Anthem Veteran (PPO)

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$0.00
Monthly Premium

Anthem Veteran (PPO) is a PPO plan offered by Anthem Inc.

Plan ID: H4036-024

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 Veteran (PPO) - H4036-024 by Anthem Inc. as well as other Medicare Advantage plans available in your area.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $-1
Out of Pocket Max In-Network: $6751
Out-of-Network: 10000
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit

Out-of-Network:
$30% coinsurance
Specialty Doctor Visit

Out-of-Network:
$30% coinsurance
Inpatient Hospital Care

Out-of-Network:
30% coinsurance per stay
Urgent Care
Urgent Care: $25.00 copay
Emergency Room Visit
Emergency Care: $115.00 copay
Worldwide Coverage: This plan covers urgent care and emergency services, including emergency transportation, 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: $290.00 copay Per Trip
Air Ambulance: $290.00 copay

Health Care Services and Medical Supplies

Anthem Veteran (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: 30% 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)
In-Network:
20% coinsurance
Diagnostic Tests, Lab and Radiology Services, and X-Rays

Out-of-Network:
Lab Services: 30% coinsurance
X-Rays: 30% coinsurance
Therapeutic Radiological Services: 20% coinsurance
Outpatient Diagnostic Procedures/Tests: 30% coinsurance
Diagnostic Radiological Services: 30% coinsurance
Home Health Care
In-Network:
$0.00 copay
Mental Health Inpatient Care

Out-of-Network:
30% coinsurance per stay
Mental Health Outpatient Care

Out-of-Network:
30% coinsurance
Outpatient Services / Surgery

Out-of-Network:
Outpatient Hospital - Surgery: 30% coinsurance
Observation Services: 30% coinsurance
Ambulatory Surgical Center: 30% coinsurance
Outpatient Substance Abuse Care

Out-of-Network:
30% coinsuranceIn-Network:
Individual and Group Sessions: $45.00 copay
Over-the-counter (OTC) Items
Podiatry Services

Out-of-Network:
Medicare Covered Podiatry Services: 30% coinsurance
Routine Foot Care: 30% coinsuranceIn-Network:
Medicare Covered Podiatry Services: $0.00 copay - $45.00 copay
Routine Foot Care: $0.00 copay
12 routine foot care visit(s) each year.
Skilled Nursing Facility Care

Out-of-Network:
30% coinsurance per stay

Dental Benefits

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

Coverage Cost
Dental Care
This plan covers 2 oral exams, 2 cleanings, 2 fluoride treatments, and 2 dental X-rays every year.
This plan covers up to a $1,000 allowance for covered preventive and comprehensive dental services every year.


In-Network

Medicare Covered Dental: $0.00 copay

Preventive Dental: $0.00 copay


Comprehensive Dental: 25% coinsurance

Vision Benefits

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

Coverage Cost
Vision Benefits

Out-of-Network:
Medicare Covered Eye Exam: 30% coinsurance
Routine Eye Exam: $0.00 copay
Medicare Covered Eye Wear: $0.00 copay
Routine Eye Wear: $0.00 copay

Hearing Benefits

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

Coverage Cost
Hearing Benefits

Out-of-Network:
Medicare Covered Hearing Exam: 30% 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:
30% coinsurance
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