Medicare insurance is not an option for you. However, Anthem is part of BlueCross BlueShield, so potential clients may be able to find coverage options through another BlueCross BlueShield subsidiary.

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The Bottom Line

Anthem offers a selection of Medicare coverage options and benefits, but is not available in every state. If Anthem insurance coverage is not in your state, you may be able to find insurance coverage through another BlueCross BlueShield subsidiary. Otherwise, you'll have to consider other Medicare carriers.

Before enrolling in an Anthem Medicare plan, be sure to understand the costs and benefits associated with each plan. Doing this will help ensure that you have the Medicare coverage you need.

Despite offering a good selection of Medicare plans and supplemental insurance plans, Medicare shoppers should be cautious when considering Anthem as their medical insurance provider. Pay attention to customer reviews and ask questions to understand your coverage options better.

Data breaches are becoming more common and no one is exempt from risk, so it's important to be selective of whom you trust to handle your data, especially your medical data. If you're considering Anthem as your Medicare insurance company, it's a good idea to ask questions on how the company has improved its data security before committing.

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1.6

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12 Reviews

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8%

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17%

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Sandy Oregon, WI

They will not pay for a flu shot if you get it at a pharmacy. You must go to your doctor's office if you want Anthem to pay for it. My local doctor does not have it so I would have to drive some distance to another doctor and I would have to make an appointment. Forget it. I paid for it out-of-pocket. By making it so difficult, they are not encouraging patients to get a flu shot. It's a ridiculous requirement. Flu shots are much less costly than being treated for the flu. I guess they don't see it that way.

5 years ago

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Daniel Joyner Warner Robins, GA

Switch from Humana to Anthem in 2022 worst thing I ever did, I did not like Humana but compared to Anthem Humana was great. Anthem started lying to me right off the bat when I signed up they told me my deductible was 75.00 come Jan when I ordered medicine I was told the deductible was 150.00, also I had to get a CAT scan, I called two times and talked to two different reps and gave them the facility I was planning to use and was assured that it was covered and I would have to pay a 150.00 copay and was billed a 250.00 copay, I then called Anthem and they told me that I had to use a stand alone facility and not one affiliated with any hospital well no stand alone place can afford a CAT scan machine around here. I filed a grievance, they reviewed the recorded calls where I was told twice that the facility I was good to go and would cost me 150.00 they admitted they made a mistake and would do more training for reps but I would still have to pay 250.00. This is just two of many underhanded things they pulled they class a lot of drugs as tier 3 then most everyone else classifies as tier 1 or 2, stay away from BCBS Anthem.

2 years ago

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Steve Escondido, CA

This Year I needed some medical procedures. Most currently, for a MRI on my shoulder from a fall. The doctor was quite sure that the muscle is ripped. The pre-authorization that the doctor requested was denied. I am in horrible pain, and the doctor told me to use it as little as possible. With the denial for a simple diagnostic procedure I am stuck. This is completely unacceptable as I now have to spend weeks fighting this determination. Earlier in the year I had a sinus issue and this time the pre-authorization for the sinus MRI was approved, After the MRI, it was determined that surgery was needed. Again another pre-authorization was submitted and it came back with with allowing for the surgery but disallowing for a technique that is needed to do the job correctly. Without being able to use that technique the doctor told me that there would be to high of a risk of a bad outcome and he was not willing to do it. I have a PPO plan with 4 doctors visits per year where I only have to pay the CoPay, yet every time I go to a doctor, I get a bill in full and I am told that it is being applied to my deductible. So every time I have to call, wait on the phone for 30 to 45 minutes to tell them that the visit is part of the 4 included. They say sorry and make to correction. If this would happen every once in a while it would be understandable but it happens every time, year after year. It is a big waste of my time. All I can say is that if you want an insurance company to provide you with the coverage you require, Anthem is not the company you want to sign up for. If you like throwing away your money and wasting your time then Anthem will take it.

5 years ago

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Natalia C Hampton, VA

I did not use them for medical issues yet but their customer support and their site are both ridiculously ineffective. Every time I need to change my Autopay to a new method (new credit card), the site fails to process it right. Before I used to be able to set it on the phone but now their "beautiful" policy states that the option is no longer available. So, with the site not working right and the tech support not being able to help, they offer me to fill a paper form and send it to them (why even have the site then if it never works? ). I am not sure even this option will work right (seeing the efficiency of their customer support). I just want to pay the bill, and even that is a huge problem. I can only imagine what people have to go through if they have a serious problem. Absolutely the worst experience with the online payment issues and the worst tech support specialists.

5 years ago

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Michele T Indianapolis, IN

I turned 51 and had my first colonoscopy. This is a preventative service that is supposed to be covered by my insurance. Anthem denied the claim. The doctor who performed the service is in-network but Anthem said the building he performed the service at is out of network so I get a bill for over $1000. This makes no sense whatsoever to me, if the doctor is in-network. I submitted an appeal 2 months ago and they have not given me any sort of update. Every time I call them I get the run around. They are the worst insurance company I’ve ever dealt with!!!

2 years ago

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Robert Hockenberry Oak Lawn, IL

They are in fact, the worst insurance company I've ever dealt with. All they do is deny claims ,approvals and procedures. Like everyone says, it ain't worth the amount a person has to pay for plan. Better off saving your money and just paying bills, because there sure and hell ain't going to. There is no insurance involved, it's a huge scam on the pour souls of hard working American familys .next week I'll be cancelling my so called (Insurance Coverage)!!

4 years ago

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samanta Ann Arbor, MI

Anthem Blue Cross Absolutely the worst insurance I have ever had. They are not organized, they take weeks to process a medical service, meaning the bills are always a surprise! It is impossible to control the dedusible. need to call several times to complain about the same thing and do not solve anything. And you never know how much a consultation, exam ...

5 years ago

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Chuck Apley San Diego, CA

Customer service is awful. The 800 number is just a revolving menu of options that never put you in touch with a real person. The email contact method through their dismal website results in a referral to their 800 number with no allowable reply to the email. I have PPO coverage and have never been able to get a doctor because they cannot verify coverage with the member number provided by Anthem. I have been issued FOUR ID cards from Anthem, and none of them works! I wish I was back at Kaiser...

5 years ago

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Jacob Aldie, VA

Total RIP off, can't even use it until you pay out poket 1200 and than they cover 80 percent and still have to come up with the rest. I went to chiropractic he was in a network and insurance did cover everything. He told me It would b cheaper if I didn't use anthem

5 years ago

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Max Winkel Lindon, UT

Typical insurance company. They reject claims and then you have to call them to get it them to respond. It shouldn't be that way. Insurance companies just operate that way.

4 years ago

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David Gainsforth Herriman, UT

Anthem has me out multiple times when it came to medical bills. Absolutely recommend it to anyone.

2 years ago

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Jimmy Arredondo Beech Grove, IN

They pay for nothing. Having insurance through Anthem is not much better than having to pay on your own.

4 years ago