2021 Anthem Shield Coverage

Anthem Health Insurance, also known as Anthem Blue Cross, is a for-profit health insurance provider. The company was founded in 2004 and currently has 40 million health plan members enrolled throughout 14 states. They are a part of the Blue Cross and Blue Shield Association. Anthem offers both PPO and HMO plans. They also provide Medicare, Medicaid, individual, family, and employer group plans. Anthem Health Insurance provides a selection of health insurance plans as well as helpful Medicare solutions.

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Anthem Operating States

Anthem Health Insurance is currently offered in 14 states throughout the United States. These states are California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.

Anthem Health Insurance Overview

As more people begin to look for better healthcare options, there are plenty of questions about what’s new for Anthem Health Insurance for 2021. Here are a few of the most frequently asked questions regarding Anthem Health Insurance to help you understand more about this affordable form of quality health care.

Does Anthem cover Acupuncture? 

Yes, Anthem Health Insurance will offer coverage in some instances where acupuncture is performed to relieve pain. Coverage for In-Network Provider is limited to a combined 60 day limit per benefit period for physical, occupational, and speech therapy. Chiropractor visits count towards your physical and occupational therapy limit.


Does Anthem Cover Chiropractic Care? 

Yes, most Anthem Blue Cross plans (HMO and PPO) have chiropractic benefits. Their PPO plan is limited to 25 visits per calendar year.


Does Anthem Cover Allergy Testing?

Yes, Anthem Blue Cross covers Allergy testing, including serums.


Does Anthem Cover abortions?

Anthem Health Insurance covers abortions based on the state’s regulations. Patients should be aware that some hospitals or facilities may refuse to perform this service based on their beliefs. It is the right of the facility to make this decision even if Anthem Health Insurance covers the service.


Does Anthem PPO Cover abortions?

Yes, Anthem PPO covers abortions (both surgical and prescription) based on state regulations.

Does Anthem Cover Gender Reassignment Surgery?

Most gender-affirming surgeries, reconstructive surgeries, and hair removal procedures to treat tissue donor sites for a planned phalloplasty or vaginoplasty procedure are deemed medically necessary when all criteria are met. Click to read their guidelines


Does Anthem Cover Birth Control?

Anthem Health Insurance Plans do cover birth control. In most cases, the insurance will cover the generic formula of the drug unless otherwise authorized by a physician. Under the Affordable Health Care Act, insurance companies are required by law to include birth control coverage as part of their health care policies.


Does Anthem Cover Breast Reductions?

Reduction mammaplasty is considered medically necessary when all criteria are met. Click to read their guidelines. However, breast reduction surgery is deemed to be cosmetic and not medically necessary for: 

  • poor posture
  • breast asymmetry
  • pendulousness
  • problems with clothes fitting properly 
  • nipple-areola distortion 
  • psychological considerations


Does Anthem Cover Infertility?

Anthem Blue Cross recognizes that infertility is a life-changing event. That’s why they offer the option to choose fertility treatment with all of their medical plans. Each medical plan includes different services and supplies outlined in their Evidence of Coverage.


Does Anthem Cover STD Testing?

The Affordable Care Act requires Anthem Blue Cross and Blue Shield to cover specific preventive care services, such as screening and counseling for sexually transmitted infections, with no member cost-sharing. The cost-sharing requirement may still apply to preventive care services received from out-of-network providers. 

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Anthem Mental Health Insurance Overview

Does Anthem Cover mental health

Yes, Anthem does cover mental health services, such as:

  • Depression screenings
  • Inpatient & outpatient mental health care 
  • Alcohol misuse: related screening and behavioral counseling


Does Anthem Cover Therapy?

Yes, Anthem Blue Cross is one of the top health insurance companies that offer mental health care coverage. However, key details such as co-payments, deductibles, or how many visits per year you have available on your specific plan will vary.


Anthem Dental Insurance Overview

Anthem is one of America’s top-rated dental insurance providers with a wide range of affordable and worthwhile plans. With 100% coverage for exams, cleanings, and X-rays without waiting periods included as part of most offerings – it’s easy to see why so many are choosing Anthem over other providers!


Does Anthem Cover Dental?

Your Anthem dental plan ensures that you have access to dentists in your area or anywhere else in the country. You also receive a discount when using one of our network partners.

Your Anthem Dental Care Plan gives you full control over where and how often you get work done on your teeth—as long as it’s with an authorized dentist.


Does Anthem Cover Braces?

While full coverage dental plans do not cover 100% of the costs, they help with preventive care such as braces and clear aligners like Invisalign and other orthodontic treatments if they are included as part of your dental plan benefits.


Does Anthem Cover Braces for Adults?

Dental insurance typically does not cover orthodontic work for adults; however, some Anthem dental plans offer some benefits. 


Does Anthem Cover Dental Surgery? 

It all depends on your policy benefits. Most plans include the cost of preventive care, plus a portion of the cost after you meet your deductible for other procedures.


Does Anthem Cover Wisdom Teeth Removal?

Yes, the plan will cover a portion of the costs of the removal of an impacted tooth. 

Does Anthem Cover Dental Implants?

No. Anthem Health Insurance does not offer coverage for dental implants. While some dental services may be discounted, dental implants are not listed as one of these services, and they are excluded from coverage. The only exception is if the dental implants are associated with a covered prosthetic appliance. Anthem Blue Cross and Blue Shield will provide coverage for a full or partial bridge if that is the case.

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Anthem Vision Insurance Overview

You can choose to buy a Blue View Vision plan by itself or add it to any of Anthem’s health insurance and dental plans. Your coverage includes check-ups, eye exams, as well as yearly eyewear allowances for glasses or contacts.


Does Anthem Cover Lasik?

Anthem does not cover the entire cost of Lasik surgery; however, they offer discounts. 


Does Anthem Cover Cataract Surgery? 

Currently, Anthem insurance will cover the basic costs of cataract surgery, including the surgeon fee, facility fee, and anesthesiologist fees.


Anthem Prescription Drug Insurance Overview

Anthem Blue Cross Blue Shield provides prescription drug benefits, including medications on the Anthem Drug List. This can provide potential savings when your physician prescribes drugs from this list. To learn more, visit: https://www.anthem.com/ca/ms/pharmacyinformation/home.html


Does Anthem Cover Hearing Aids?

Many Anthem health insurance plans include part or full hearing aid coverage in many of their benefits packages. 


Does Anthem Cover a Blood Pressure Monitor?

Yes, in most cases, at-home digital blood pressure monitoring machines are a covered benefit if prescribed by your doctor. 


Does Anthem Cover Cialis

Currently, Cialis is listed as a “non-formulary drug,” meaning it is not included on a plan’s Drug List. Anthem recommends that you discuss formulary alternatives with your physician.  


Does Anthem Cover Chantix

Yes. Currently, you can receive 60 Chantix tablets per 30 days or one starter pack per year. Additional three-month approval for those who successfully quit smoking at the end of 12 weeks will be considered with a prior authorization request.


Does Anthem Cover the Shingles Vaccine?

As of 2018, Anthem covers the shingles vaccine under the affordable care acts preventative coverage, based on a new recommendation by the Advisory Committee on Immunization Practices (ACIP).

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