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Legal

CMS Disclaimer

Non-Discrimination Notice: The plan documents may be available in other languages. Or, if you have special needs, the documents may be available in other formats. Please review the Notice of Non-Discrimination in Health Programs and Activities and call Customer Service for details. For Anthem HealthKeepers plans, review the Notice of Non-Discrimination in Health Programs and Activities and call Customer Service for details.


Anthem Blue Cross and Blue Shield and its affiliate Anthem HealthKeepers is a Medicare Advantage plan with a Medicare contract. Anthem Blue Cross and Blue Shield is a Prescription Drug Plan with a Medicare contract. For Dual-Eligible Special Needs Plans: Anthem Blue Cross and Blue Shield is a Medicare Advantage plan with a Medicare contract and a contract with the state Medicaid programs. Enrollment in Anthem Blue Cross and Blue Shield 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 January 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. For Dual-Eligible Special Needs Plans: This plan is available to anyone who has both Medical Assistance from the State and Medicare.


Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call our Customer Service number, (TTY: 711).


ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a nuestro número de Servicio de Atención al Cliente (TTY: 711).


注意:如果您使用非英語的其他語言,您可以免費獲得語言援助服務。請致電聯絡客戶服務部(聽語障用戶請致電:711)。

Grievances and Appeals Disclaimer

Evidence of Coverage Disclaimer

Evidence of Coverage:

Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits. If you have special needs, our Plan documents may be available in other formats. Please call Customer Care for details.

For information on provisions for non routine access to covered Part D drugs at out-of-network pharmacies, including limits and financial responsibility for access to these drugs please reference your Evidence of Coverage, or call Customer Care.

Customer Service

Disclaimer for the "Find a Pharmacy" search tool:

Note: The pharmacy network may change at any time. You will receive notice when necessary. Changes to our pharmacy network may occur during the benefit year. You may also call Customer Service for updated information.

Not a member? You can locate the pharmacies in your area that participate in our Medicare Advantage Prescription Drug (MA-PD) or Medicare Part D (PDP) Plans.

Already a plan member? You can search for participating pharmacies and obtain contact information and driving directions. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Comprehensive Formulary documents.

You can choose to filter the search results by Pharmacy Type. If the Pharmacy Type you selected includes preferred pharmacies, then the pharmacies listed in the search results are sorted first by the network pharmacies with preferred cost-sharing. There may also be network pharmacies with standard cost-sharing within the search criteria. In the search results, we identify pharmacies which offer preferred cost-sharing to distinguish them from the pharmacies which offer standard cost sharing. You can go to all the pharmacies listed, but your costs for some drugs may be less at the pharmacies in the list which offer preferred cost sharing.

Need additional help finding an in-network pharmacy?

If you need additional help or would like a Pharmacy Directory mailed to you, please call us at the phone number listed for prospective members to request a copy.
If you are already a member, please call the Customer Service number on your Member ID card or log into your account to request a directory.

Important information for members:

We call the pharmacies in the search our “network pharmacies” because we have made arrangements with them to provide prescription drugs to plan members. Our plans feature more than 70,000 pharmacies in our network. Generally, members must use network pharmacies to access their prescription drug benefit and receive plan coverage. Our network includes both pharmacies with preferred cost sharing and standard cost sharing. You are never far from one of our network pharmacies; but you may pay a lower amount, if you go to one of the pharmacies with preferred cost sharing. Pharmacies with standard cost sharing are still in our network but do not offer the lowest cost shares available at pharmacies with preferred cost sharing. Cost sharing information can be found in the Summary of Benefits document.

Please note that our plans have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area. In addition, even though a pharmacy is listed as in-network in the search results in this directory, this does not guarantee that the pharmacy is still in-network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

In most cases, your prescriptions are covered under your plan only if they are filled at a network pharmacy or through our mail-order pharmacy service. Once you go to one pharmacy, you are not required to continue to go to the same pharmacy to fill your prescription, but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage document.

The plan’s pharmacy network covers a larger area than the plan’s service area. You may fill your prescriptions at any network pharmacy, which includes those located outside of your zip code. To find a specific pharmacy in the plan’s network, enter the name of the pharmacy to search the directory.

