Anthem MediBlue Dual Advantage (HMO SNP)

Medicare Advantage Plan for Wisconsin

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderAnthem BCBS
Plan IDH9525-3-0
CMS Rating1
Plan TypeHMO SNP
Annual Deductible$405.00

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
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$6,700 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
$0 copay
Outpatient hospital coverage
$0 copay
Doctor visits
Primary:
$0 copay
Specialist:
$0 copay
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
$0 copay
Lab services:
$0 copay
Diagnostic radiology services (e.g., MRI):
$0 copay
Outpatient x-rays:
$0 copay
Mental health services
$0 copay
Outpatient group therapy visit with a psychiatrist:
$0 copay
Outpatient individual therapy visit with a psychiatrist:
$0 copay
Outpatient group therapy visit:
$0 copay
Outpatient individual therapy visit:
$0 copay
Skilled Nursing Facility
$0 copay
Rehabilitation services
Occupational therapy visit:
$0 copay
Physical therapy and speech and language therapy visit:
$0 copay
Ambulance
$0 copay
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
$0 copay
Routine foot care:
$0
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
$0 copay
Prosthetics (e.g., braces, artificial limbs):
$0 copay
Diabetes supplies:
$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
$0 copay
Other Part B drugs:
$0 copay

Coverage Area for Anthem MediBlue Dual Advantage (HMO SNP)

StateWisconsin
CountyMilwaukee

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$0 copay$0 copayNot offered
Tier 2: Non-Preferred Generic$6 copay$6 copayNot offered
Tier 3: Preferred Brand Name$47 copay$47 copayNot offered
Tier 4: Non-Preferred Brand Name$95 copay$100 copayNot offered
Tier 5: Specialty Tier25% coinsurance25% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copayNot offered
Tier 2: Non-Preferred Generic$18 copay$18 copayNot offered
Tier 3: Preferred Brand Name$141 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
Not Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Not Rated
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
Not Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
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 Dual Advantage (HMO SNP) for Wisconsin

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HANSON, JOHN
2901 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
KNIPPEL, MARTIN
2025 W OKLAHOMA AVE
MILWAUKEE, WI 53215
JACOBSOHN, HAROLD
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
DIULIO, ROBERT
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
NANGIA, VIKRAM
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
KRAUS, ANDREA
3237 S 16TH ST STE 100
MILWAUKEE, WI 53215
GONCHAROVA, IRINA
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
KABBANI, MOUHAMMED
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
SYED, ATHER
3305 S. 20TH ST.
MILWAUKEE, WI 53215
WHITTLE, DONNA
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
HARRIS, PAUL
3267 S 16TJ STREET
MILWAUKEE, WI 53215
KEATING, E
3201 S 16TH STREET
MILWAUKEE, WI 53215
HANNA-SALAMI, AMY
2801 W KINNICKINNIC RIVER PKWY STE 330
MILWAUKEE, WI 53215
ALEMAN, ALVARO
3527 W NATIONAL AVE
MILWAUKEE, WI 53215
GUENTHER, NEIL
2900 W OKLAHOMA AVE
MILWAUKEE, WI 53215
LAWAL, ADEGBOYEGA
2900 W OKLAHOMA AVE
MILWAUKEE, WI 53215
RIVERA, MARIA
2801 W KK RIVER PKWY
MILWAUKEE, WI 53215
GUPTA, MADHU
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
CRONSELL, CHRISTOPHER
3237 S 16TH ST
MILWAUKEE, WI 53215
ARANA, EMILIA
2906 S 20TH ST
MILWAUKEE, WI 53215
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
2906 S 20TH ST
MILWAUKEE, WI 53215
BARTON, JAMES
3033 S 27TH ST
MILWAUKEE, WI 53215
AMMAR, KHAWAJA
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
Details
JOHN HANSON, M.D.
Phone Number
(414) 385-3086
Office Locations
2901 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215
2901 W KINNICKINNIC RIVER PKWY MILWAUKEE WI, 53215

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