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Anthem Full Dual Advantage Support (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Full Dual Advantage Support (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 Support (HMO D-SNP) in 2026, please refer to our full plan details page.
Anthem Full Dual Advantage Support (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 Support (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 Support (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 Support (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 Support (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $24.60. 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 Support (HMO D-SNP)
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Drug Coverage
The Anthem Full Dual Advantage Support (HMO D-SNP) prescription drug 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 obtained through standard pharmacies or standard mail order. This cost-sharing structure ensures that essential medications in these tiers are highly accessible. For other drug categories, including Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance at standard pharmacies and through standard mail order. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply. These straightforward coinsurance rates help you easily plan for your prescription medication expenses.
Additional Benefits
The Anthem Full Dual Advantage Support (HMO D-SNP) plan offers comprehensive medical coverage with many essential services requiring no copayments. You will pay no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, and home health services. For outpatient services, primary care, and diagnostic testing, the plan generally features no copay alongside a 20% coinsurance. Supplemental benefits include dental, vision, and hearing coverage, highlighted by a $3,000 annual dental allowance and up to $3,000 for prescription hearing aids with no copay or coinsurance. Vision coverage provides up to $450 annually for eyewear with no copay, though a 20% coinsurance applies to routine eye exams and contact lenses. Additionally, members receive up to 60 free one-way transportation trips per year, alongside no-copay coverage for over-the-counter items and home meals.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Anthem Full Dual Advantage Support (HMO D-SNP) with no copay and no coinsurance for acute and psychiatric stays, although prior authorization is required. Additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers outpatient services with no copayments, although a 20% coinsurance and prior authorization apply to outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered under the Anthem Full Dual Advantage Support (HMO D-SNP) plan with a $105.00 copay and no coinsurance, and prior authorization is required.
Ambulance and Transportation Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, while transportation services are partially covered with no copay or coinsurance. Transportation benefits are limited to 60 one-way trips per year to plan-approved health-related locations, meaning trips to any health-related location are not covered.
Emergency Services See details
Anthem Full Dual Advantage Support (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 with no copay and no coinsurance, up to a maximum plan benefit limit of $100,000.
Primary Care See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers primary care, specialist, therapy, mental health, and opioid treatment services with no copay and 20% coinsurance, though prior authorization is generally required. Telehealth services are available with no copay and no coinsurance, while routine podiatry is limited to four annual visits with 20% coinsurance, and chiropractic services are not covered in practice.
Preventive Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and select supplemental benefits like fitness programs and personal emergency response systems. Additional preventive benefits are partially covered, excluding health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional or dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling. Other services, including 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 Support (HMO D-SNP) covers routine hearing exams with a 20% coinsurance and no copay, while Medicare-covered exams and fittings have no copay and no coinsurance. Hearing aids are covered with no copay or coinsurance, providing up to $300 annually for OTC devices and up to $3,000 annually for prescription hearing aids, which are partially covered as inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers one routine eye exam per year with no copay and a 20% coinsurance, while other eye exams are not covered. Eyewear is covered up to a $450 annual limit with no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, though upgrades are not covered.
Dental Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) offers partially covered dental services with an annual maximum benefit of $3,000, featuring no copay and no coinsurance for most preventive and comprehensive care. Medicare-covered dental services require no copay and a 20% coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Anthem Full Dual Advantage Support (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, though manufacturer limits and prior authorization requirements apply.
Diagnostic and Radiological Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers diagnostic and radiological services, including lab work, outpatient X-rays, and therapeutic radiological services, with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Home Health Services See details
Home health services are covered by the Anthem Full Dual Advantage Support (HMO D-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers some services for cardiac rehabilitation with no copay and no coinsurance, subject to prior authorization. However, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Anthem Full Dual Advantage Support (HMO D-SNP) with no copay and no coinsurance, though additional days beyond Medicare-covered days are not covered. Prior authorization is required for this benefit, but a three-day prior inpatient hospital stay is not necessary before admission.
Other Services See details
Anthem Full Dual Advantage Support (HMO D-SNP) covers several additional services with no copay and no coinsurance, including up to 12 acupuncture treatments per year (prior authorization required), over-the-counter items, and home meals for qualifying medical conditions. Medicare Community Resource Support is also covered with no copay and no coinsurance, while highly integrated services for dual-eligible SNPs are not covered.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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