What is a premium?
- Anthem Copay For Urgent Care
- Does Anthem Cover Urgent Care
- Anthem Insurance Urgent Care Copay
- Anthem Urgent Care Ca
A premium is a set amount of money you pay each month to have health care coverage from BadgerCare Plus. To keep your BadgerCare Plus benefits, you’ll need to pay your premium monthly or all at once when you renew.
Who has to pay premiums?
You may have to pay a monthly premium if your household income before taxes is more than:
- $531 per month for one person.
- $718 per month for a family of two.
Emergency room care $200 copay/visit; deductible does not apply Covered as in-network Copay waived if admitted. Emergency medical transportation 20% coinsurance Covered as in-network None Urgent care $50 copay/visit; deductible does not apply 40% coinsurance None. Urgent Care (office setting) Copay waived if admitted. Costs may vary by site of service. 20 copay per visit Covered as In-Network Outpatient Mental/ Behavioral Health and Substance Abuse Doctor office visit $ 20 copay per visit Not covered Facility visit: Facility fees No charge Not covered Outpatient Surgery Facility fees: Hospital $ 125. Emergency room care $250 copay/visit. Deductible does not apply. Same as in-network plus excess over allowed amount. Copay waived if admitted. Emergency medical transportation No charge No charge None. Urgent care $15 copay/visit. Deductible does not apply. 20% coinsurance None.
You don’t have to pay a monthly premium if you:
- Are an Alaskan native or American Indian.
- Were homeless at any point in the last 12 months.
- Were in a medical institution for at least 30 days.
- Have a disability.
How much is the monthly premium?
Anthem Copay For Urgent Care
$8 per household
You can lower your monthly premium to as low as $4 per household by taking an optional health survey. Learn more about the survey below.
How do I pay my premium?
Your monthly premium will be due on the 10th of every month. ForwardHealth will send you a letter before your first payment is due.
How to pay:
- On the ACCESS website
- On the MyACCESS mobile app
- Mail in a check or money order
You must pay the premium to keep your BadgerCare Plus benefits. You can pay your premium each month, or pay all of your premiums at once when you renew your benefits each year.
What if I don’t pay my premium?
Your monthly premium will be due on the 10th of every month. You can pay your premiums at any time before your yearly renewal time, or before your BadgerCare Plus coverage ends.
If you do not pay all owed premiums at your yearly renewal time or when your BadgerCare Plus coverage ends, you will not be able to re-enroll for six months. In order to reapply for benefits, you can pay all of your owed premiums, or wait for six months to apply again.
Call the 2-1-1 Helpline if you can’t pay your monthly premiums.
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Anthem MediBlue Plus (HMO) H3447-021 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Anthem HealthKeepers available to residents in Indiana. This plan includes additional Medicare prescription drug (Part-D) coverage. The Anthem MediBlue Plus (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $4,400 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $4,400 out of pocket. This can be a extremely nice safety net.
Anthem MediBlue Plus (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.
Anthem HealthKeepers works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Anthem MediBlue Plus (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Anthem HealthKeepers and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Anthem HealthKeepers except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST
2021 Anthem HealthKeepers Medicare Advantage Plan Costs
| Name: | |
|---|---|
| Plan ID: | H3447-021 |
| Provider: | Anthem HealthKeepers |
| Year: | 2021 |
| Type: | Local HMO |
| Monthly Premium C+D: | $0 |
| Part C Premium: | $0 |
| MOOP: | $4,400 |
| Part D (Drug) Premium: | $0 |
| Part D Supplemental Premium | $0 |
| Total Part D Premium: | $0 |
| Drug Deductible: | $0 |
| Tiers with No Deductible: | 0 |
| Gap Coverage: | Yes |
| Benchmark: | not below the regional benchmark |
| Type of Medicare Health: | Enhanced Alternative |
| Drug Benefit Type: | Enhanced |
| Similar Plan: | H3447-022 |
Anthem MediBlue Plus (HMO) Part-C Premium
Anthem HealthKeepers plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H3447-021 Part-D Deductible and Premium
Anthem MediBlue Plus (HMO) has a monthly drug premium of $0 and a $0 drug deductible. This Anthem HealthKeepers plan offers a $0 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Anthem HealthKeepers above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Anthem HealthKeepers Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Anthem HealthKeepers plan does offer additional coverage through the gap.
