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Anthem Extra Help (HMO-POS) - H3447-028-000

3.5 out of 5 stars* for plan year 2025

$8.10

Monthly Premium

Anthem Extra Help (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Anthem HealthKeepers

Plan ID: H3447-028-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$8.10

Monthly Premium

Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Virginia Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Compare plans today.

Speak with a licensed insurance agent

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Enrollment may be limited to certain times of the year. See why you may be able to enroll.

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$8.10
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$590.00
Out-of-pocket maximum$2,900.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$2,000.00
Primary care doctor visitIn-Network:
$0.00 copay
Specialty doctor visitIn-Network:
$25.00 copay
Inpatient hospital careIn-Network:
Days 1-5: $300.00 per day, per admission / Days 6-90: $0.00 per day, per admission
Urgent careUrgent Care: $25.00 copay
Emergency room visitEmergency Care: $140.00 copay
Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000 per year.
Ambulance transportationGround Ambulance: $300.00 copay Per Trip
Air Ambulance: 20% coinsurance

Health Care Services and Medical Supplies

Anthem Extra Help (HMO-POS) covers a range of additional benefits. Learn more about Anthem Extra Help (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic servicesIn-Network:
Medicare Covered Chiropractic Services: $20.00 copay
Diabetes supplies, training, nutrition therapy and monitoringIn-Network:
Diabetic Supplies: $0.00 copay
Durable medical equipment (DME)In-Network:
20% coinsurance
Diagnostic tests, lab and radiology services, and X-raysIn-Network:
Lab Services: $0.00 copay
X-Rays: $20.00 copay - $90.00 copay
Therapeutic Radiological Services: 20% coinsurance
Outpatient Diagnostic Procedures/Tests: $0.00 copay - $100.00 copay
Diagnostic Radiological Services: $20.00 copay - $300.00 copay
Home health careIn-Network:
$0.00 copay
Mental health inpatient careIn-Network:
Days 1-5: $300.00 per day, per admission / Days 6-90: $0.00 per day, per admission
Mental health outpatient careIn-Network:
Individual and Group Sessions: $40.00 copay
Outpatient services/surgeryIn-Network:
Outpatient Hospital - Surgery: $300.00 copay
Observation Services: $300.00 copay
Ambulatory Surgical Center: $250.00 copay
Outpatient substance abuse careIn-Network:
Individual and Group Sessions: $40.00 copay
Over-the-counter itemsThis plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $110 every quarter. Unused OTC amounts do roll over to the next quarter. Unused OTC amounts expire at the end of the calendar year.
Podiatry servicesIn-Network:
Medicare Covered Podiatry Services: $0.00 copay - $25.00 copay
Routine Foot Care: $0.00 copay
6 routine foot care visit(s) each year.
Skilled Nursing Facility (SNF) careIn-Network:
Days 1 - 20: $0.00 per day / Days 21 - 100: $214.00 per day

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental careIn-Network and POS (Out-of-Network):
This plan covers up to a $3,000 allowance for covered preventive and comprehensive dental services every year.

In-Network:
Medicare Covered Dental: $0.00 copay
Preventive Dental Services: $0.00 copay
Comprehensive Dental Services: $0.00 copay

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

CoverageDetails
Vision careIn-Network:
Medicare Covered Eye Exam: $0.00 copay - $25.00 copay
Routine Eye Exam: $0.00 copay
This plan covers 1 routine eye exam(s) every year.
Medicare Covered Eye Wear: $0.00 copay
Routine Eye Wear: $0.00 copay
This plan covers up to $300 for eyeglasses or contact lenses every year.

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing careIn-Network:
Medicare Covered Hearing Exam: $25.00 copay
Routine Hearing Exam: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount.
This plan covers 1 routine hearing exam every year. $300 maximum plan benefit for over-the-counter hearing aids OR 1 routine hearing aid fitting evaluation and a $3,000 maximum plan benefit for prescribed hearing aids every year.

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Preventive services and health/wellness education programsIn-Network:
$0.00 copay for Medicare Covered Preventive Services

Prescription Drug Costs and Coverage

The Anthem Extra Help (HMO-POS) offers prescription drug coverage, with an annual drug deductible of $590.00 (excludes Tiers 1 and 6)

Coverage & Cost
Coverage
Cost
Annual drug deductible$590.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $0.00
  • Standard mail order $0.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00
Annual drug deductible$590.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $0.00
  • Standard mail order $0.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00
Annual drug deductible$590.00 (excludes Tiers 1 and 6)
Tier 1
  • Standard retail $0.00
  • Standard mail order $0.00
Tier 6
  • Standard retail $0.00
  • Standard mail order $0.00

When reviewing Virginia Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Virginia that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

Virginia Counties Served

We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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