Anthem Prime (HMO-POS)
H4161-009- Primary care
- $0
- Specialist
- $0
- Inpatient hospital
- $0 per stay
- Emergency care
- $150; waived if admitted within 24 hours
- Urgent care
- $25
2026 Medicare Advantage plan details
Compare selected 2026 costs and benefits from Anthem’s consumer Summaries of Benefits. Verify your ZIP-code eligibility, care team, prescriptions, and pharmacy before enrolling.
This page is a selected summary, not a complete description of benefits. You must continue to pay your Medicare Part B premium. Review the carrier document and Evidence of Coverage for limitations, exclusions, and complete plan rules.
Side-by-side plan view
Select uses a focused network of doctors and hospitals. Confirm the exact PCP, medical group, specialists, and facilities for either plan.
| Compare | Anthem Prime (HMO-POS) | Anthem Select (HMO-POS) |
|---|---|---|
| Part D deductible | $0 | $200 on Tiers 3-5 |
| Selected Tier 1 / Tier 2 pricing | Tier 1 and Tier 2: $0, 30-day retail | Tier 1 and Tier 2: $0, 30-day retail |
| OTC allowance | $50 per quarter | $54 per quarter |
| Routine vision eyewear | $75 annual eyewear allowance | $75 annual eyewear allowance |
| Transportation | 2 one-way trips; 60-mile limit | 2 one-way trips; 60-mile limit |
Prescription costs depend on the drug, tier, pharmacy, day supply, coverage phase, Extra Help status, and plan rules. “Not highlighted” does not necessarily mean a service is excluded; consult the full plan documents.
Network before extras
Do not rely on a hospital or medical-group name alone. Confirm the exact doctor, location, medical group assignment, and plan network for the 2026 plan before enrolling.
Original carrier material
These are unchanged consumer-facing 2026 carrier documents used to prepare the selected summary above. Broker FAQs and broker-only materials are not posted.
Benefits and costs shown are selected highlights from the linked 2026 carrier material and may be subject to eligibility, network, authorization, coverage, and other plan rules. Enrollment depends on the plan’s Medicare contract renewal.
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We do not offer every plan available in your area. The organizations and number of plans we represent vary by location and eligibility. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.