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The Centers for Medicare & Medicaid Services (CMS) publishes annual Star Ratings that reflect how each Medicare Advantage plan performs across a range of metrics, using a system of one to five stars.
Anthem Veteran (PPO) is a PPO plan offered by Anthem Inc.
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.
| 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 |
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 |
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 |
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 |
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). |
The following services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Preventive Services and Health/Wellness Education Programs | Out-of-Network: 30% coinsurance |