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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 2025, 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 Virginia. The overall rating for this plan is not yet available for 2025.
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 $11.90. 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 $590.00 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 $9350.00 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) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you will pay $11.90 per month for your Part D premium.
Additional Benefits
The Anthem Full Dual Advantage 2 (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Many services have no copay, including preventive services like annual physical exams, hearing aid fitting/evaluation, and vision exams. Additionally, the plan has a $3,500 annual maximum for dental services, and covers home health services with no copay and no coinsurance. The plan uses coinsurance for many services, including outpatient services, primary care, and ambulance services. Emergency Services have a $110 copay, while Urgently Needed Services have a $45 copay. The plan also includes coverage for prescription and OTC hearing aids, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Anthem Full Dual Advantage 2 (HMO D-SNP) plan, but additional days, non-Medicare-covered stays, and upgrades for acute and psychiatric care are not covered. You will be responsible for the Medicare-defined cost share for tier 1, and the coinsurance will vary.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a coinsurance of 20%, Outpatient Substance Abuse Services with a 20% coinsurance, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay and are limited to 108 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a $45 copay; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Physical Therapy and Speech-Language Pathology Services, Psychiatric Services, and Opioid Treatment Program Services all have a 20% coinsurance. Chiropractic Services and Podiatry Services are covered with a 20% coinsurance for Routine Care, and Routine Foot Care, respectively. Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services that may require a copay. Other covered services include Personal Emergency Response Systems and Fitness Benefits with no copay, and Home and Bathroom Safety Devices and Modifications, which have a maximum benefit coverage amount of $500 per year with no copay. Additionally, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, while fitting/evaluation for hearing aids has no copay. Prescription hearing aids are covered with no copay, and OTC hearing aids are covered with no copay, but the plan covers a maximum of $3,000 per year for prescription hearing aids and $300 per year for OTC hearing aids. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear. Routine eye exams have no copay and a 20% coinsurance, and eyewear has a 20% coinsurance, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames have no copay.
Dental Services See details
The Anthem Full Dual Advantage 2 (HMO D-SNP) plan covers dental services, including a 20% coinsurance for Medicare Dental Services. Other dental services have a maximum plan benefit of $3,500 per year, and many services such as oral exams, x-rays, cleaning, fluoride treatments, and other preventive services have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the Anthem Full Dual Advantage 2 (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable medical equipment has no copay and a coinsurance between 0% and 20%, and medical supplies and prosthetic devices have a 20% coinsurance. Diabetic supplies and diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay for all diagnostic and radiological services. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan, with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Anthem Full Dual Advantage 2 (HMO D-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered. Prior authorization is required, and the plan charges the Medicare-defined cost share for tier 1, but the specific coinsurance amount is not provided.
Other Services See details
The Anthem Full Dual Advantage 2 (HMO D-SNP) plan covers acupuncture with no copay, but it is limited to 12 treatments per year and requires prior authorization. Over-the-counter (OTC) items are covered with no copay, up to a maximum of $400 every three months. Meal benefits and Medicare Community Resource Support are also covered with no copay. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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