Anthem I MaineHealth Advantage Veteran (PPO)
Maine Medicare Advantage Plan (2026 Plan)
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Name
Anthem I MaineHealth Advantage Veteran (PPO)
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Anthem I MaineHealth Advantage Veteran (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Maine and offered by the health insurance company AMH Health. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Annual Deductible
$750 annual deductible
Primary doctor visit
$0 copay
Specialist visit
$45 copay
Anthem I MaineHealth Advantage Veteran (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $750 annual deductible and a maximum out of pocket cost sharing of $11,500 In and Out-of-network
$7,200 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 I MaineHealth Advantage Veteran (PPO) are defined below.
No
Part D Prescription Drug Coverage
Anthem I MaineHealth Advantage 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 I MaineHealth Advantage Veteran (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Anthem I MaineHealth Advantage Veteran (PPO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
$11,500 In and Out-of-network
$7,200 In-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: 50% coinsurance
Specialist visit
In-network: $45 copay
Out-of-network: 50% coinsurance
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $0-$140 copay
Out-of-network: 50% coinsurance
Lab services
In-network: $0-$15 copay
Out-of-network: 50% coinsurance
Diagnostic radiology services (like MRI)
In-network: $50-$350 copay
Out-of-network: 50% coinsurance
Outpatient x-rays
In-network: $50-$110 copay
Out-of-network: 50% coinsurance
Hospital Services
Inpatient hospital coverage
In-network:
Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
$50% per stay
Outpatient hospital coverage
In-network: $0-$350 copay
Out-of-network: 50% coinsurance
Skilled nursing facility
Skilled nursing facility
In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
$50% per stay
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: 50% coinsurance
Ambulance
Ground ambulance
In-network: $323 copay
Out-of-network: $323 copay
Therapy services
Occupational therapy visit
In-network: $35 copay
Out-of-network: 50% coinsurance
Physical therapy & speech & language therapy visit
In-network: $35 copay
Out-of-network: 50% coinsurance
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $45 copay
Out-of-network: 50% coinsurance
Outpatient individual therapy with a psychiatrist
In-network: $45 copay
Out-of-network: 50% coinsurance
Outpatient group therapy visit
In-network: $45 copay
Out-of-network: 50% coinsurance
Outpatient individual therapy visit
In-network: $45 copay
Out-of-network: 50% coinsurance
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Diabetes supplies
In-network: $0 copay
Out-of-network: 50% coinsurance
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: 0%-50% coinsurance
Other Part B drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-50% coinsurance
Hearing
Hearing exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: 50% coinsurance
Hearing aids - prescription
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - over the counter
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: 25% coinsurance
Out-of-network: 50% coinsurance
Endodontics
In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Periodontics
In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, removable
In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, fixed
In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Maxillofacial prosthetics
Oral and maxillofacial surgery
In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Adjunctive general services
In-network: 25% coinsurance
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
When Can I Sign Up for Medicare?
Enter your birthday month and year to learn when you can sign up for different Medicare plan options.
Health Plan Radar