[October 01, 2015]

Anthem Blue Cross and Blue Shield Emphasizes Better Health through New Medicare Advantage Plans in Missouri, Provider Collaboration, Extra Benefits

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 extra benefits.

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 visits.

"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 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 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 its members.

Online doctor's visits. Anthem is bringing LiveHealth Online (LHO) telehealth to its Missouri MAPD plans. Participants are encouraged to use LHO for non-emrgency 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 (News - Alert) 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. Also follow us on Twitter (News - Alert) at www.twitter.com/AskAnthem or on Facebook (News - Alert) at www.facebook.com/AskAnthem.

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