SOUTH PORTLAND, Maine–(BUSINESS WIRE)–As Medicare’s primary sales season gets under way, Anthem Blue Cross and
Blue Shield (Anthem) is emphasizing better health in Maine through
provider collaboration agreements and Medicare Advantage plans with
This includes provider collaboration plans in some areas as well as
expanding Dual-Eligible Special Needs Plans (DSNPs) for people eligible
for both Medicare and Medicaid. Anthem Medicare Advantage Prescription
Drug plans (MAPD) continue to offer significant benefits not available
in Original Medicare, including dental and vision coverage and online
“Even with the Medicare reimbursement environment changing, we think
it’s critical to structure our plans to provide our members with real
value over Original Medicare, including extra benefits and strong local
alliances,” said John Caby, president of Anthem’s Medicare east region.
Following are some specifics on Anthem MAPD plans that will be available
for the Annual Election Period, or AEP, which begins Oct. 15 and
continues through Dec. 7. Anthem offers MAPD plans in all but one Maine
county (Aroostook). Plans are effective Jan. 1, 2016.
Expansion plans. Anthem is expanding its $0 premium MAPD
Dual-Eligible Special Needs plan called Anthem MediBlue Dual Advantage
(HMO SNP) and a traditional $0 premium HMO plan called Anthem MediBlue
Plus (HMO) to Knox County for 2016. Like existing Anthem special needs
plans in the state, the DSNP includes dental and vision coverage, some
transportation to doctor’s appointments, some over-the-counter drug
costs and a fitness program, all at no extra cost. Unlike most plans,
people who qualify for a DSNP have a continuous Special Election Period,
which means they can elect to join a new plan at any time throughout the
Provider collaboration. To improve member health and lower member
costs, Anthem continues to implement provider collaboration agreements.
Online doctor’s visits. LiveHealth Online (LHO) telehealth will
continue to be available in Anthem’s Maine MAPD plans. LHO allows
members to access board-certified doctors through their computer or
mobile device, and will include a behavioral health benefit effective
Jan. 1, 2016. With this additional benefit, members can generally choose
a qualified mental health expert and schedule a counseling session in
advance to be held during available hours. (Those in crisis should call
911). Both seeing a doctor and counseling visits are available at a $0
copay to eligible members.
More $0 generics. Anthem is enhancing its Medicare pharmacy
benefits in 2016. Both Prescription Drug Plans (PDP) and MAPD plans will
feature a “Select Tier” with selected generic drugs for a $0 copay at
preferred pharmacies, including some drugs that treat high blood
pressure, high cholesterol and diabetes. Anthem also has several PDP
plans that offer certain generics in the coverage gap for a $0 copay.
Anthem has more than 100 preferred pharmacies in Maine, including
CVS/pharmacy, Hannaford, Target and Wal-Mart (Sam’s Club).
New Plan Names. As part of its initiative of being easier to do
business with, Anthem has introduced a standard nomenclature nationwide
to its individual MAPD plans. This includes Anthem MediBlue Dual
Advantage (HMO SNP) for DSNPs, Anthem MediBlue Plus (HMO) for HMOs, and
Anthem MediBlue Access (PPO) for PPOs.
In addition to MAPD plans, Anthem offers Medicare Supplement plans and
standalone PDP plans across all Maine counties. Medicare Supplement
plans help cover costs Original Medicare doesn’t, such as copayments,
coinsurance and deductibles. These plans offer access to any doctor or
medical facility that accepts Medicare, generally for a higher premium
than an MAPD. They are generally paired with a PDP.
“We pride ourselves in being one of the nation’s only insurers that can
offer a full continuum of Medicare products, including something for
every budget and lifestyle,” Caby said.
For details about Anthem Medicare plans in your area, call (855)
866-4320 or visit Anthem’s Medicare online store at www.anthem.com/shop.
Anthem will be holding educational events and home visits throughout AEP.
Anthem is a PPO plan, an HMO plan and a PDP with a Medicare contract.
Enrollment in Anthem depends on contract renewal. This information is
not a complete description of benefits. Contact the plan for more
information. Limitations, copayments, and restrictions may apply.
Benefits, premiums and/or co-payments/co-insurance may change on Jan. 1
of each year. The formulary, pharmacy network, and/or provider network
may change at any time. You will receive notice when necessary.
You must continue to pay your Medicare Part B premium.
This plan is available to anyone who has both Medical Assistance from
the State and Medicare. Premiums, co-pays, co-insurance and deductibles
may vary based on the level of Extra Help you receive. Please contact
the plan for further details.
About Anthem Blue Cross and Blue Shield
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health
Plans of Maine, Inc., and an independent licensee of the Blue Cross Blue
Shield Association. ANTHEM is a registered trademark of Anthem Insurance
Companies, Inc. The Blue Cross and Blue Shield names and symbols are
registered marks of the Blue Cross and Blue Shield Association.
Additional information about Anthem Blue Cross and Blue Shield in Maine
is available at www.anthem.com.
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Anthem Blue Cross and Blue Shield in Maine
Doug Bennett Jr.,