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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 2025, 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 2025.
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 $33.60. 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 $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 Healthy Blue Full Dual Advantage (HMO D-SNP) plan has a deductible of $590.00. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. Once you reach that amount, you will enter the next coverage phase. If you qualify for the low-income subsidy, your monthly premium for Part D will be $33.60. After your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Healthy Blue Full Dual Advantage (HMO D-SNP) plan offers a wide range of benefits with varying cost-sharing. Many services, like primary care, preventive services, and home health services, have no copay. The plan also provides coverage for hearing aids, vision, and dental services, often with no copay or a coinsurance. This plan offers coverage for emergency services, ambulance, and transportation services. Outpatient services, including substance abuse treatment, have a 20% coinsurance. The plan also covers medical equipment, diagnostic services, and home infusion with a mix of no copay and coinsurance options.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization, but the plan does not specify the cost sharing details. Additional days for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse, and Ambulatory Surgical Center (ASC) Services have a coinsurance of 20%.
Partial Hospitalization See details
Partial Hospitalization is covered by the Healthy Blue Full Dual Advantage (HMO D-SNP) plan, but requires prior authorization. You will have a copay of $55 for this benefit.
Ambulance and Transportation Services See details
The Healthy Blue Full Dual Advantage (HMO D-SNP) plan covers ambulance and transportation services. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay.
Emergency Services See details
Emergency Services are covered, with a $90 copay for emergency services and a $20 copay for urgently needed services; worldwide emergency services are also covered, with a $0 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation. There is no coinsurance for any of these services.
Primary Care See details
The Healthy Blue Full Dual Advantage (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, individual and group sessions for mental health and psychiatric services have a 20% coinsurance. Additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services includes coverage for Medicare-covered services with no copay, as well as an annual physical exam with no copay. Other preventive services may have a copay or 20% coinsurance.
Hearing Services See details
The Healthy Blue Full Dual Advantage (HMO D-SNP) plan covers hearing exams with a coinsurance of at most 20% and a copay for Medicare-covered benefits and fitting/evaluation for hearing aids, which has no copay. The plan also covers prescription hearing aids with no copay and up to $2500 per year, and OTC hearing aids with no copay up to $300 per year. Prescription hearing aids for the inner, outer, and over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams have no copay. Eyewear has a 20% coinsurance, while contact lenses, eyeglasses (lenses and frames), and eyeglass lenses have no copay, with a combined maximum benefit of $400 per year, but upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Other dental services have a maximum plan benefit of $3,500 per year, and include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics, all with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while 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 under the Healthy Blue Full Dual Advantage (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, and Prosthetics/Medical Supplies with no copay and 20% coinsurance. Diabetic Equipment is also covered, with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay. 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 Healthy Blue Full Dual Advantage (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Healthy Blue Full Dual Advantage (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 additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. The plan requires prior authorization, and the coinsurance information is available in the plan details.
Other Services See details
The Healthy Blue Full Dual Advantage (HMO D-SNP) plan covers Over-the-Counter (OTC) items and Meal Benefit with no copay. Acupuncture and several other services are not covered.
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