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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 WI. This plan received an overall rating of 3.5 out of 5 stars in 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 $0.00. 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 $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) Medicare plan features an annual drug deductible of $590. Plan members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when filled at standard pharmacies or through standard mail order. This ensures zero-cost access to many essential and everyday medications. For other prescription tiers, a 25% coinsurance applies to Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs. Tier 5 specialty medications require a 26% coinsurance for a one-month supply. These cost-sharing rates are consistent across both standard retail pharmacies and standard mail-order services.
Additional Benefits
The Anthem Full Dual Advantage 2 (HMO D-SNP) offers robust medical coverage, featuring inpatient hospital stays, skilled nursing care, and home health services with no copay and no coinsurance. Outpatient hospital services, doctor visits, and diagnostic tests generally feature no copay and a 20% coinsurance. Emergency room visits require a $115 copay, while urgent care services require a $20 copay, both with no coinsurance. Beyond medical care, members receive valuable supplemental benefits like up to $3,000 annually for both dental care and prescription hearing aids with no copay or coinsurance. The plan also covers up to 96 one-way transportation trips and eyewear up to a $450 annual limit with no copay or coinsurance. Routine vision and hearing exams are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers inpatient hospital services, offering acute and psychiatric care with no copay and no coinsurance, though prior authorization is required. Under this benefit, additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers outpatient services with no copays, although a 20% coinsurance and prior authorization apply to outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
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, while transportation services are partially covered with no copay and no coinsurance. Under the transportation benefit, members receive up to 96 one-way trips per year to plan-approved locations, but 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 $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
Anthem Full Dual Advantage 2 (HMO D-SNP) covers primary care, specialist visits, therapy, and mental health services with no copay and a 20% coinsurance, while telehealth services feature no copay and no coinsurance. Although chiropractic services are technically listed as covered, routine and other chiropractic sub-services are not covered in practice.
Preventive Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) preventive services are partially covered, offering annual physicals, kidney education, fitness benefits, remote access, and home safety modifications with no copay and no coinsurance. Other services like glaucoma screenings, diabetes training, digital rectal exams, and EKGs have no copay and 20% coinsurance, but health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers hearing services, including routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered up to $3,000 annually with no copay or coinsurance, though inner ear, outer ear, and over-the-ear models are not covered. OTC hearing aids are also covered up to $300 annually with no copay or coinsurance.
Vision Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) provides partially covered vision services with no deductibles, including one annual routine eye exam with no copay and a 20% coinsurance. Covered eyewear features a $450 annual limit, offering eyeglasses with no copay and no coinsurance, and contact lenses with no copay and a 20% coinsurance. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) offers partially covered dental services, excluding maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services have no copay and a 20% coinsurance, while other covered dental services feature no copay and no coinsurance up to a $3,000 annual maximum.
Home Infusion bundled Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy may be required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance of up 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 durable medical equipment with no copay and coinsurance ranging from no coinsurance to 20%. Prosthetics and medical supplies are covered with no copay and 20% coinsurance, while diabetic equipment and supplies feature no copay and no coinsurance.
Diagnostic and Radiological Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) covers diagnostic and radiological services—including lab work, diagnostic tests, therapeutic radiology, and X-rays—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 Anthem Full Dual Advantage 2 (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
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 (SET) for peripheral artery disease (PAD) 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 and the standard three-day prior hospital stay is waived. While standard Medicare-covered days are included, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Anthem Full Dual Advantage 2 (HMO D-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items, meal benefits for chronic illness, and Medicare Community Resource Support. Acupuncture is not covered under this plan.
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