ST. LOUIS–(BUSINESS WIRE)–As Medicare’s primary sales season gets under way, Anthem Blue Cross and
Blue Shield (Anthem) is emphasizing better health in Missouri through
provider collaboration agreements and new 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, and traditional HMOs for the general
population. Anthem Medicare Advantage Prescription Drug plans (MAPD)
continue to offer significant benefits not available in Original
Medicare, including dental and vision coverage and online doctor’s
“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 David McNichols, president of Anthem’s Medicare central
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 southwest Missouri
and the St. Louis area. Plans are effective Jan. 1, 2016.
Plan expansions / changes. Anthem is expanding its $0 premium
MAPD Medicare Dual-Eligible Special Needs Plan, also known as a DSNP,
called Anthem MediBlue Dual Advantage (HMO SNP), and its $0 premium MAPD
traditional HMO plan called Anthem MediBlue Plus (HMO) in the following
12 Missouri counties: Barry, Dade, Dallas, Douglas, Franklin, Jasper,
Lawrence, Newton, Ozark, Polk, Webster and Wright. 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 year.
Anthem also has reduced the copayments for visits to participating
primary care physicians on most of its Missouri MA plans to encourage
members to take advantage of preventive care and wellness benefits.
Provider collaboration. To improve member health and lower member
costs, Anthem continues to implement provider collaboration agreements.
To date, Anthem has about 535 Missouri medical providers participating
in Medicare provider collaboration agreements, covering about 1,930 of
Online doctor’s visits. Anthem is bringing LiveHealth Online
(LHO) telehealth to its Missouri MAPD plans. Participants are encouraged
to use LHO for non-emergency situations only, such as colds, sore
throats, flu, allergies and infections. These online doctors can send
prescriptions directly to a member’s pharmacy where they may be paid by
the member’s MAPD or Medicare prescription drug plan. A summary of each
visit is created and can be forwarded to the patient’s primary care
doctor with their permission, supporting continuity of care and
collaboration among providers.
LHO also is offering behavioral health for 2016. With this additional
benefit, members can choose a qualified mental health expert and
schedule a counseling session in advance 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 nearly 300 preferred pharmacies in Missouri, including CVS,
Kroger (Gerbes, Dillons),Target and Wal-Mart (Sam’s Club).
In addition to MAPD plans, Anthem offers Medicare Supplement plans and
standalone PDP plans across all Missouri 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,” McNichols said.
For details about Anthem Medicare plans in your area, call (855)
866-4236 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
In Missouri (excluding 30 counties in the Kansas City area) Anthem Blue
Cross and Blue Shield is the trade name of RightCHOICE® Managed Care,
Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO
Missouri, Inc. RIT and certain affiliates administer non-HMO benefits
underwritten by HALIC and HMO benefits underwritten by HMO Missouri,
Inc. RIT and certain affiliates only provide administrative services for
self-funded plans and do not underwrite benefits. Independent licensees
of the Blue Cross and 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 Blue
Shield Association. Additional information about Anthem Blue Cross and
Blue Shield in Missouri is available at www.anthem.com.
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Anthem Blue Cross and Blue Shield in Missouri
Jr., (502) 889-2103