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Anthem Blue Cross and Blue Shield
PW_E179236
2012 Medicare Advantage Summary of Benefits (SOB), Evidence of Coverage (EOC) and Formularies for Individual Medicare Advantage Products. If the product you are searching for is not on the list below, then please call the number on the back of the member’s ID card for EOC, SOB, and Formulary information.
Colorado
SureValue Basic (HMO)
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Anthem Medicare Preferred Core (PPO)
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Anthem Medicare Preferred Premier (PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Connecticut
MediBlue Plus (HMO)
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Anthem Medicare Preferred Standard (PPO)
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Indiana
Anthem Medicare Preferred Standard (PPO)
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Anthem Medicare Preferred Select (PPO)
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Blue Medicare Access Value (Regional PPO)
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Blue Medicare Access Standard (Regional PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Kansas
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Value (PDP)
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Blue MedicareRx Plus (PDP Kansas City KS)
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Blue MedicareRx Premier (PDP Kansas City KS)
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Blue MedicareRx Value (PDP Kansas City KS)
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Kentucky
Anthem Senior Advantage Complete (HMO)
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Anthem Senior Advantage Value (HMO)
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Anthem Medicare Preferred Standard (PPO)
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Anthem Medicare Preferred Select (PPO)
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Blue Medicare Access Value (Regional PPO)
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Blue Medicare Access Standard (Regional PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Maine
Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Missouri
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Anthem Medicare Preferred Core (PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Value (PDP)
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Blue MedicareRx Plus (PDP Kansas City MO)
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Blue MedicareRx Premier (PDP Kansas City MO)
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Blue MedicareRx Value (PDP Kansas City MO)
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Nevada
Anthem Medicare Preferred Core (PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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New Hampshire
Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Ohio
Anthem Senior Advantage Basic (HMO)
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Anthem Senior Advantage Plus (HMO)
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Anthem Senior Advantage Value (HMO)
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Anthem Medicare Preferred Standard (PPO)
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Anthem Medicare Preferred Select (PPO)
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Blue Medicare Access Classic* (Regional PPO)
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Blue Medicare Access Value (Regional PPO)
*No Part D is sold with this product
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Standard (PDP)
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Virginia
Anthem Medicare Preferred Standard (PPO)
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Anthem Medicare Preferred Premier (PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Wisconsin
Anthem Medicare Preferred Core (PPO)
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Anthem Medicare Preferred Select (PPO)
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Blue MedicareRx Plus (PDP)
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Blue MedicareRx Premier (PDP)
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Blue MedicareRx Standard (PDP)
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Additional Part D Forms
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