Medicare Advantage Providers
Anthem offers a variety of Medicare plans to support member needs. We also support our providers with access to information about our plans and member benefits, news and updates, training materials and guides and other helpful resources.
Plans & Benefits
To search for evidence of coverage (EOC), summary of benefits (SOB) and Formulary documents for our Individual Medicare Advantage products please visit our Medicare Advantage Plans page. If the product you are searching for is not listed, please call the number on the back of the member’s ID card.
GRS Hearing Aid Coverage Update
Effective January 01, 2022
Many Group Retiree Solutions (GRS) plans now include the requirement that all hearing aids be supplied by Hearing Care Solutions (HCS).
If you are not an HCS provider and are going to fit a patient for a hearing aid, first verify the member’s out-of-network benefits and then follow the protocol outlined in the following document:
Medicare Advantage Updates
Stay current on the latest news and changes with these important Medicare Advantage updates.
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Provider Guides & Forms
Make use of these helpful resources to assist you when working with our Medicare Advantage products and patient claims
HMO & PPO Provider Guidebook
Important information about credentialing, reimbursement, appeals, and more.
Member ID Card Samples
Examples of member identification cards to familiarize yourself with the format.
Provider Forms
A library of forms related to Medicare Advantage and doing business with Anthem.
Featured Videos
As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play.
Individual Plans & Employer Group Plans
Anthem reimbursement policies outline the basis for reimbursement for services covered by a member’s benefit plan and serve as a guide to assist you in accurate claims submission.
Medicare Advantage PPO members of non-Anthem Blue Plans should utilize our Medicare Advantage reimbursement policies. There are five reimbursement policies that only apply to MA PPO members of non-Anthem Blue Plans. These policies have been listed as MA PPO.
Ready to become a provider in the Anthem network?
We look forward to working with you to provide quality service for our members.
Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place.