If you are enrolled in a health plan that does not include Medicare Part D prescription drug coverage, these pharmacies are listed in the plan’s directory because the pharmacies can fill one or more prescription drugs that are covered under your health benefits (because they are covered under Medicare Part B). If you are not sure whether you have Part D coverage, please refer to your Summary of Benefits or Evidence of Coverage, or call the Customer Service phone number listed on your member ID card.

Need more information on the mail-order delivery program?

You can get prescription drugs shipped to your home through our network mail-order delivery program. You also have the choice to sign up for automated mail-order delivery. For more information on getting prescription drugs shipped directly to your home through our network mail-order delivery program, please contact Customer Service. Typically, you should expect to receive your prescription drugs within 10 business days from the time that the mail-order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please call Customer Service at the phone number listed for your plan, or call the Customer Service phone number listed on your Member ID card. If you have used mail order services with your current plan within the last 12 months, or if you opt in now, our network pharmacy will automatically fill and ship new prescriptions received directly from your doctors or other prescribers. You may opt out of automatic deliveries of new prescriptions at any time by contacting us. If you never had mail order delivery and/or decide to stop automatic fills of new prescriptions, we will contact you each time we get a new prescription from a provider, to see if you want the medication filled and shipped at that time. This will give you an opportunity to make sure that the correct drug (including strength, amount, and form) will be delivered, and, if necessary, allow you to cancel or delay the order before you are billed and it is shipped. If you have questions about any of the above or if you need instructions on how to submit claims for prescriptions that you had to fill at a non-network pharmacy, please contact Customer Service.

 

There may be limited access to pharmacies with preferred cost sharing. Please review the following information about the pharmacy network for specific plans:
  • The Anthem MediBlue Dual Advantage (HMO SNP) and Anthem MediBlue Plus (HMO) pharmacy network offers limited access to pharmacies with preferred cost sharing in suburban and rural areas of CA. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-888-230-7338 (TTY: 711) or consult the online pharmacy directory at https://www.anthem.com/ca/shop
  • The Anthem MediBlue Dual Advantage (HMO SNP) pharmacy network offers limited access to pharmacies with preferred cost sharing in suburban areas of VA. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-855-363-0724 (TTY: 711) or consult the online pharmacy directory at https://www.anthem.com/shop
  • The Anthem MediBlue Access (PPO) pharmacy network offers limited access to pharmacies with preferred cost sharing in rural areas of VA. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-866-827-9866 (TTY: 711) or consult the online pharmacy directory at https://www.anthem.com/shop

 

Disclaimer for "Find your covered drugs" search tool:

Please contact Customer Service for the most recent list of covered drugs or Find Your Covered Drugs.


Please note that there may be times when certain drugs will not be displayed within the search results. To view a document containing the complete list of covered drugs within the search results or after you have selected your plan, click “View List of Covered Drugs”.


Note: The formulary may change at any time. You will receive notice when necessary. All changes are subject to the policy issued by the Centers for Medicare and Medicaid Services (CMS) and can only occur when specific guidelines are met.


The Medicare Advantage with Prescription Drug (MA-PD) plans and Medicare Prescription Drug plans (PDPs) cover both brand-name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand-name drug. The Food and Drug Administration (FDA) requires generic drugs to meet the same safety and quality standards as brand-name drugs, but generic drugs often cost less.


Your plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy and other plan rules are followed.


For more information about whether or not your Part D drugs are covered at out-of-network pharmacies, please see the Evidence of Coverage for your plan, call Customer Service at the phone number listed for your plan, or call the Customer Service phone number on your Member ID card.


The drug costs displayed in the search results are only estimates. Actual costs may vary based on the specific quantity, strength and/or dosage of the drug, as well as drug manufacturer and dispensing pharmacy, as examples.

Plan Documents Disclaimer

Additional Information about the Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD)  and Prescription Drug (PDP) Plans:

Grievances, Appeals and Exceptions Information

Service Area Disclaimer - CT

In Connecticut, these are the service areas for Medicare Advantage with Prescription Drug (MA-PD) plans:

Anthem MediBlue Plus (HMO) plan – Contract H5854 007:
Our service area includes this county in Connecticut:
Hartford

Anthem MediBlue Plus (HMO) plan – Contract H5854 009:
Our service area includes these counties in Connecticut:
Fairfield, Litchfield, Middlesex, New Haven, and Windham

Anthem MediBlue Select (HMO) plan – Contract H5854 010:
Our service area includes these counties in Connecticut:
Fairfield, Hartford, Litchfield, Middlesex, New Haven, and Windham

Anthem MediBlue Dual Advantage (HMO SNP) plan – Contract H5854 008:
Our service area includes these counties in Connecticut:
Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland, and Windham

Full Legal MA and MAPD Disclaimer -CT

Legal Disclaimer for Medicare Advantage with Prescription Drug (MA-PD) plans:

PPO plans:
Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee 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 and Blue Shield Association.

