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Anthem Veteran (PPO)

Indiana Medicare Advantage Plan (2025 Plan)

Monthly Premium

Your Cost
$0
by Anthem Blue Cross and Blue Shield

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 3.5
out of 5 stars

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Plan Overview

Plan Name
Anthem Veteran (PPO)
Insurance Carrier
Anthem Blue Cross and Blue Shield
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
PPO

Anthem Veteran (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Indiana and offered by the health insurance company Anthem Blue Cross and Blue Shield. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$9,350
Primary doctor visit
$0 copay
Specialist visit
$45 copay per visit
ER visit
$110 copay per visit (always covered)
Ambulance
$290 copay

Anthem Veteran (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $14,000 In and Out-of-network $9,350 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 Veteran (PPO) are defined below.

Additional Benefits and Coverage

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Anthem Veteran (PPO) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Anthem Veteran (PPO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Anthem Veteran (PPO) 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
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of Anthem Veteran (PPO) to Other Plans in Indiana

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, Anthem Veteran (PPO) received an overall government quality rating of 3.5 stars out of 5 stars.

Anthem Veteran (PPO) performed worse than Indiana’s State average overall quality score of 3.7 stars.

This Plan’s 5-star Gov’t Quality Score
Indiana State Average Score
Overall Government 5 Star Quality Rating
 3.5
 3.7
Summary rating of health plan quality
 3.5
 3.7
Staying healthy: screenings, tests, & vaccines
 3
 3.6
Managing chronic (long term) conditions
 3
 3.4
Member experience with health plan
 3
 3.8
Member complaints & changes in the health plan's performance
 3
 4.0
Health plan customer service
 5
 3.9

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Anthem Veteran (PPO) received 3.5 stars for its health plan quality score which is worse than the Indiana State average health plan quality score of 3.7 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$14,000 In and Out-of-network
$9,350 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
https://shop.anthem.com/medicare
Plan Link
https://shop.anthem.com/medicare

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: 30% coinsurance per visit
Specialist visit
In-network: $45 copay per visit
Out-of-network: 30% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0-100 copay
Out-of-network: 30% coinsurance
Lab services
In-network: $0-50 copay
Out-of-network: 30% coinsurance
Diagnostic radiology services (like MRI)
In-network: $50-350 copay
Out-of-network: 30% coinsurance
Outpatient x-rays
In-network: $50-110 copay
Out-of-network: 30% coinsurance
Emergency care
$110 copay per visit (always covered)
Urgent care
$25 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $350 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per stay
Outpatient hospital coverage
In-network: $0-350 copay per visit
Out-of-network: 30% coinsurance 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: 30% per stay

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: 30% coinsurance

Ambulance

Ground ambulance
In-network: $290 copay
Out-of-network: $290 copay

Therapy services

Occupational therapy visit
In-network: $35 copay
Out-of-network: 30% coinsurance
Physical therapy & speech & language therapy visit
In-network: $45 copay
Out-of-network: 30% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $45 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy with a psychiatrist
In-network: $45 copay
Out-of-network: 30% coinsurance
Outpatient group therapy visit
In-network: $45 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy visit
In-network: $45 copay
Out-of-network: 30% coinsurance

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 0-20% coinsurance per item
Out-of-network: 30% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Diabetes supplies
In-network: $0 copay
Out-of-network: 30% coinsurance per item

Prescription Drug Benefits

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

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-30% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-30% coinsurance

Extra Benefits

Hearing

Hearing exam
In-network: $45 copay
Out-of-network: 30% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: 20% coinsurance
Hearing aids - All types
In-network: $0 copay
Out-of-network: $0 copay

Preventive Dental

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

Comprehensive dental

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

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
Upgrades
In-network: $0 copay
Out-of-network: $0 copay

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