Anthem Kidney Care (HMO-POS C-SNP)

Georgia Chronic Condition Special Needs C-SNP Plan (2025 Plan)


Monthly Premium

Your Cost
$0
by Anthem Blue Cross and Blue Shield

Additional Coverage

HearingVisionDental

Overall Government Star Rating

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Plan Name
Anthem Kidney Care (HMO-POS C-SNP)
Insurance Carrier
Anthem Blue Cross and Blue Shield
Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Network Type
HMO

Anthem Kidney Care (HMO-POS C-SNP) is a Chronic Condition Special Needs Plan (C-SNP), which is available in Georgia and offered by the health insurance company Anthem Blue Cross and Blue Shield. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$5,900
Primary doctor visit
$0 copay
Specialist visit
$0-40 copay per visit
ER visit
$125 copay per visit (always covered)
Ambulance
$220 copay

Anthem Kidney Care (HMO-POS C-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $5,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Anthem Kidney Care (HMO-POS C-SNP) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Anthem Kidney Care (HMO-POS C-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Anthem Kidney Care (HMO-POS C-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Anthem Kidney Care (HMO-POS C-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$5,900 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
In-network: $0 copay
Specialist visit
In-network: $0-40 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0-175 copay
Lab services
In-network: $0-10 copay
Diagnostic radiology services (like MRI)
In-network: $50-325 copay
Outpatient x-rays
In-network: $50-125 copay
Emergency care
$125 copay per visit (always covered)
Urgent care
$50 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $325 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: Not Applicable
Outpatient hospital coverage
In-network: $0-325 copay per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay

Ambulance

Ground ambulance
In-network: $220 copay

Therapy services

Occupational therapy visit
In-network: $40 copay
Physical therapy & speech & language therapy visit
In-network: $40 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $40 copay
Outpatient individual therapy with a psychiatrist
In-network: $40 copay
Outpatient group therapy visit
In-network: $40 copay
Outpatient individual therapy visit
In-network: $40 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 0-20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Diabetes supplies
In-network: $0 copay

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$9.00 copay$0 copay
Generic$12.00 copay$0 copay
Preferred Brand25% coinsurance$0 copay
Non-Preferred Drug25% coinsurance$0 copay
Specialty Tier33% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance

Hearing

Hearing exam
In-network: $40 copay
Fitting/evaluation
In-network: $0 copay
Hearing aids - All types
In-network: $0 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Fluoride treatment
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 20%-50% coinsurance

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Prosthodontics, removable
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Implant services
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Orthodontics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Adjunctive general services
In-network: $0 copay
Out-of-network: 20%-50% coinsurance

Vision

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Upgrades
Not covered

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