Anthem Plan & Rate Updates Effective January 2026
Anthem announced rate and plan updates for January 1, 2026 effective dates. Rates are available for quoting!
Rates
Medical Quarterly Rate Change Average:
- PPO: 1.7%
- HMO: 2.6%
Medical Average Annual / Renewal Rate Change Average:
- PPO: 10.2%
- HMO: 12.7%
Portfolio Updates
Anthem is adding new Virtual Access Plus plans in 2026. These plans will offer members:
- Copay centric/Ded/Copay Plans = Predictable costs. Eliminates coinsurance uncertainty
- $0 Virtual Primary Care through in-network PCPs
- $0 Virtual Behavioral Health visit through online in-network providers
- Office based Behavioral Health visits= PCP copay
- Network Access Prudent Buyer PPO/Select PPO = Broad network access
- A simplified and integrated Sydney experience.
A Doula Benefit is being added to all plans, which includes:
- Coverage = 9 visits, (1 initial, 8 prenatal/postnatal) plus labor & delivery support
- Members can access either “The Doula Network of providers” or locally contracted providers
The Virtual Access Plus plans and the Doula Benefit will be available in ACA and ABF portfolios.
As a reminder, some Anthem plans may have slight changes in 2026 due to updated actuarial value calculator settings. Here is a list of some of the changes which includes changes to deductibles, OOPMs, and ER copays only (all other member cost shares remain unchanged).
| Product/Plan Name | Plan Changes to get Product/Plan Name to AV compliance |
|---|---|
| Anthem Platinum HMO, Select HMO, Priority Select HMO20 | Increase OOPM to 2100/4200 and ER copay to 300 |
| Anthem Gold PPO, Select PPO 25/30% | Increase OOPM to 10150/20300 increase ER copay to 400 |
| Anthem Gold Vivity HMO 25 | Increase OOPM to 8000/16000 |
| Anthem Gold PPO, Select PPO HSA/H 1700/3300/340015% PrevRx | Increase ded to 1900/3400/3800 OOPM to 4500/9000 |
| Anthem Silver PPO, Select PPO HSA/H 2000/3300/400035% PrevRx | Increase ded to 3000/3400/6000 OOPM to 8450/16900 |
| Anthem Silver HMO, Select HMO 60/2200/45% | Increase OOPM to 10150/20300 |
| Anthem Silver HMO, Select HMO 60/2500/45% | Increase OOPM to 10150/20300 and ER copay to 500 |
| Anthem Silver PPO, Select PPO HSA/H 2100/3300/420030% PrevRx | Increase ded to 2300/3400/4600 OOPM to 8450/16900 |
| Anthem Silver PPO, Select PPO HSA/H 2600/3400/520035% PrevRx Single | Increase ded to 3400 OOPM to 8450/16900 |
| Anthem Bronze Select PPO 75/7300/40% | Increase OOPM to 10150/20300 |
For questions or help with an Anthem Blue Cross quote, please contact a member of your B&P Sales Team - (888) 722-3373.