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Anthem Dual Advantage (PPO D-SNP)

Anthem Blue Cross and Blue Shield
Anthem Dual Advantage (PPO D-SNP) H2441-001 Plan Details
Plan too new to be measured

Anthem Dual Advantage (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield
Plan ID: H2441-001

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Anthem Dual Advantage (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield
Plan ID: H2441-001

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Anthem Blue Cross and Blue Shield
Anthem Dual Advantage (PPO D-SNP) H2441-001 Plan Details
Plan too new to be measured

Anthem Dual Advantage (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield
Plan ID: H2441-001

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Virginia Counties Served

Henry Botetourt Carroll Montgomery Franklin Radford Pittsylvania Norton City Pulaski Bedford Grayson Wythe Bland Martinsville City Salem Lee Washington Scott Dickenson Tazewell Wise Buchanan Galax City Staunton City Bath Buena Vista City Alleghany Highland Rockbridge Covington City Lexington City Lynchburg City Danville City Smyth Loudoun Clarke Manassas City Fauquier Manassas Park City Culpeper Rappahannock Winchester City Greene Falls Church City Spotsylvania King and Queen Stafford Fredericksburg City Hanover Shenandoah Gloucester New Kent Caroline Richmond Essex Orange Northumberland Westmoreland Nelson King George Warren Albemarle Lancaster Middlesex King William Frederick Page Madison Rockingham Fluvanna Harrisonburg City Augusta Louisa Richmond City Charlottesville City Nottoway York Amherst Waynesboro City Amelia Buckingham Charles City Lunenburg James City Goochland Poquoson City Mathews Henrico Cumberland Powhatan Chesterfield Suffolk City Southampton Williamsburg City Isle of Wight Northampton Portsmouth City Chesapeake City Virginia Beach City Norfolk City Newport News City Floyd Hampton City Brunswick Dinwiddie Petersburg City Emporia City Halifax Prince George Surry Prince Edward Greensville Craig Sussex Colonial Heights City Franklin City Jefferson Charlotte Hopewell City Patrick Mecklenburg Giles Russell Appomattox Roanoke Campbell Bristol City Roanoke City

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $9350
Out-of-Network: N/A
Initial Coverage Limit $2000
Catastrophic Coverage Limit $2,000
Primary Care Doctor Visit
In-Network:
$0.00 copay
Out-of-Network:
$0.00 copay
Specialty Doctor Visit
In-Network:
$0.00 copay
Out-of-Network:
$0.00 copay
Inpatient Hospital Care
In-Network:
$0.00 copay per stay
Out-of-Network:
$0.00 copay per stay
Urgent Care
Urgent Care: $0.00 copay
Emergency Room Visit
Emergency Care: $0.00 copay
Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000 per year.
Ambulance Transportation
Ground Ambulance: $0.00 copay Per Trip
Air Ambulance: $0.00 copay