HMO plans:
Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee 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 and Blue Shield Association

HMO SNP plans:
Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the Connecticut Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee 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 and Blue Shield Association.

Enrollment Instructions

How to Enroll  in a Plan:     
You have three options for enrolling: online, by phone, or by mail or fax.
If you choose to print the enrollment form, and then apply by mail or fax, review the Enrollment Instructions for information on where to submit the form.

Legal Disclaimer Terms of Use - CT

This online store is owned and operated by Anthem Blue Cross and Blue Shield. By using this online store, you acknowledge and agree to abide by all of these terms of use.  The insurance products described in this online store are offered only to persons over the age of 18 and who are residents of Connecticut. You must be a resident of the state where the policy is offered.  The Medicare Supplement products are not connected with or endorsed by the U.S. Government or the federal Medicare program.  The purpose of this communication is the solicitation of insurance.  Contact will be made by an insurance agent or an insurance company if you submit a request for more information or an application. This site is intended for consumer and informational use only. We do not guarantee to provide you coverage and we reserve the right to reject your application based on applicable enrollment and eligibility criteria specific to Medicare Advantage, Part D or Medicare Supplement Products.  Do not cancel your existing insurance until you receive written confirmation from Anthem Blue Cross and Blue Shield that your application has been approved and your policy is in effect.  Your completion of the online enrollment process constitutes your acceptance of the applicable policy should we approve your application. Your enrollment/acceptance constitutes your authorization for the initial and recurring premium payment by credit card or automatic bank draft, should you select those methods. 

The insurance product that we offer to you through this online store is based, in part, on the zip code that you provide. You accept sole responsibility for entering the proper zip code into the shopping experience. You are responsible for maintaining the confidentiality of your username and password for this online store and for restricting access to your computer.  You acknowledge and agree that neither Anthem Blue Cross and Blue Shield nor any of its affiliates will have any liability to you for any unauthorized application, enrollment or credit card transaction made using your username and password if such transaction occurs before you have notified us of possible unauthorized use and we had a reasonable period of time to act on that notice. Further, we may suspend or cancel your account or your access to the Site at any time even without receiving notice from you if we suspect that your account and/or password is being used in an unauthorized or fraudulent manner. Anthem Blue Cross and Blue Shield may, in its sole discretion, change, suspend or terminate, temporarily or permanently, the online store (in part or in full), for any reason, without notice and without liability to you.  If another party is providing information on behalf of the consumer as part of the application or enrollment process, the party meets applicable laws regarding authorized representatives, and the party entering such information hereby agrees to accept all liability that may arise from providing us inaccurate information and/or selecting the proper/improper product.

DISCLAIMER OF WARRANTIES: YOU AGREE THAT ALL CONTENT PROVIDED ON OR THROUGH THIS ONLINE STORE IS PROVIDED “AS IS”.  ANTHEM BLUE CROSS AND BLUE SHIELD AND ITS AFFILIATES DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED.  NEITHER ANTHEM BLUE CROSS AND BLUE SHIELD, ITS AFFILIATES AND RELATED ENTITIES, NOR ANY OF THEIR RESPECTIVE EMPLOYEES, AGENTS, THIRD PARTY CONTENT PROVIDERS OR LICENSORS WARRANT THAT THIS ONLINE STORE WILL BE UNINTERRUPTED, TIMELY, SECURE OR ERROR FREE; THAT ANY DEFECTS OR ERRORS WILL BE CORRECTED; THAT THE CONTENT OR SERVICE IS FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. LIMITATION OF LIABILITY: NEITHER ANTHEM BLUE CROSS AND BLUE SHIELD NOR ITS EMPLOYEES SHALL BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES RESULTING FROM THE USE OR INABILITY TO USE THIS SITE.