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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 2025, 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 2025.
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 $30.70. 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 $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 Support (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, you will pay $30.70 per month for your Part D premium. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Anthem Full Dual Advantage Support (HMO D-SNP) plan offers comprehensive coverage with a focus on affordability. Many services have no copay, including preventive services like annual physical exams, additional telehealth benefits, hearing aid fittings, contact lenses, eyeglasses, and many dental services. You'll also find no copays for home health services, medical supplies, and acupuncture. The plan features coinsurance for various services. You can expect a 20% coinsurance for outpatient services, primary care, vision services, and dental services. Emergency services come with a $110 copay, while urgently needed services have a $45 copay.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with coinsurance costs that align with Original Medicare, but additional days, non-Medicare stays, and upgrades for both are not covered. Prior authorization is required for both.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services, and 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 Support (HMO D-SNP) plan and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground and air ambulance services, each with a 20% coinsurance, and transportation services to plan-approved health-related locations with no copay and up to 60 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Anthem Full Dual Advantage Support (HMO D-SNP). Emergency Services have a $110 copay, and Urgently Needed Services have a $45 copay. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Under the Anthem Full Dual Advantage Support (HMO D-SNP) plan, primary care physician services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services are covered. Primary care physician services, chiropractic services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, and physical therapy and speech-language pathology services have a 20% coinsurance, while additional telehealth benefits have no copay.
Preventive Services See details
The Anthem Full Dual Advantage Support (HMO D-SNP) plan covers preventive services with no copay for annual physical exams. Additional preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, have a 20% coinsurance.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have a coinsurance of at most 20% for routine exams, and fitting/evaluation for hearing aids has no copay. Prescription hearing aids (all types) have no copay, with a maximum plan benefit of $3,000 per year. OTC hearing aids have no copay, with a maximum benefit of $300 per year.
Vision Services See details
Under the Anthem Full Dual Advantage Support (HMO D-SNP) plan, vision services include eye exams with a 20% coinsurance for routine eye exams, and eyewear with a 20% coinsurance. Routine eye exams have no copay, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames have no copay, while upgrades are not covered.
Dental Services See details
Dental Services are covered, with Medicare Dental Services requiring prior authorization and a 20% coinsurance. Other Dental Services have a maximum plan benefit of $4,000 every year, and oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics have no copay and require prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Anthem Full Dual Advantage Support (HMO D-SNP) plan. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies with no copay and a 20% coinsurance for some services. Diabetic Equipment is covered with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Anthem Full Dual Advantage Support (HMO D-SNP) plan. You will pay no copay for diagnostic and radiological services, and a coinsurance of at most 20% for diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Anthem Full Dual Advantage Support (HMO D-SNP) plan with no copay and no coinsurance, but 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 Support (HMO D-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. The plan does not cover additional days beyond Medicare-covered SNF, or non-Medicare-covered stays.
Other Services See details
Other Services include acupuncture with no copay, and 12 treatments per year with prior authorization, over-the-counter items with no copay, and a monthly benefit, and a meal benefit with no copay. This plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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