H3447-021 Formulary or Drug Coverage
Anthem MediBlue Plus (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
2021 Anthem MediBlue Plus (HMO) Summary of Benefits
Additional Benefits
| No |
|---|
Comprehensive Dental
| Diagnostic services | Not covered |
|---|---|
| Endodontics | Not covered |
| Extractions | Not covered |
| Non-routine services | Not covered |
| Periodontics | Not covered |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
| Restorative services | Not covered |
Deductible
| $0 |
|---|
Diagnostic Tests and Procedures
| Diagnostic radiology services (e.g., MRI) | $140-225 copay |
|---|---|
| Diagnostic tests and procedures | $0-160 copay |
| Lab services | $0-10 copay |
| Outpatient x-rays | $50-120 copay |
Doctor Visits
| Primary | $5 copay per visit |
|---|---|
| Specialist | $40 copay per visit |
Emergency care/Urgent Care
| Emergency | $90 copay per visit (always covered) |
|---|---|
| Urgent care | $35 copay per visit (always covered) |
Foot Care (podiatry services)
| Foot exams and treatment | $0-40 copay |
|---|---|
| Routine foot care | $0 copay |
Ground Ambulance
| $295 copay |
|---|
Hearing
| Fitting/evaluation | $0 copay |
|---|---|
| Hearing aids | $0 copay |
| Hearing exam | $40 copay |
Inpatient Hospital Coverage
| $295 per day for days 1 through 7 $0 per day for days 8 through 90 |
|---|
Medical Equipment/Supplies
| Diabetes supplies | $0 copay |
|---|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | 0-20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
Medicare Part B Drugs
| Chemotherapy | 20% coinsurance |
|---|---|
| Other Part B drugs | 20% coinsurance |
Mental Health Services
| Inpatient hospital - psychiatric | $210 per day for days 1 through 8 $0 per day for days 9 through 90 |
|---|---|
| Outpatient group therapy visit | $40 copay |
| Outpatient group therapy visit with a psychiatrist | $40 copay |
| Outpatient individual therapy visit | $40 copay |
| Outpatient individual therapy visit with a psychiatrist | $40 copay |
MOOP
| $4,400 In-network |
|---|
Option
| No |
|---|
Optional supplemental benefits
| Yes |
|---|
Outpatient Hospital Coverage
| $0-275 copay per visit |
|---|
Package #1
| Deductible | |
|---|---|
| Monthly Premium | $15.00 |
Package #2
| Deductible | |
|---|---|
| Monthly Premium | $26.00 |
Package #3
| Deductible | |
|---|---|
| Monthly Premium | $51.00 |
Preventive Care
| $0 copay |
|---|
Preventive Dental
| Cleaning | $0 copay |
|---|---|
| Dental x-ray(s) | $0 copay |
| Fluoride treatment | $0 copay |
| Oral exam | $0 copay |
Rehabilitation Services
| Occupational therapy visit | $35 copay |
|---|---|
| Physical therapy and speech and language therapy visit | $35 copay |
Skilled Nursing Facility
| $0 per day for days 1 through 20 $184 per day for days 21 through 100 |
|---|
Transportation
| $0 copay |
|---|
Vision
| Contact lenses | $0 copay |
|---|---|
| Eyeglass frames | $0 copay |
| Eyeglass lenses | $0 copay |
| Eyeglasses (frames and lenses) | $0 copay |
| Other | Not covered |
| Routine eye exam | $0 copay |
| Upgrades | Not covered |
Wellness Programs (e.g. fitness nursing hotline)
| Covered |
|---|
Reviews for Anthem MediBlue Plus (HMO) H3447
| 2019 Overall Rating |
|---|
| Part C Summary Rating |
| Part D Summary Rating |
| Staying Healthy: Screenings, Tests, Vaccines |
| Managing Chronic (Long Term) Conditions |
| Member Experience with Health Plan |
| Complaints and Changes in Plans Performance |
| Health Plan Customer Service |
| Drug Plan Customer Service |
| Complaints and Changes in the Drug Plan |
| Member Experience with the Drug Plan |
| Drug Safety and Accuracy of Drug Pricing |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating |
|---|
| Breast Cancer Screening |
| Colorectal Cancer Screening |
| Annual Flu Vaccine |
| Improving Physical |
| Improving Mental Health |
| Monitoring Physical Activity |
| Adult BMI Assessment |
Managing Chronic And Long Term Care for Older Adults
| Total Rating |
|---|
| SNP Care Management |
| Medication Review |
| Functional Status Assessment |
| Pain Screening |
| Osteoporosis Management |
| Diabetes Care - Eye Exam |
| Diabetes Care - Kidney Disease |
| Diabetes Care - Blood Sugar |
| Rheumatoid Arthritis |
| Reducing Risk of Falling |
| Improving Bladder Control |
| Medication Reconciliation |
| Statin Therapy |
Member Experience with Health Plan
| Total Experience Rating |
|---|
| Getting Needed Care |
| Customer Service |
| Health Care Quality |
| Rating of Health Plan |
| Care Coordination |
Member Complaints and Changes in Anthem MediBlue Plus (HMO) Plans Performance
| Total Rating |
|---|
| Complaints about Health Plan |
| Members Leaving the Plan |
| Health Plan Quality Improvement |
| Timely Decisions About Appeals |
Health Plan Customer Service Rating for Anthem MediBlue Plus (HMO)
| Total Customer Service Rating |
|---|
| Reviewing Appeals Decisions |
| Call Center, TTY, Foreign Language |
Anthem MediBlue Plus (HMO) Drug Plan Customer Service Ratings
| Total Rating |
|---|
| Call Center, TTY, Foreign Language |
| Appeals Auto |
| Appeals Upheld |
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating |
|---|
| Complaints about the Drug Plan |
| Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement |
Does Anthem Cover Urgent Care
Member Experience with the Drug Plan
| Total Rating |
|---|
| Rating of Drug Plan |
| Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
| Total Rating |
|---|
| MPF Price Accuracy |
| Drug Adherence for Diabetes Medications |
| Drug Adherence for Hypertension (RAS antagonists) |
| Drug Adherence for Cholesterol (Statins) |
| MTM Program Completion Rate for CMR |
| Statin with Diabetes |
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST
Coverage Area for Anthem MediBlue Plus (HMO)
(Click county to compare all available Advantage plans)
| State: | Indiana |
|---|---|
| County: | Adams,Allen,Carroll,Cass,Clay, Clinton,Crawford,Daviess,De Kalb, Dearborn,Delaware,Dubois,Fayette, Franklin,Gibson,Grant,Greene, Howard,Huntington,Knox,Lawrence, Martin,Miami,Monroe,Noble, Ohio,Orange,Owen,Parke, Pike,Posey,Ripley,Spencer, Steuben,Sullivan,Tipton,Union, Vanderburgh,Vermillion,Vigo,Wabash, Warrick,Wayne,Wells,Whitley, |
Anthem Insurance Urgent Care Copay
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Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.