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Anthem Full Dual Advantage 2 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Full Dual Advantage 2 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Full Dual Advantage 2 (HMO D-SNP) in 2026, please refer to our full plan details page.
Anthem Full Dual Advantage 2 (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 to people living in Select counties in OH. The overall rating for this plan is not yet available for 2026.
It's important to know that Anthem Full Dual Advantage 2 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Anthem Full Dual Advantage 2 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem Full Dual Advantage 2 (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Anthem Full Dual Advantage 2 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $2.30. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Anthem Full Dual Advantage 2 (HMO D-SNP)
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Drug Coverage
The Anthem Full Dual Advantage 2 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when filled through standard pharmacies or standard mail order services. This makes essential and select care medications highly affordable for enrolled members. For other drug categories, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy and standard mail order fills for one, two, or three-month supplies, except for Tier 5 specialty drugs which are limited to a one-month supply. This straightforward cost structure helps you easily plan for your monthly prescription drug expenses.
Additional Benefits
The Anthem Full Dual Advantage 2 (HMO D-SNP) offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, and home health services. For outpatient care, diagnostic services, and specialist visits, you will generally pay no copay but will be responsible for a 20% coinsurance. Emergency room visits require a $115 copay, while urgent care services are covered with a $20 copay, both with no coinsurance. This plan also features valuable supplemental benefits, including no copay and no coinsurance for preventive dental care, fitness programs, and home-delivered meals. Vision and hearing benefits feature no deductibles, offering eyewear allowances up to $350 and prescription hearing aids up to $3,000 annually with no copay or coinsurance. Additionally, members can access up to 60 one-way transportation trips per year and over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers outpatient services with no copay, though a 20% coinsurance and prior authorization are required for outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers partial hospitalization services with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Anthem Full Dual Advantage 2 (HMO D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation benefits are partially covered with no copay or coinsurance for up to 60 one-way trips per year to plan-approved health-related locations, though trips to any health-related location are not covered.
Emergency Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed care with a $20 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay or coinsurance, up to a $100,000 maximum benefit limit.
Primary Care See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers primary care, specialist, therapy, mental health, and podiatry services with no copay and a 20% coinsurance, though prior authorization is typically required. Telehealth benefits are available with no copay and no coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) provides partially covered preventive services, offering annual physicals, kidney education, fitness benefits, and home safety devices with no copay and no coinsurance. While glaucoma screenings and diabetes self-management training require a 20% coinsurance and no copay, several options like health education, nutritional therapy, and in-home support are not covered.
Hearing Services See details
Hearing services under Anthem Full Dual Advantage 2 (HMO D-SNP) are covered with no deductible, featuring routine exams with a 20% coinsurance and no copay, and Medicare-covered exams requiring a copay. Prescription hearing aids are partially covered up to $3,000 annually with no copay or coinsurance, excluding inner ear, outer ear, and over-the-ear types, while over-the-counter hearing aids are covered up to $300 annually with no copay or coinsurance.
Vision Services See details
Vision Services are partially covered by Anthem Full Dual Advantage 2 (HMO D-SNP), featuring no deductibles and a $350 annual limit for eyewear. Routine eye exams and contact lenses have no copay and a 20% coinsurance, while eyeglasses, lenses, and frames are covered with no copay or coinsurance, though upgrades and other eye exams are not covered.
Dental Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) offers partially covered dental services with no copay and 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services. Prior authorization is required for many services, and fluoride treatment, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers durable medical equipment with no copay and 0% to 20% coinsurance, while Medicare-covered prosthetics and medical supplies have no copay and a 20% coinsurance. Diabetic supplies, therapeutic shoes, and inserts are covered with no copay and no coinsurance, though prior authorization and manufacturer limitations may apply to certain equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Anthem Full Dual Advantage 2 (HMO D-SNP) with a 20% coinsurance and no copay, subject to prior authorization. This coverage includes outpatient diagnostic tests, lab services, diagnostic and therapeutic radiological services, and X-rays.
Home Health Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required before you can receive these services.
Cardiac Rehabilitation Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) offers cardiac rehabilitation services with no copay, though prior authorization is required. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. This benefit is partially covered because additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers other services, providing over-the-counter (OTC) items, meal benefits, and Medicare community resource support with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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