Anthem Kidney Care (PPO C-SNP)
Anthem Blue Cross Life and Health Insurance Company · PPO C-SNP · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $9,250
- Drug deductible
- $0
- Tied for lowest here
- Medicare star rating
- 2.5 of 5
This is a special needs plan. Only some people can join: Chronic or Disabling Condition.
In plain English
Compared with the 17 other plans in Madera County that the same person could join.
What stands out
- No monthly premium
- No drug deductible, tied for lowest here
- Dental, vision and hearing extras included
Watch out for
- $40 for urgent care, highest of 17 plans here
- Dental: plan pays up to $2,500 a year, less than most plans here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$0$0 in premiums + $0 for care2 checkups and 2 lab tests.Not counted, because the plan charges a percentage: Lab tests.
- A busier year$40$0 in premiums + $40 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Not counted, because the plan charges a percentage: Specialist visit, Lab tests, X-rays.
- A hard year$115$0 in premiums + $115 for careLower than most plans here6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Not counted, because the plan charges a percentage: Specialist visit, Lab tests, MRI, CT and other scans, Ground ambulance, Hospital stay.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$0 or 20%Plan approval may be needed
- Urgent care$40Highest of 17 plans here
- Emergency room$115
- Lab tests20%Plan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center20%Plan approval may be needed
- Outpatient hospital care20%
- X-rays20%Plan approval may be needed
- MRI, CT and other scans20%Plan approval may be needed
- Ground ambulance20%Plan approval may be needed
From the costs the plan filed with Medicare for 2026. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 17 other plans in Madera County that the same person could join. Read the plan’s 2026 booklet (PDF)
What medicines cost
| Drug tier | Preferred pharmacy | Other network pharmacy |
|---|---|---|
| 1Preferred Generic | $0 | $0 |
| 2Generic | $0 | $5 |
| 3Preferred Brand | 15% of the price | 20% of the price |
| 4Non-Preferred Drug | 25% of the price | 25% of the price |
| 5Specialty Tier | 33% of the price | 33% of the price |
| 6Select Care Drugs | $0 | $0 |
For a 1-month supply. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2026, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams: $0. Fillings, crowns and dentures: you pay $0.Cleanings and exams: plan pays up to $2,500 a year. Plan pays up to $2,500 a year for all dental.
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eye exams: plan pays up to $69 a year. Eyewear: plan pays up to $275 a year.
- Hearing IncludedHearing test: $0. Hearing aids covered.Hearing tests: plan pays up to $59 a year. Hearing aids: plan pays up to $2,000 a year, both ears.
- Over-the-counter items IncludedUp to $60 a month for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness IncludedIncludes gym or fitness classes.
- Rides to care Included52 one-way rides to medical visits a year.
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Anthem Kidney Care (PPO C-SNP), plan number H8552-028, for 2026?”