Anthem MediBlue Plus (HMO)

Medicare Advantage Plan for Colorado

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderAnthem BCBS
Plan IDH4346-12-0
CMS Rating1
Plan TypeHMO
Annual Deductible$0.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$4,300 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
Cost
Inpatient hospital coverage
$289 for days 1 through 6
$0 for days 7 through 90
Outpatient hospital coverage
$0-275 per visit
Doctor visits
Primary:$0 copay
Specialist:$40 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:$80 per visit (always covered)
Urgent care:$50 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:$0-50
Lab services:$0-50
Diagnostic radiology services (e.g., MRI):$260-300
Outpatient x-rays:$5-40
Mental health services
$260 for days 1 through 6
$0 for days 7 through 90
Outpatient group therapy visit with a psychiatrist:$40
Outpatient individual therapy visit with a psychiatrist:$40
Outpatient group therapy visit:$40
Outpatient individual therapy visit:$40
Skilled Nursing Facility
Tier 1
$0 for days 1 through 20
$137.50 for days 21 through 100
Tier 2
$0 for days 1 through 20
$167.50 for days 21 through 100
Rehabilitation services
Occupational therapy visit:$40
Physical therapy and speech and language therapy visit:$40
Ambulance
$350 or 20%
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:$40
Routine foot care:Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):20% per item
Prosthetics (e.g., braces, artificial limbs):20% per item
Diabetes supplies:$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:20%
Other Part B drugs:20%

Coverage Area for Anthem MediBlue Plus (HMO)

StateColorado
CountyDenver

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$5 copay$10 copayNot offered
Tier 2: Non-Preferred Generic$8 copay$13 copayNot offered
Tier 3: Preferred Brand Name$42 copay$47 copayNot offered
Tier 4: Non-Preferred Brand Name$95 copay$100 copayNot offered
Tier 5: Specialty Tier33% coinsurance33% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$15 copay$30 copayNot offered
Tier 2: Non-Preferred Generic$24 copay$39 copayNot offered
Tier 3: Preferred Brand Name$126 copay$141 copayNot offered
Tier 4: Non-Preferred Brand Name$285 copay$300 copayNot offered
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept Anthem MediBlue Plus (HMO) for Colorado

/
TRAN, QUY
1023 S FEDERAL BLVD
DENVER, CO 80219
GARRETT, RAYMOND
1930 S FEDERAL BLVD
DENVER, CO 80219
MCCRANIE, KATHY
1380 S SANTA FE DR
DENVER, CO 80223
DRAPER, DARLA
205 S GARRISON ST
LAKEWOOD, CO 80226
COLORADO PAIN SPECIALISTS PC
325 S TELLER ST
LAKEWOOD, CO 80226
JOHANNES, ROBERT
96 WADSWORTH BLVD UNIT 100
LAKEWOOD, CO 80226
PEARSON, LESLIE
8383 W ALAMEDA AVE
LAKEWOOD, CO 80226
LANE, JOHAN
8383 W ALAMEDA AVE
LAKEWOOD, CO 80226
NEUMANN, ALICE
9423 W KENTUCKY PL
LAKEWOOD, CO 80226
BRODY, HOLLY
620 S VANCE ST
LAKEWOOD, CO 80226
NGUYEN, LISA
8015 W ALAMEDA AVE
LAKEWOOD, CO 80226
RESKE, MERILEE
7500 W MISSISSIPPI AVE
LAKEWOOD, CO 80226
CLARK, JOHN
8383 W ALAMEDA AVE
LAKEWOOD, CO 80226
COAKLEY, LEEANNE
8383 W ALAMEDA AVE
LAKEWOOD, CO 80226
SEEFELDT, BRIEANNA
8015 W ALAMEDA AVE
LAKEWOOD, CO 80226
PERNA, JOHN
777 BANNOCK ST
DENVER, CO 80204
CHAMMAS, MARIO
777 BANNOCK ST
DENVER, CO 80204
Details
QUY TRAN, M.D.
Phone Number
(303) 936-4966
Office Locations
1023 S FEDERAL BLVD
DENVER, CO 80219
1023 S FEDERAL BLVD DENVER CO, 80219

Similar Plans

PremiumPlan NameCMS Rating
from $0
Kaiser Permanente Senior Advantage Core (HMO)
Details
from $24
SilverScript Choice (PDP)
Details
from $22
Express Scripts Medicare - Saver (PDP)
Details
from $0
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
Details
from $18
Blue Cross MedicareRx Basic (PDP)
Details

Related Articles

Related Searches

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

{}