Find Anthem Network Doctors

In this article...
  • Find Anthem in-network doctors by using the Anthem provider lookup tool or by calling to speak with a licensed insurance agent who can help you compare plans where you live and the provider networks of each plan. Learn if your doctor accepts an Anthem Medicare plan before you enroll.

Anthem Blue Cross and Blue Shield, part of the Anthem family of brands, offers private Medicare insurance plans as well as individual and family health insurance plans.

Depending on which type of Anthem insurance plan you have, you may need to see an Anthem in-network doctor to get the most from your coverage and to save on out-of-pocket costs. Below we review the Anthem network and how to find a doctor near you who will accept your plan.

You can also compare Anthem BCBS Medicare Advantage (Medicare Part C) plans sold where you live and find out if your doctor accepts the plan. Medicare Advantage plans cover everything Original Medicare (Part A and Part B) covers, and most Anthem Medicare Advantage plans cover additional benefits such as prescription drugs, dental, hearing, vision and more.

You can compare plan networks online or call to speak with a licensed insurance agent.  

How Do I Find Doctors in the Anthem Network?

Current Anthem Medicare beneficiaries can use the Anthem online Find Care tool to search for local in-network doctors.

Prospective Anthem Medicare Advantage plan beneficiaries can also use the online lookup tool, but you may have an easier time calling to speak with a licensed Anthem BCBS insurance to make sure you look at the correct plan networks.

What Is an Anthem In-network Doctor? 

Anthem in-network doctors are those who accept Anthem insurance plans and agree to the cost-sharing terms of the plan. Anthem in-network health care providers can include:

  • General practitioners
  • Specialists
  • Pharmacies
  • Hospitals
  • Other medical facilities and suppliers of medical equipment and supplies

When Should You See an Anthem In-network Doctor?

In most cases, you should always try to see an Anthem in-network health care provider whenever possible.

  • If you have an HMO plan, your coverage is restricted only to in-network providers, and you will be responsible for all costs when visiting a doctor or other provider that is not part of the Anthem network.

    When in an HMO plan, your primary care physician (PCP) will coordinate your care within the Anthem network of specialists and facilities and issue referrals for advanced care. 

  • If you have a PPO plan, you can often seek care outside of the Anthem network and still receive at least partial coverage in most cases with no need to obtain referrals. However, your savings will be maximized when you stay within the Anthem network.

    For example, an Anthem Medicare Advantage plan might require a 20% coinsurance payment for care received inside the Anthem network but a 50% coinsurance payment for care received outside of the Anthem network. 

There are two times however when you may not need to worry about seeing an Anthem in-network doctor (but be sure to check with your plan details and documentation):

  • When seeking emergency care. Emergency care services are typically covered the same whether received within the Anthem provider network or not.

  • With an Anthem Medigap plan. Medicare Supplement Insurance (Medigap) plans don’t use provider networks and may be used at any health care provider who accepts Original Medicare.

You can call a licensed insurance agent to find out which health care providers in your area will accept an Anthem Medicare plan or for help comparing networks, benefits and costs among Anthem plans that may be available where you live. 

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