Anthem Medicare Advantage 3 (PPO)

4 out of 5 stars

^$29.00

Monthly Premium

Anthem Medicare Advantage 3 (PPO) is a PPO plan offered by Anthem Blue Cross and Blue Shield

Plan ID: H4036-042

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as Anthem Medicare Advantage 3 (PPO) - H4036-042 by Anthem Blue Cross and Blue Shield as well as other Medicare Advantage plans available in your area.

^$29.00

Monthly Premium

Georgia Counties Served

Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur Dekalb Dodge Dooly Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gadsden Gilmer Glascock Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion Mcduffie Mcintosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Russell Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Wilcox Wilkes Wilkinson Worth

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$0
Out of Pocket Max	In-Network: $6750 Out-of-Network: N/A
Initial Coverage Limit	$0
Catastrophic Coverage Limit	$2000
Primary Care Doctor Visit	Out-of-Network: $50% coinsurance
Specialty Doctor Visit	Out-of-Network: $50% coinsurance
Inpatient Hospital Care	Out-of-Network: 50% coinsurance per stay
Urgent Care	Urgent Care: $35.00 copay
Emergency Room Visit	Emergency Care: $125.00 copay Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000 per year.
Ambulance Transportation	Ground Ambulance: $270.00 copay Per Trip Air Ambulance: $270.00 copay

Health Care Services and Medical Supplies

Anthem Medicare Advantage 3 (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage	Cost
Chiropractic Services	Out-of-Network: Medicare Covered Chiropractic Services: 50% coinsuranceIn-Network: Medicare Covered Chiropractic Services: $15.00 copay
Diabetes Supplies, Training, Nutrition Therapy and Monitoring	In-Network: Diabetic Supplies: $0.00 copay
Durable Medical Equipment (DME)	Out-of-Network: 50% coinsurance
Diagnostic Tests, Lab and Radiology Services, and X-Rays	Out-of-Network: Lab Services: 50% coinsurance X-Rays: 50% coinsurance Therapeutic Radiological Services: 50% coinsurance Outpatient Diagnostic Procedures/Tests: 50% coinsurance Diagnostic Radiological Services: 50% coinsurance
Home Health Care	Out-of-Network: 50% coinsurance
Mental Health Inpatient Care	Out-of-Network: 50% coinsurance per stay
Mental Health Outpatient Care	Out-of-Network: 50% coinsurance
Outpatient Services / Surgery	Out-of-Network: Outpatient Hospital - Surgery: 50% coinsurance Observation Services: 50% coinsurance Ambulatory Surgical Center: 50% coinsurance
Outpatient Substance Abuse Care	Out-of-Network: 50% coinsuranceIn-Network: Individual and Group Sessions: $25.00 copay
Over-the-counter (OTC) Items
Podiatry Services	Out-of-Network: Medicare Covered Podiatry Services: 50% coinsurance Routine Foot Care: 50% coinsuranceIn-Network: Medicare Covered Podiatry Services: $0.00 copay - $25.00 copay Routine Foot Care: $0.00 copay Unlimited routine foot care visits each year.
Skilled Nursing Facility Care	In-Network: Days 1 - 20: $0.00 per day / Days 21 - 100: $214.00 per day

Dental Benefits

The following dental services are covered from in-network providers.

Coverage	Cost
Dental Care	This plan covers up to a $2,000 allowance for covered preventive and comprehensive dental services every year. In-Network: Medicare Covered Dental: $0.00 copay Preventive Dental Services: $0.00 copay Comprehensive Dental Services: $0.00 copay

Vision Benefits

The following vision services are covered from in-network providers.

Coverage	Cost
Vision Benefits	In-Network: Medicare Covered Eye Exam: $0.00 copay - $25.00 copay Routine Eye Exam: $0.00 copay This plan covers 1 routine eye exam(s) every year. $69 maximum eye exam coverage amount. Medicare Covered Eye Wear: $0.00 copay Routine Eye Wear: $0.00 copay This plan covers up to $325 for eyeglasses or contact lenses every year.

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage	Cost
Hearing Benefits	Out-of-Network: Medicare Covered Hearing Exam: 50% coinsurance Routine Hearing Exam: 20% coinsurance for routine hearing exam(s).

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage	Cost
Preventive Services and Health/Wellness Education Programs	Out-of-Network: 50% coinsurance

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