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Healthy Blue Full Dual Advantage (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Healthy Blue Full Dual Advantage (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Healthy Blue Full Dual Advantage (HMO D-SNP) in 2026, please refer to our full plan details page.
Healthy Blue Full Dual Advantage (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 Kansas. The overall rating for this plan is not yet available for 2026.
It's important to know that Healthy Blue Full Dual Advantage (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:
Healthy Blue Full Dual Advantage (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 Healthy Blue Full Dual Advantage (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 Healthy Blue Full Dual Advantage (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.70. 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:
Sign up for Healthy Blue Full Dual Advantage (HMO D-SNP)
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Drug Coverage
The Healthy Blue Full Dual Advantage (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Enrollees will enjoy no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs when using standard pharmacies or standard mail order services. This zero-cost coverage applies to one-month, two-month, and three-month supplies of these essential medications. For other drug categories, including Tier 3 preferred brand and Tier 4 non-preferred drugs, standard pharmacy and mail order fills require a 25% coinsurance. Tier 5 specialty drugs also carry a 25% coinsurance, which is restricted to a one-month supply. Understanding these cost-sharing details helps you estimate your out-of-pocket prescription expenses under this HMO D-SNP plan.
Additional Benefits
The Healthy Blue Full Dual Advantage (HMO D-SNP) offers robust medical coverage with many essential services featuring no copayments. Inpatient hospital stays, home health, and skilled nursing facility care are covered with no copay and no coinsurance, while outpatient services, doctor visits, and diagnostic tests generally require a 20% coinsurance and no copay. Emergency room visits carry a $115 copay, and urgent care services have a $20 copay. This plan also provides valuable supplemental benefits, including dental care up to a $3,500 annual limit and vision eyewear up to $300, both with no copays. Additionally, members receive no-copay coverage for up to 48 one-way transportation trips per year and prescription hearing aids up to a $2,500 annual limit. Over-the-counter items and chronic illness meals are also fully covered with no copay or coinsurance.
Inpatient Hospital See details
Healthy Blue Full Dual Advantage (HMO D-SNP) partially covers inpatient hospital services with no copay and no coinsurance, although prior authorization is required. Covered acute and psychiatric inpatient stays do not include additional days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers outpatient services with no copays, although a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Healthy Blue Full Dual Advantage (HMO D-SNP) with a $60.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
Healthy Blue Full Dual Advantage (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 or coinsurance, up to a maximum plan benefit of $100,000.
Primary Care See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers primary care, specialist, therapy, psychiatric, and podiatry services with no copay and 20% coinsurance, while chiropractic services are not covered. Additional telehealth benefits are also covered with no copay and no coinsurance.
Preventive Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) provides partially covered preventive services with no copay or coinsurance for annual physicals, kidney education, fitness benefits, remote access, and home safety modifications. Glaucoma screenings, diabetes training, digital rectal exams, and EKGs are covered with no copay and a 20% coinsurance. Sub-services not covered under this benefit include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling.
Hearing Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers annual routine hearing exams with a 20% coinsurance and no copay, alongside annual fitting evaluations with no copay. Prescription hearing aids are partially covered up to $2,500 annually with no copay or coinsurance, excluding inner ear, outer ear, and over the ear models, while over-the-counter hearing aids are covered up to $300 annually with no copay or coinsurance.
Vision Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) offers partially covered vision services with no deductibles, including one annual routine eye exam with no copay and 20% coinsurance, while other eye exam services are not covered. Eyewear is covered up to a $300 annual limit with no copay and no coinsurance for eyeglasses, and no copay with 20% coinsurance for contact lenses, though upgrades are not covered.
Dental Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $3,500 annual limit. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Healthy Blue Full Dual Advantage (HMO D-SNP) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Healthy Blue Full Dual Advantage (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, including supplies and therapeutic shoes or inserts, is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Healthy Blue Full Dual Advantage (HMO D-SNP) plan with prior authorization required, featuring no copay and a 20% coinsurance. This coverage includes diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Healthy Blue Full Dual Advantage (HMO D-SNP) plan, as sub-services including intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation are not covered in practice and carry a 20% coinsurance with no copay.
Skilled Nursing Facility (SNF) See details
Healthy Blue Full Dual Advantage (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Healthy Blue Full Dual Advantage (HMO D-SNP) with no copay and no coinsurance for covered benefits including over-the-counter (OTC) items, chronic illness meal benefits, and Medicare Community Resource Support. Acupuncture is not covered under this plan.
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