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Anthem Veteran (PPO)
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.
$0.00
Monthly Premium
Anthem Veteran (PPO) is a PPO plan offered by Anthem Blue Cross and Blue Shield
Plan ID: H4036-037
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) - H4036-037 by Anthem Blue Cross and Blue Shield as well as other Medicare Advantage plans available in your area.
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Monthly Premium
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Monthly Deductible | $-1 |
| Out of Pocket Max |
In-Network: $5900 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 | In-Network: $40.00 copay |
| Inpatient Hospital Care | In-Network: Days 1-5: $350.00 per day, per admission / Days 6-90: $0.00 per day, per admission |
| Urgent Care | Urgent Care: $55.00 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: $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: 50% coinsuranceIn-Network: Medicare Covered Chiropractic Services: $0.00 copay |
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | Out-of-Network: 50% coinsurance |
| Durable Medical Equipment (DME) | In-Network: 20% 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 | In-Network: Days 1-5: $350.00 per day, per admission / Days 6-90: $0.00 per day, per admission |
| Mental Health Outpatient Care | In-Network: Individual and Group Sessions: $40.00 copay |
| Outpatient Services / Surgery | In-Network: Outpatient Hospital - Surgery: $350.00 copay Observation Services: $350.00 copay Ambulatory Surgical Center: $300.00 copay |
| Outpatient Substance Abuse Care | In-Network: Individual and Group Sessions: $40.00 copay Out-of-Network: 50% coinsurance |
| Over-the-counter (OTC) Items | This plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $45 every quarter. Unused OTC amounts do roll over to the next quarter. Unused OTC amounts expire at the end of the calendar year. |
| Podiatry Services | Out-of-Network: Medicare Covered Podiatry Services: 50% coinsuranceIn-Network: Medicare Covered Podiatry Services: $40.00 copay |
| 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 | Out-of-Network: Medicare Covered Eye Exam: 50% 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: 50% coinsurance Routine Hearing Exam: 50% 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 | In-Network: $0.00 copay for Medicare Covered Preventive Services |