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Anthem Dual Advantage (HMO D-SNP)

Health Insurance Company: Anthem Blue Cross and Blue Shield

Medicare Advantage Plan Details

Medicare-Medicaid Dual Eligible (D-SNP)

Anthem Blue Cross and Blue Shield
$13 /mo
monthly premium
Anthem Dual Advantage (HMO D-SNP)
Additional Coverage
Overall Star Rating (2025)
  • Rx
  • Dental
  • Vision
  • Hearing
3.5
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$2900
Rx Drug Coverage
Yes
Rx Deductible
$590
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$0 or $25 copay per visit

Additional Benefits

Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Transportation for non-emergency
Yes
Fitness Benefits
Yes
Worldwide emergency
Yes
Telehealth
Yes
Part B Give Back
No

Doctor & Hospital Coverage

Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$0 or $25 copay per visit
Periodic Exam Coverage
$0 copay

Emergency Room

$0 or $90 copay per visit (always covered)

Ambulance Coverage

$0 or $250 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: $0 or $0-35 copay
Medicare-covered lab services: $0 copay
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): $0 or $25-150 copay
Medicare-covered x-ray services: $0 or $25 copay

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: $0 or $0-245 copay per visit

Hospitalization Coverage

Inpatient hospital-acute:
$0 or $245 per day for days 1 through 8
$0 per day for days 9 through 90
Inpatient hospital psychiatric:
$0 or $245 per day for days 1 through 8
$0 per day for days 9 through 90

Rehabilitation Coverage

Occupational therapy services:
$0 or $25 copay
Physical therapy and speech and language therapy services:
$0 or $25 copay

Urgent Care Coverage

$0 or $20 copay per visit (always covered)

Skilled Nursing Facility (SNF)

$0 per day for days 1 through 20
$0 or $203 per day for days 21 through 100

Mental Health Coverage

Medicare-covered individual sessions: $0 or $25 copay
Medicare-covered group sessions: $0 or $25 copay

Dental, Vision, Hearing Benefits

Dental Services

Oral exams:
In-network: $0 copay
Out-of-network: $0 copay
Prophylaxis (cleaning):
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays:
In-network: $0 copay
Out-of-network: $0 copay

Vision Benefits

Eye exams:
Routine eye exams: $0 copay
Eyewear:
Contact Lenses: $0 copay
Eyeglasses: $0 copay

Hearing Benefits

Hearing exams:
Routine hearing exams: $0 or $25 copay
Hearing aids:
Hearing aids (all types): $0 copay

More Additional Benefits

Annual physical exams
Yes
Chiropractic Coverage
No
Acupuncture
No
Massage Therapy
No
Health Education
No
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
Yes
In-home support services
No
Home and bathroom safety devices
Yes
Meals for short duration
Yes

Plan Links

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Where This Plan is Available

Additional Plan Info

Plan Year:
2025
Insurance Company Website:
Anthem Blue Cross and Blue Shield

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint