Anthem Medicare Part D Review

Licensed Insurance Agent and Medicare Expert Writer
December 11, 2019

Preferred Pharmacies:

  • Kroger
  • Rite Aid
  • Walmart
  • WellPoint NextRx

Anthem has a Medicare Rating of 4 out of 5 stars1 and is one of 36 companies in the Blue Cross Blue Shield (BCBS) network but serves nearly 15% of BCBS Part D enrollees across 14 states.2,3 Anthem also offers Medicare Advantage and Medicare Supplement plans.

Meanwhile, Anthem Part D plans achieve high Medicare Star Ratings from the Centers of Medicare and Medicaid Services (CMS).4 In short, if you live in Anthem territory, you could find a quality plan with this insurer.

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States Anthem serves

  • California
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • New Hampshire
  • Nevada
  • New York
  • Ohio
  • Virginia
  • Wisconsin

Who might want an Anthem Part D plan?

  • Kroger, Walmart, and Rite Aid customers: These preferred pharmacies offer Anthem’s lowest copayments.
  • People who want a $0 deductible: Anthem Blue Cross MedicareRx Plus (PDP) coverage kicks in right away.
  • Fans of Blue Cross Blue Shield: Anthem is 1 of 36 companies in the Blue Cross Blue Shield network.
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Anthem Part D prescription drug plans

When we sampled Anthem’s Medicare Part D prescription drug coverage, we found the company offers three Part D plans. Many other companies offer three or more plans, so Anthem is right up there in terms of choices.

If choosing between these three plans, look past their premiums. Instead, which plan is right for you—and how much you'll end up paying under a certain plan—largely depends on the specific medications you take.

Anthem Part D sample rates

Anthem MediBlueRx Standard (PDP)
AnthemMediBlue Rx Plus (PDP)
Anthem MediBlue Rx Enhanced (PDP)

Sample location

Manchester, NH 03111

Manchester, NH 03111

Manchester, NH 03111

Deductible

$400

$0

$300

Tier 1 (preferred generics)

$1

$1

$1

Tier 2 (generic drugs)

$3

$3

$2

Tier 3 (preferred brand drugs)

$32

$40

20%

Tier 4 (non-preferred brand drugs)

40%

42%

37%

Tier 5 (specialty drugs)

25%

33%

25%

Sample plan #

S5596-046

S5596-001

S5596-066

Sample plans based on anthem.com and are for illustration purposes only. Assumes prescriptions filled by a preferred retail pharmacy with a 30-day supply. Actual plans may vary. Data effective 12/11/19.


Input your drugs into Anthem’s drug formulary tool to find out which tiers they fall into.


Anthem Blue MedicareRx Standard (PDP)

In the location we sampled (Manchester, New Hampshire), this plan comes with a $400 deductible. For Tiers 2 through 5, you’ll need to pay the full $400 before your benefits kick in, whereas Tier 1 drugs are immediately covered. Once you reach the deductible, you could pay just $3 for a 30-day supply of Tier 2 prescriptions. Prices jump if you don’t use one of Anthem’s preferred pharmacies, however. Tier 1 drugs rise to $11; Tier 2 drugs go from $3 to $12.

If you take Tier 3, 4, or 5 medications, the cost difference between preferred and non-preferred pharmacies lessens. In fact, this plan's higher-tier drugs are cheaper than with Anthem's MediBlue Rx Plus (PDP) plan.

If you take a lot of high-tier drugs and those costs quickly surpass the $400 deductible, the Anthem Blue Medicare Rx Standard (PDP) plan could be a solid choice for you.

Anthem Blue Cross MedicareRx Plus (PDP)

This plan comes with a $0 deductible, so you’ll start saving on your prescriptions immediately. That's a relief for a lot of people, since it eliminates having to shell out more money for medications at the beginning of each year.

For medications in Tiers 1, 2, and 4, costs sit as low or lower than with Anthem’s standard plan. If you take drugs in Tiers 3 or 5, however, you may have higher costs with this plan.

The MediBlue Rx Plus (PDP) plan could be a good choice for you if you expect your annual drug costs won’t reach $400 or you take mostly Tier 1, 2, and 4 medications.

Anthem MediBlue Rx Enhanced (PDP)

Although the deductible for this plan is $300, it doesn't apply to Tier 1 and Tier 2 drugs. Once that deductible is met, Anthem covers a higher portion of Tier 3, 4, and 5 drugs than its two other plans. Additionally, out of the three plans we sampled, this one had the lowest premium by thirty dollars.

If all that sounds too good to be true, keep in mind that this plan is only really best if it covers your medications the best. The only way to know for sure is to enter them into Anthem's formulary and find out.

In general, if you rely mainly on generics, Anthem's MediBlue Rx Enhanced (PDP) plan may be a good fit for you.

Bottom Line: High-rated plans, limited by location

Pay close attention to which tiers your medications fall in to save the most with Anthem.

If you live in a state Anthem serves, you could have prescription drug coverage options with high Medicare Star Ratings. Anthem's two plans fit some people better than others. Whether they fit you will depend mainly on which tiers your medications fall into.

And, of course, another deciding factor could be how much each plan costs in your area. Weigh costs carefully, and don’t forget to factor in premiums, deductibles, and out-of-pocket costs at the pharmacy.

Want help finding the right Medicare Part D prescription drug coverage for you? Licensed sales agents can help.

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Want to learn more?

Still have questions? Check out these other pages and learn more about Anthem and the Medicare Part D program.

Anthem Medicare FAQ

Is a Part D plan right for me?

There's no one-size-fits-all Medicare plan, and what's right for your spouse, friend, or other consumers may not be right for you. That’s why we recommend making your own choice when it comes to the Medicare program.

Choosing the right plan—Part C, Part D, or Medigap—can be tough if you don’t understand the parts of Medicare, so browse the recommended links above to learn more about Medicare.

Does Anthem offer other kinds of Medicare health insurance too?

Anthem offers Medicare Advantage (MA) health insurance with its Anthem MediBlue SNP, HMO, and PPO MA plans. This insurer also offers Medicare Supplement (Medigap) plans, which you can add to Original Medicare.

When can I enroll in a Part D plan?

Most people enroll during their Initial Enrollment Period (IEP), which begins three months before they become eligible for Medicare and runs for seven months.

If you miss that period, you can wait until the fall Annual Enrollment Period (AEP) October 15 through December 7. Or you can use a Special Enrollment Period (SEP), if you qualify for one.

Learn more about Medicare Enrollment Periods.


Sources

1. Center for Medicare and Medicaid Services, “Part C and D Performance Data
2. Center for Medicare and Medicaid Services, “Enrollment by Contract
3. Kaiser Family Foundation, “Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing
4. Center for Medicare and Medicaid Services, “Part C and D Performance Data

Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.

Written by
Kat Casna
Kathryn is a Medicare and geriatric specialist who has appeared on Baby Boomers, OppLoans, and Best Company. Her readers don’t need a degree in government-speak to get the right coverage because Kathryn sifts through Medicare’s parts, plans, and premiums to distill only the most useful information. Her favorite place in the world is a hammock that swings peacefully between two crabapple trees somewhere in New Mexico’s Gila National Forest.
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