Find Anthem Network Doctors

Anthem Blue Cross and Blue Shield, part of the Anthem family of brands and the Blue group of affiliated companies, offers private Medicare insurance plans as well as individual and family health insurance plans.

Depending on which type of Anthem insurance plan you have, you may need to see an Anthem in-network doctor to get the most from your coverage and to save on out-of-pocket costs. Below we review the Anthem and Blue Cross Providers network and how to find a doctor near you who will accept your plan.

You can also compare Anthem BCBS Medicare Advantage (Medicare Part C) plans sold where you live and find out if your doctor accepts the plan. Medicare Advantage plans cover everything Original Medicare (Part A and Part B) covers, and some Anthem Medicare Advantage plans can cover additional benefits such as prescription drugs, dental, hearing or vision.

How to Find an Anthem Doctor in Network

Current Anthem Medicare beneficiaries can use the Anthem online Find Care tool to run a provider search.

Prospective Anthem Medicare Advantage plan beneficiaries can also use the online lookup tool, but you may have an easier time calling to speak with a licensed Anthem BCBS insurance agent to make sure you look at the correct plan networks.

What Is an Anthem In-network Doctor? 

Anthem in-network doctors are those who accept Anthem insurance plans and agree to the cost-sharing terms of the plan. Anthem in-network health care providers can include:

• General practitioners
• Specialists
• Pharmacies
• Hospitals
• Other medical facilities and suppliers of medical equipment and supplies

In most cases, you should always try to see an Anthem in-network health care provider whenever possible.

• If you have an HMO plan, your coverage is restricted only to in-network providers, and you will be responsible for all costs when visiting a doctor or other provider that is not part of the Anthem network.
  
  When in an HMO plan, your primary care physician (PCP) will coordinate your care within the Anthem network of specialists and facilities and issue referrals for advanced care. 
  
  
• If you have a PPO plan, you can often seek care outside of the Anthem network and still receive at least partial coverage in most cases with no need to obtain referrals. However, your savings will be maximized when you stay within the Anthem network.
  
  For example, an Anthem Medicare Advantage plan might require a 20% coinsurance payment for care received inside the Anthem network but a 50% coinsurance payment for care received outside of the Anthem network. 

There are two times however when you may not need to worry about seeing an Anthem in-network doctor (but be sure to check with your plan details and documentation):

• When seeking emergency care. Emergency care services are typically covered the same whether received within the Anthem provider network or not.
  
  
• With an Anthem Medigap plan. Medicare Supplement Insurance (Medigap) plans don’t use provider networks and may be used at any health care provider who accepts Original Medicare.

Helpadvisor.com is owned and operated by Tranzact, the parent company of TZ Insurance Solutions LLC, which is the owner/operator of MedicareAdvantage.com and other websites mentioned on HelpAdvisor and which has a financial relationship with some of the carriers listed on HelpAdvisor.