Anthem provides a range of coverage options for individuals and families, but high deductibles may be cost-prohibitive for some customers.
Overall rating: 4.6
Anthem is the third-largest health insurance company in the nation, selling policies in all 50 states to meet the needs of individuals, families, seniors, and those who qualify for its state Medicaid programs. It operates through affiliated companies and subsidies that serve specific states and regions throughout the country and has more than 106 million customers in all.
Keep reading to learn more about Anthem’s individual plans, including costs, scopes of coverage, and customer ratings to determine whether this company is right for you.
|Coverage area||All 50 states|
|A.M. Best rating||A+|
|NCQA rating||4.5 to 2.5|
|What we like about Anthem health insurance plans:||The drawbacks of Anthem health insurance plans:|
The federal Health Insurance Marketplace features eight Anthem plans across three metal tiers, with monthly premiums ranging from $327 to $459 before federal subsidies. All plans are Health Maintenance Organization plans, which rely on networks of contracted providers to administer health services to policyholders. All plans have annual deductibles that must be met before coverage kicks in, and out-of-pocket maximums range between $7,000 and $8,550.
|Plan name||Monthly premium||Annual deductible||Office visits||Annual maximum out-of-pocket cost|
|Anthem HealthKeepers bronze X 8200||$327.40||$8,200||40% after deductible||$8,550|
|Anthem HealthKeepers bronze X 5900 for HSA||$346.49||$5,900||35% coinsurance after deductible||$7,000|
|Anthem HealthKeepers silver X 6250||$427.96||$6,250||Primary care: $35
Specialist: 35% coinsurance after deductible
|Anthem HealthKeepers gold X 2000||$431.71||$2,000||Primary care: $25
Specialist: 20% coinsurance after deductible
|Anthem HealthKeepers silver X 2200||$458.91||$2,200||Primary care: $35
Specialist: 30% coinsurance after deductible
*Based on pricing for a nonsmoking 35-year-old female in Richmond, VA
We’ve rated Anthem across the following four categories to help you see how the company stacks up to the competition. See our Anthem review.
|Financial strength rating: 5||Customer satisfaction rating: 4.5||Value rating: 4.5||Coverage rating: 4.5|
An insurer’s financial strength weighs how effectively it can fulfill their financial obligations to its customers. A financially vulnerable insurance company may not pay out claims on time or at all, jeopardizing your financial security if you experience a serious injury or illness.
Anthem’s financial strength is measured based on its A.M. Best financial strength rating. A.M. Best uses its algorithm and other factors to assess a company’s financial viability, providing a robust, impartial assessment of financial health.
The way an insurance company has dealt with customers’ claims and complaints in the past is a good indicator of how it will handle your claims. Anthem’s customer satisfaction score is based on feedback gathered from three consumer agencies to give you a clear idea of what to expect from its customer service.
The Better Business Bureau gives Anthem a low rating of F. In the past three years, the company has closed 61 complaints, most of which were related to billing or problems with denied claims.
The National Committee for Quality Assurance gives Anthem’s private health insurance plans overall ratings between 4.5 and 2.5, or mid- to high-performance. This score is based on how the plans rate across three categories: Consumer Satisfaction, Prevention, and Treatment. Most plans rate as low- to moderate-performing, though a handful of plans rate strongly in Consumer Satisfaction and Prevention.
Consumer Affairs gives Anthem a rating of 4 out of 5 stars. This rating is based on 1,324 reviews, most of which feature 4- and 5-star ratings. Many reviewers speak highly of their coverage’s scope and reliability.
Anthem’s value rating provides a picture of how far your health care dollars go with an Anthem plan compared to plans from other insurers. To calculate this score, we consider not only Anthem’s monthly premiums but also how much its policyholders spend on primary and specialty care, how much it costs to get emergency care, whether you have to meet a deductible before your plan pays out for services, and how high the annual out-of-pocket limit is.
Anthem’s coverage rating is based on factors that influence how well its plans accommodate your needs and provide easy access to care. Some factors that influence this score include how many types of coverage are available, how large the provider’s coverage map is, and how many health care providers accept Anthem.