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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 Virginia. 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 $13.80. 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) plan 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 filled through standard pharmacies or standard mail order. This coverage applies to one-month, two-month, and three-month supplies, providing excellent savings on essential medications. For Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance for standard pharmacy and mail-order fills. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply. This structure helps beneficiaries clearly understand their out-of-pocket costs for various prescription tiers.
Additional Benefits
The Anthem Full Dual Advantage 2 (HMO D-SNP) offers robust medical coverage with no copay for inpatient hospital stays, skilled nursing, and home health services. Many outpatient, primary care, specialist, and diagnostic services also feature no copay, though they generally require a 20% coinsurance. For urgent and emergency needs, members pay a $40 copay for urgent care and a $115 copay for emergency services, with no coinsurance required for either. Supplemental benefits include dental and vision coverage with no copay or coinsurance up to set annual limits, as well as prescription hearing aids covered up to $3,000 yearly. Additionally, the plan covers up to 108 one-way transportation trips to approved locations and offers over-the-counter items and meals with no copay or coinsurance. Durable medical equipment and diabetic supplies are also available with no copay, though some medical equipment carries a coinsurance of up to 20%.
Inpatient Hospital See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though prior authorization is required. Additional hospital days, upgrades, and non-Medicare-covered stays are not covered under this benefit.
Outpatient Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers outpatient services with no copays, though outpatient hospital, observation, ambulatory surgical center, and substance abuse services require a 20% coinsurance and prior authorization. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered under the Anthem Full Dual Advantage 2 (HMO D-SNP) plan with a $105.00 copay and no coinsurance. Prior authorization is required for these 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, requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 108 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 $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit limit with no copay and no coinsurance.
Primary Care See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers primary care, specialist, mental health, podiatry, and therapy services with no copay and 20% coinsurance, while telehealth services are offered with no copay and no coinsurance. Chiropractic services are not covered in practice as both routine and other chiropractic sub-services are excluded from coverage.
Preventive Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) provides partially covered preventive services, offering annual physicals, kidney disease education, fitness benefits, and remote access technologies with no copay and no coinsurance. However, health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional smoking and tobacco cessation counseling, enhanced disease management, telemonitoring, and counseling services are not covered. Medicare-covered glaucoma screenings, diabetes self-management training, digital rectal exams, and EKGs following a welcome visit are covered with no copay and a 20% coinsurance.
Hearing Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers hearing services, featuring routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay. Prescription hearing aids are covered up to $3,000 yearly and OTC hearing aids up to $300 yearly with no copay or coinsurance, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) provides partially covered vision services, excluding upgrades and other non-routine eye exams. Covered routine eye exams (one per year) and contact lenses feature no copay and a 20% coinsurance, while eyeglasses (lenses and frames) have no copay and no coinsurance, up to a $325 annual combined limit.
Dental Services See details
Dental services are partially covered by Anthem Full Dual Advantage 2 (HMO D-SNP), excluding maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $3,500 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment. DME features a coinsurance range of 0% to 20%, prosthetics and medical supplies require 20% coinsurance, and diabetic supplies and therapeutic shoes have 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, subject to prior authorization. Covered benefits include lab services, diagnostic procedures, therapeutic radiological services, and outpatient 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 to receive these covered services.
Cardiac Rehabilitation Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers some cardiac rehabilitation services with no copay and prior authorization required, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy for peripheral artery disease services 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, though prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond standard Medicare-covered days are not covered.
Other Services See details
Other services are partially covered by Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay and no coinsurance for acupuncture, over-the-counter items, a meal benefit, and Medicare Community Resource Support. Highly integrated services for Dual Eligible SNPs and certain other services are not covered under this plan.
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