Effective October 1, 2021, Town of Manchester and Manchester BOE in Connecticut will offer an Anthem Medicare Preferred (PPO) plan. Anthem will provide medical benefits for Town of Manchester retirees through the Anthem Local Preferred Provider Organization (LPPO) product, which includes the National Access Plus benefit. The LPPO plan allows members to receive services from any provider, as long as the provider is eligible to receive payments from Medicare.


Town of Manchester members’ copay or coinsurance percentage will be the same whether their provider is in- or out-of-network. Locally or nationwide, doctors or hospitals, member share-of-cost (SOC) doesn’t change.


Non-contracted providers may continue treating Town of Manchester members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member SOC. 


The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers, while covering additional benefits that Medicare does not, such as LiveHealth Online* and SilverSneakers.*


The prefix on the Medicare Advantage ID cards is ZDX.


Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool on the Availity Portal* at https://www.availity.com.


Providers will follow their normal claim filing procedures for Town of Manchester member claims.


Providers may call Provider Services at 833-848-8730 for eligibility, prior authorization requirements, and any questions about the Town of Manchester member benefits or coverage.


* Availity is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. LiveHealth Online is the trade name of Health Management Corporation, an independent company, providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. Tivity Health Inc. is an independent company providing the SilverSneakers fitness program on behalf of Anthem Blue Cross and Blue Shield.

Featured In:
October 2021 Anthem Connecticut Provider News