Medicare Advantage · C-SNP · HMOPOS · 2027
Anthem Kidney Care (HMO-POS C-SNP)
No referral needed to see a specialist
At a glance: $0 monthly premium and $0 primary care visits.
Eligibility required for this C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Chronic kidney disease. See who can enroll
- Monthly premium
- $0
- Part B premium separate
- Yearly limit
- $6,100
- Most you’d pay for in-network care
- Hearing
- $2,000/yr
- Hearing aid allowance
- Doctor visits
- $0
- Primary care · specialists $40
Check this plan for you
Add your doctors and prescriptions to see how they work with this plan.
- HearingHearing aid allowance
- $2,000/yr
- DentalPreventive & comprehensive dental allowance
- $1,800/yr
- OTC allowance
- $110/quarter
- VisionEyewear allowance
- $225/yr
- Fitness$0 fitness benefit
- Included
- Transportation120 one-way trips/year
- Included
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Enter your ZIP code to see how you can enroll
Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.
Who can enroll
Eligibility for this Special Needs Plan
Eligibility required for this C-SNP
The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Chronic kidney disease. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.
Extra benefits for members who qualify
- $50/month food and produce allowance
- $150/quarter general supports for living
These benefits are not available to every member. Even if you have a listed chronic condition, the plan must confirm that you meet its coverage criteria. See the Evidence of Coverage for complete rules.
Costs and copays
Deductibles, yearly limit, visits, hospital stays and drug tiers
- DeductiblesMedical · $700 for drugs
- $0
- Yearly limitIn-network care, not counting drugs
- $6,100
- Primary doctorPer visit
- $0
- SpecialistPer visit · no referral needed
- $40
- Hospital stayNo limit on covered hospital days
- Days 1-5: $325/day, Days 6-90: $0/day
- Inpatient mental healthNo limit on covered hospital days
- Days 1-5: $325/day, Days 6-90: $0/day
- Outpatient surgeryPer procedure
- $325
- Emergency roomPer visit
- $130
- Urgent carePer visit
- $50
- Tier 1 · Preferred Generic30-day supply at a retail pharmacy
- $0
- Tier 2 · Generic30-day supply at a retail pharmacy
- $0
- Tier 3 · Preferred Brand30-day supply at a retail pharmacy, after deductible
- 25%
- Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy, after deductible
- 26%
- Tier 5 · Specialty30-day supply at a retail pharmacy, after deductible
- 25%
Our take
Where this plan shines, and what to know
Where this plan shines
- This plan has a $0 monthly premium.
- See your primary doctor for $0.
- No separate medical deductible.
- Some out-of-network care is covered (HMO-POS).
Things to know before you enroll
- This plan’s out-of-pocket maximum is above the national median.
- Limited coverage while traveling outside the plan’s service area.
Similar plans
Other Medicare Advantage plans offered in Virginia
Browse the full 2027 Chronic Condition Special Needs Plan directory. This plan is offered in Virginia. Plan availability can vary by county.
More Chronic Condition Special Needs Plan options
These plans are offered in at least one of the same states. Check your ZIP or county before choosing a plan.
- Anthem Chronic Care (HMO-POS C-SNP)Anthem HealthKeepers · H3447-037Offered in Virginia
- DEVOTED C-SNP ENHANCED 003 VA (HMO C-SNP)Devoted Health · H6994-003Offered in Virginia
- DEVOTED C-SNP ENHANCED 010 VA (HMO C-SNP)Devoted Health · H6994-010Offered in Virginia
- DEVOTED C-SNP ENHANCED 013 VA (HMO C-SNP)Devoted Health · H6994-013Offered in Virginia
- DEVOTED C-SNP GIVEBACK EXTRAS 026 VA (HMO C-SNP)Devoted Health · H6994-026Offered in Virginia
- DEVOTED C-SNP GIVEBACK EXTRAS 027 VA (HMO C-SNP)Devoted Health · H6994-027Offered in Virginia
Common questions
6 answers about this plan
What does Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) cover?
Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) is a Chronic Condition Special Needs Plan, a Medicare Advantage plan for people whose qualifying condition the plan verifies, including end stage renal disease. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 5 formulary tiers. Published supplemental benefits include dental ($1,800/yr preventive & comprehensive dental allowance), vision ($225/yr eyewear allowance), hearing ($2,000/yr hearing aid allowance), and over-the-counter (OTC) ($110/quarter OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) cost in 2027?
The published 2027 monthly plan premium for Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) is $0. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $700. The in-network medical out-of-pocket maximum is $6,100; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $40. These figures are plan data, not a personal yearly-cost estimate.
Understand Medicare drug-cost limitsCan I use my current doctors with Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS)?
CMS lists Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) as a HMOPOS plan. The plan record says specialist referrals are not required. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.
Check your doctorsWhat chronic conditions qualify for Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS)?
Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) is listed in the current plan record as a C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Chronic kidney disease. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.
Learn about Special Needs PlansHow does Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) coordinate care for my chronic condition?
Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) is identified in the current plan record as a Chronic Condition Special Needs Plan for qualifying conditions that include Chronic kidney disease. The record also lists dental ($1,800/yr preventive & comprehensive dental allowance), vision ($225/yr eyewear allowance), and hearing ($2,000/yr hearing aid allowance). The data on this page does not describe a personal care plan or promise a specific care coordinator. Review the Evidence of Coverage and ask the plan how its model of care, provider communication, and medication support apply to your verified condition.
When can I enroll in Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS)?
Anthem Kidney Care (HMO-POS C-SNP) (HMOPOS) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a C-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsPlan documents
Summary of Benefits and Evidence of Coverage
- Summary of Benefits (PDF)Download the plan's official Summary of Benefits document
- Evidence of Coverage (PDF)Complete plan details and rules
- Check Your DoctorsSee if your doctors accept this plan
- Documentos en españolLlame a The Pocket Protector al 1-866-764-3312 (TTY: 711) para recibir ayuda con documentos en español
Enter your ZIP code to see how you can enroll
Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.
