Anthem Medicare Advantage Review (2026): Pros & Cons

Anthem offers four Medicare Advantage plan types for 2026, 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. Anthem structures its market around the plan type where its pricing advantage is strongest and adds broader coverage in areas with stronger provider networks.

Members in states with only one plan type are effectively choosing between Anthem and a competitor, not between Anthem plan types. Federal mandates for 2026 require behavioral health cost-sharing to match or improve upon Original Medicare. Insulin costs are capped with no deductible and members enrolled in the Medicare Prescription Payment Plan are automatically re-enrolled each year unless they opt out  

• 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 in emergencies.
• 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. In-network visits cost less and out-of-network care is covered at higher rates.
• Regional PPO: Anthem Regional PPO plans extend coverage across multiple states with full PPO flexibility, useful for members who travel frequently or split time between states.

Anthem has Medicare Advantage plans across multiple states, including HMO, PPO and SNP options. Plan types include HMO, HMO-POS, PPO, Regional PPO and PFFS, though availability differs by location. California has six HMO-POS plans, while 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.

Anthem Medicare Advantage plans score 3.3 to 3.89 out of 5 for 2026, based on CMS evaluations of customer service, care coordination, member satisfaction and health outcomes. HMO-POS options score below national benchmarks. 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 benchmarks, that's the cleaner signal for most members. HMO-POS plans are different. A 0.71-star gap below the national HMO-POS average of 4.01 is large enough to warrant comparison shopping against other carriers before enrolling, particularly if care coordination and chronic condition management are priorities.

Anthem's HMO-POS plans offer the strongest value, averaging $6 per month versus the $47 national average, 64% charge no premium. These plans also have the lowest out-of-pocket limits, averaging $4,544 or $528 below the national average.

HMO plans cost $16 monthly on average, $10 below the national rate and 40% have no premium. Out-of-pocket limits 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.

A $6 monthly average premium combined with a $4,544 average out-of-pocket maximum is a rare combination. Most low-premium plans trade upfront affordability for higher exposure when you use care. Anthem HMO-POS plans hold both numbers down at the same time, which is the plan type's primary advantage. 

The federal maximum out-of-pocket limit for 2026 is $9,250, down from $9,350 in 2025. All Anthem plan types fall below this cap. You'll also pay your Medicare Part B premium of $203 monthly for any plan you select.

Anthem Medicare Advantage plans include supplemental benefits that Original Medicare doesn't cover. Anthem's supplemental lineup follows a pattern common among mid-tier Medicare Advantage carriers: the flex card and fitness membership are broadly available across most plans, while higher-value benefits like meal delivery and transportation assistance are plan- and market-specific. The SilverSneakers membership and LiveHealth Online telehealth service appear across most Anthem plans.

• Dental and vision coverage: Anthem covers two cleanings and one dental exam annually, plus X-rays. Anthem also covers fillings, bridges and dentures on certain plans. Vision benefits cover one eye exam per year. Eyeglass or contact lens allowances are available through Anthem. Preventive dental and vision services cost $0 on many Anthem plans.
• Hearing services: Anthem covers annual hearing exams and hearing aid fittings. Anthem's 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. 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 through Anthem cost the same as in-office appointments for primary care and specialist consultations. Anthem covers routine follow-ups and prescription refills, plus behavioral health appointments
• 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.

Anthem offers Medicare Advantage plans across multiple states, including HMO, PPO and SNP options. Use the table to filter plans by state and compare coverage, costs and extra benefits:

*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 earns its 4.0/5 MoneyGeek rating in its 12-state coverage area. HMO and PPO plans score above their national benchmarks. Both also average premiums below national averages, a combination that's harder to find than the raw numbers suggest.

Skip Anthem if your situation needs multi-state coverage 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 and UnitedHealthcare cover 40-plus states and earn 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.

Common questions about Anthem Medicare Advantage answered below:

MoneyGeek analyzed Anthem Medicare Advantage plans nationwide 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; in-network maximum out-of-pocket limits carry 20%. Lower premiums and MOOP amounts score higher.
• Star Ratings (40%): CMS 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 predicts day-to-day plan experience better than any single metric.
• 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 predict day-to-day plan experience; availability accounts for where coverage actually reaches.