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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 2025 to people living in Select counties in MO. This plan received an overall rating of 3.5 out of 5 stars in 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 $23.70. 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:
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Drug Coverage
The Anthem Full Dual Advantage 2 (HMO D-SNP) features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when using standard pharmacies or standard mail order. This coverage applies to one-month, two-month, and three-month supplies of these medications. For Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs, a 25% coinsurance applies to standard pharmacy and standard mail order fills for up to a three-month supply. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply. This structure provides clear and predictable cost-sharing for your prescription needs.
Additional Benefits
The Anthem Full Dual Advantage 2 (HMO D-SNP) offers comprehensive coverage with no copay for inpatient hospital stays, primary care, home health services, and many preventive care visits. However, members should expect a 20% coinsurance with no copay for various outpatient services, specialist visits, diagnostic tests, and durable medical equipment. Emergency care requires a $115 copay, while urgently needed services have a $20 copay. This plan also provides valuable supplemental benefits, including dental coverage up to a $3,500 yearly maximum and routine vision care with a $475 annual eyewear allowance, both featuring no copays. Additionally, members can access routine hearing aid coverage with no copay, as well as up to 48 one-way transportation trips per year to plan-approved locations with no copay or coinsurance. Other perks like over-the-counter items and chronic illness meals are also covered with no copay and no coinsurance.
Inpatient Hospital See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers inpatient hospital services, providing acute and psychiatric hospital stays with no copay, no coinsurance, and prior authorization requirements. However, this plan does not cover additional hospital days, room upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers outpatient services with no copays, though a 20% coinsurance and prior authorization apply to 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 $60.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, while transportation to any health-related location is 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 services with a $20 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no 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, psychiatric, and podiatry services with no copay and 20% coinsurance, though prior authorization is required for most services. Chiropractic services are not covered, but additional telehealth benefits are provided with no copay and no coinsurance.
Preventive Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and select supplemental benefits like memory fitness. However, other preventive services like glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome visit EKGs require a 20% coinsurance with no copay, and several supplemental benefits such as health education and in-home safety assessments are not covered.
Hearing Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers hearing services, featuring routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay, no coinsurance, and a $3,000 annual limit, though inner ear, outer ear, and over-the-ear models are not covered. OTC hearing aids are also covered with no copay, no coinsurance, and a $300 yearly limit.
Vision Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers vision services with no deductible, including one annual routine eye exam with no copay and a 20% coinsurance. Eyewear is covered up to $475 yearly with no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, while upgrades and other eye exam services are not covered.
Dental Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers Medicare-approved dental services with no copay and a 20% coinsurance. Other dental services are partially covered with no copay and no coinsurance up to a $3,500 yearly maximum, though maxillofacial prosthetics, implant services, 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. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers durable medical equipment (DME) and prosthetics with no copay, requiring a 0% to 20% coinsurance for DME and a 20% coinsurance for prosthetic devices and medical supplies. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay and a 20% coinsurance, though prior authorization is required. This coverage applies to all diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home health services are covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers some cardiac rehabilitation services with no copay and a 20% coinsurance, subject to prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay, though Medicare-defined coinsurance applies and prior authorization is required. This benefit does not require a prior three-day inpatient hospital stay, but 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 with no copay and no coinsurance for over-the-counter items, chronic illness meal benefits, and Medicare community resource support. Acupuncture is not covered under this plan.
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