Health Care Services and Medical Supplies

Anthem Dual Advantage (PPO D-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network:
Medicare Covered Chiropractic Services: $0.00 copay
Out-of-Network:
Medicare Covered Chiropractic Services: $0.00 copay
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network:
Diabetic Supplies: $0.00 copay
Out-of-Network:
$0.00 copay
Durable Medical Eqipment (DME)
In-Network:
$0.00 copay
Out-of-Network:
$0.00 copay
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In-Network:
Lab Services: $0.00 copay
X-Rays: $0.00 copay
Therapeutic Radiological Services: $0.00 copay
Outpatient Diagnostic Procedures/Tests: $0.00 copay
Diagnostic Radiological Services: $0.00 copay
Out-of-Network:
Lab Services: $0.00 copay
X-Rays: $0.00 copay
Therapeutic Radiological Services: $0.00 copay
Outpatient Diagnostic Procedures/Tests: $0.00 copay
Diagnostic Radiological Services: $0.00 copay
Home Health Care
In-Network:
$0.00 copay
Out-of-Network:
$0.00 copay
Mental Health Inpatient Care
In-Network:
$0.00 copay per stay
Out-of-Network:
$0.00 copay per stay
Mental Health Outpatient Care
In-Network:
Individual and Group Sessions: $0.00 copay
Out-of-Network:
$0.00 copay
Outpatient Services / Surgery
In-Network:
Outpatient Hospital - Surgery: $0.00 copay
Observation Services: $0.00 copay
Ambulatory Surgical Center: $0.00 copay
Out-of-Network:
Outpatient Hospital - Surgery: $0.00 copay
Observation Services: $0.00 copay
Ambulatory Surgical Center: $0.00 copay
Outpatient Substance Abuse Care
In-Network:
Individual and Group Sessions: $0.00 copay
Out-of-Network:
$0.00 copay
Over-the-counter (OTC) Items
This plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $260 every quarter. Unused OTC amounts do roll over to the next quarter. Unused OTC amounts expire at the end of the calendar year.
Podiatry Services
In-Network:
Medicare Covered Podiatry Services: $0.00 copay
Routine Foot Care: $0.00 copay
4 routine foot care visit(s) each year.
Out-of-Network:
Medicare Covered Podiatry Services: $0.00 copay
Routine Foot Care: $0.00 copay
Skilled Nursing Facility Care
In-Network:
$0.00 copay per stay
Out-of-Network:
$0.00 copay per stay

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
This plan covers up to a $2,500 allowance for covered preventive and comprehensive dental services every year.

In-Network:
Medicare Covered Dental: $0.00 copay
Preventive Dental Services: $0.00 copay
Comprehensive Dental Services: $0.00 copay

Out-of-Network:
Medicare Covered Dental: $0.00 copay
Non-Medicare Preventive Dental Services: $0.00 copay
Non-Medicare Comprehensive Dental Services: $0.00 copay

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In-Network:
Medicare Covered Eye Exam: $0.00 copay
Routine Eye Exam: $0.00 copay
This plan covers 1 routine eye exam(s) every year. $69 maximum eye exam coverage amount.
Medicare Covered Eye Wear: $0.00 copay
Routine Eye Wear: $0.00 copay
This plan covers up to $325 for eyeglasses or contact lenses every year.
Out-of-Network:
Medicare Covered Eye Exam: $0.00 copay
Routine Eye Exam: $0.00 copay
Medicare Covered Eye Wear: $0.00 copay
Routine Eye Wear: $0.00 copay

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network:
Medicare Covered Hearing Exam: $0.00 copay
Routine Hearing Exam: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount.
This plan covers 1 routine hearing exam up to a $59 maximum plan benefit every year. $300 maximum plan benefit for over-the-counter hearing aids OR 1 routine hearing aid fitting evaluation and a $3,000 maximum plan benefit for prescribed hearing aids every year.
Out-of-Network:
Medicare Covered Hearing Exam: $0.00 copay
Routine Hearing Exam: $0.00 copay for routine hearing exam(s).

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In-Network:
$0.00 copay for Medicare Covered Preventive Services
Out-of-Network:
$0.00 copay

Prescription Drug Costs and Coverage

The Anthem Dual Advantage (PPO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year.

Coverage
Cost
Coverage & Cost
Annual Drug Deductible $0
Preferred Generic
  • Standard mail order $0.00
  • Standard retail $0.00
Select Care Drugs
  • Standard mail order $0.00
  • Standard retail $0.00
Annual Drug Deductible $0
Preferred Generic
  • Standard mail order $0.00
  • Standard retail $0.00
Select Care Drugs
  • Standard mail order $0.00
  • Standard retail $0.00
Annual Drug Deductible $0
Preferred Generic
  • Standard mail order $0.00
  • Standard retail $0.00
Select Care Drugs
  • Standard mail order $0.00
  • Standard retail $0.00
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