Anthem Medicare Advantage Review (2026): Pros & Cons

Anthem offers four main Medicare Advantage plan types for 2026, plus special needs plans (SNPs) for people with Medicaid or certain chronic conditions, but its lineup is not evenly distributed across states. California gets only HMO-POS plans. Indiana has the widest selection, with plans across four types. 

HMO-POS, the plan type with Anthem's lowest average premium, is sold in 10 of its 12 states. In the five states with one plan type (California, Colorado, Connecticut, Missouri and Nevada), the choice comes down to Anthem or another insurer.   

• HMO: Anthem HMO plans require you to choose a primary care doctor who coordinates all care and authorizes specialist visits. Coverage is limited to in-network providers except for emergencies, urgently needed care and out-of-area dialysis.
• HMO-POS: Anthem HMO-POS plans keep the primary care doctor and referral requirements for in-network specialists but allow out-of-network visits for certain services at higher cost.
• PPO: Anthem PPO plans require no primary care physician and no specialist referrals. You can see any Medicare-accepting provider who agrees to treat you. In-network visits cost less and out-of-network care is covered at higher rates.
• Regional PPO: Anthem Regional PPO plans extend full PPO flexibility across a Medicare-defined region, which can include multiple states, so members who split time between states in that region stay in network.

Anthem offers Medicare Advantage plans across 12 states, including HMO, PPO and SNP options. Plan types include HMO, HMO-POS, PPO and Regional PPO, though availability differs by location. California has six HMO-POS plans. Indiana offers nine total plans across four plan types. Visit anthem.com or call 1-844-717-1811 to confirm which plans serve your area for 2026 coverage.

For 2026, Anthem Medicare Advantage plans average 3.3 to 3.89 out of 5 by plan type, based on CMS evaluations of customer service, care coordination, member satisfaction and health outcomes. HMO-POS and Regional PPO options score below national averages. Anthem's HMO plans score 3.89 against a national average of 3.86, and PPO plans score 3.8 against a national average of 3.63.

Anthem HMO and PPO plans score above their national averages, making them Anthem’s best options on quality. HMO-POS plans fall 0.71 stars below the 4.01 national HMO-POS average. If care coordination or chronic condition management matters to you, compare other carriers’ HMO-POS plans before enrolling.

At $6 per month, HMO-POS is Anthem's best-value plan type, $41 below the $47 national HMO-POS average, and 64% charge no premium. Their out-of-pocket maximums are also the lowest of Anthem's plan types, at an average of $4,544, or $528 below the national average.

Anthem's HMO plans cost $16 monthly on average, $10 below the national rate, and 40% have no premium. Their out-of-pocket maximums average $6,560, which is $1,652 above the national average. PPO plans average $38 per month, $6 below the national average, though none offer $0 premiums. Maximum out-of-pocket limits for PPO plans average $7,344, or $1,078 above the national average.

Anthem's HMO and PPO plans trade below-average premiums for above-average out-of-pocket maximums. Anthem HMO-POS plans hold both numbers down at the same time, which is the plan type's primary advantage. 

The federal in-network maximum out-of-pocket limit for 2026 is $9,250, down from $9,350 in 2025. All Anthem plan type averages fall below this cap. You'll also pay the standard Medicare Part B premium of $202.90 monthly for any plan you select.

Anthem Medicare Advantage plans include supplemental benefits that Original Medicare doesn't cover. The flex card, SilverSneakers and LiveHealth Online telehealth appear across most Anthem plans, while meal delivery and transportation assistance depend on the plan and market.

• Dental and vision coverage: Anthem covers two cleanings and one dental exam annually, plus X-rays, and also covers fillings, bridges and dentures on certain plans. Vision benefits cover one eye exam per year, plus eyeglass or contact lens allowances. Preventive dental and vision services cost $0 on many Anthem plans.
• Hearing services: Anthem covers annual hearing exams and hearing aid fittings. Its network providers offer hearing aid benefits with allowance amounts that vary by plan.
• Anthem Benefits Prepaid Card: Anthem gives you a flex card loaded with a monthly or quarterly allowance for over-the-counter health products and qualifying household expenses including utilities for members with qualifying chronic conditions. Allowances reload each period based on your Anthem plan. Unused amounts don't roll over. The card works at participating pharmacies and retail locations.
• SilverSneakers fitness program: Anthem adds SilverSneakers membership at no extra cost. Access thousands of participating gyms and fitness centers nationwide plus virtual workout classes and the SilverSneakers GO mobile app through Anthem.
• 24/7 telehealth services: Anthem’s LiveHealth Online connects you with doctors virtually through phone or video. Virtual visits cost the same as in-office appointments for primary care and specialist consultations, and Anthem covers routine follow-ups and prescription refills through the service.
• Transportation assistance: Anthem provides an annual allowance on certain plans for one-way trips to medical appointments and pharmacies, including plan-approved locations. Coverage varies by Anthem plan.
• Meal delivery after hospitalization: Anthem provides up to seven days of home-delivered meals following discharge from a hospital or skilled nursing facility on certain plans to aid recovery transitions at no copay.

Use the table to filter plans by state and compare drug benefits, monthly premiums and MOOP limits:

*Plan availability and costs vary by location. Your actual premiums, benefits and out-of-pocket expenses may differ based on your specific circumstances, health needs and the plan you select.

Anthem suits members in its 12-state coverage area, where its MoneyGeek rating is 4.0/5. HMO and PPO plans score above their national averages. Both also average premiums below national averages, though their out-of-pocket maximums average above national levels.

Skip Anthem if your situation needs coverage outside Anthem's 12 states or a $0-premium PPO. HMO-POS members managing chronic conditions should compare against carriers whose HMO-POS plans score closer to the 4.01 national average before enrolling. Humana covers 40-plus states, UnitedHealthcare sells plans in most states, and both have separate MoneyGeek scores in our Best Medicare Advantage Plans comparison, which rates carriers on the same three-factor methodology. 

Members considering Original Medicare with a supplement can compare rated options in our Best Medicare Supplement Plans guide.

MoneyGeek analyzed Anthem Medicare Advantage plans across its 12 states using Centers for Medicare & Medicaid Services (CMS) data, scoring each plan across three factors.

• Affordability (50%): Premium and out-of-pocket costs have the most direct effect on retirement budgets. Monthly premiums for combined Part C and Part D coverage carry 30% weight, while in-network maximum out-of-pocket limits carry 20% weight. Lower premiums and MOOP amounts score higher.
• Star Ratings (40%): CMS star ratings cover care effectiveness, customer service and member satisfaction. The overall star rating combines Part C and Part D performance on a 1-to-5 scale and summarizes plan performance across many CMS quality measures.
• Availability (10%): State count reflects geographic flexibility for members who relocate.

Affordability carries the most weight because it has the most direct effect on retirement budgets; star ratings summarize plan quality; availability accounts for where coverage actually reaches.