Anthem Medicare Advantage 3 (PPO)
Available to residents of Champaign County, OH for 2026. Contract H4036, plan 025, segment 0.
Plan details
| Monthly drug premium | $51.00 |
|---|---|
| Drug deductible | $200.00Tier 1, 2 and 6 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H4036-025-0 |
| Offered by | Anthem Blue Cross and Blue Shield |
| Parent organization | Elevance Health, Inc. |
| Formulary drugs | 3,554 |
CMS star ratings
- Overall
- 4 out of 5 stars for Overall
- Health plan (Part C)
- 4 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H4036 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $3.00 |
| Tier 2 | $13.00 |
| Tier 3 | 20% |
| Tier 4 | 30% |
| Tier 5 | 30% |
| Tier 6 | $0.00 |
Also available in 67 other OH counties
- Adams
- Allen
- Ashland
- Ashtabula
- Auglaize
- Belmont
- Brown
- Butler
- Carroll
- Clark
- Clermont
- Clinton
- Columbiana
- Crawford
- Cuyahoga
- Darke
- Defiance
- Delaware
- Erie
- Fairfield
- Fayette
- Franklin
- Fulton
- Geauga
- Greene
- Hamilton
- Hancock
- Highland
- Holmes
- Huron
- Jefferson
- Knox
- Lake
- Lawrence
- Licking
- Lorain
- Lucas
- Madison
- Mahoning
- Marion
- Medina
- Mercer
- Miami
- Montgomery
- Morrow
- Muskingum
- Ottawa
- Pickaway
- Portage
- Preble
- Putnam
- Richland
- Ross
- Sandusky
- Seneca
- Shelby
- Stark
- Summit
- Trumbull
- Tuscarawas
Plan facts come from the CMS quarterly prescription drug plan public use files.