Anthem Dual Advantage (PPO D-SNP)
The Anthem Dual Advantage (PPO D-SNP) is a 2026 PPO D-SNP Dual Special Needs (D-SNP) plan from Anthem Blue Cross and Blue Shield with a $0 monthly premium. It may include allowances for vision, hearing, and otc / flex allowance. It's available in 127 counties across 1 state.
Reviewed by the Medicare Advocates team · 2026 plan year · sourced from CMS data
Offered in 127 counties across 1 state
- Monthly premium$0
- In-network max out-of-pocket$9,250
- Vision$325
- Hearing$3,000
- OTC / Flex allowance$820
2026 plan-year figures (premium, star rating, MOOP) from the CMS Landscape file; allowance amounts from CMS PBP data. Amounts vary by plan; not all plans offer all benefits.
What the Anthem Dual Advantage (PPO D-SNP) plan may include
- Vision: up to $325 per year in plan allowance (2026).
- Hearing: up to $3,000 per year in plan allowance (2026).
- OTC / Flex allowance: up to $820 per year in plan allowance (2026).
Costs & coverage detail
Annual Part D drug deductible: $520 (2026).
Doctor visits
- Primary care visit20% coinsurance
- Specialist visit20% coinsurance
- Chiropractic (Medicare-covered)20% coinsurance
- Podiatry (Medicare-covered)20% coinsurance
Emergency & urgent care
- Emergency room$115 copay
- Urgent care$40 copay
Tests, labs & imaging
- Diagnostic radiology (CT/MRI/PET)20% coinsurance
Home health & equipment
- Home health care$0
Medical equipment & supplies
- Durable medical equipment (DME)0–20% coinsurance
Ambulance
- Ground ambulance20% coinsurance
Dental
- Preventive dental (exams, cleanings, X-rays)$0
- Comprehensive dental (restorative)$0
Vision
- Routine eye exam20% coinsurance
- Eyewear (glasses/contacts)20% coinsurance
Hearing
- Hearing aids$0
Hospital stays
- Skilled nursing facility (SNF)$0/day, days 1–20; $218/day, days 21–100
In-network, Medicare-covered cost sharing for the 2026 plan year (CMS PBP data). Costs vary by service and setting; see the Summary of Benefits for full detail.
Extra benefit allowances
- Routine eye exam allowance$69 per year
- Eyewear allowance$325 per year
- Hearing exam allowance$59 per year
- Hearing aid allowance$3,000 per year
- Over-the-counter (OTC) allowance$205 per quarter
Preventive services
This plan covers $0 for all preventive services covered under Original Medicare when you use an in-network provider — including annual wellness visits, recommended screenings, and vaccines.
Common questions
- What is the Anthem Dual Advantage (PPO D-SNP) plan?
- It is a Dual Special Needs (D-SNP) plan (CMS plan ID H2441-001-000) offered by Anthem Blue Cross and Blue Shield for the 2026 plan year. Dual Special Needs (D-SNP) plans are for people who qualify for both Medicare and Medicaid.
- What extra benefits could this plan include?
- Depending on the plan, supplemental benefits may include allowances toward vision, hearing, otc / flex allowance. Amounts shown are for the 2026 plan year and vary by plan and area. A licensed agent can confirm what is available to you.
- Where is this plan available?
- For 2026, this plan is offered in 127 counties across 1 state. Availability and benefits depend on your specific ZIP code.
- How do I enroll or compare plans?
- Call to speak with a licensed insurance agent who can review this plan alongside the other options in your area at no cost. There is no obligation to enroll, and enrollment may be limited to certain times of year unless you qualify for a Special Enrollment Period.
Counties served
Virginia (127 counties)
Albemarle, Alleghany, Amelia, Amherst, Appomattox, Augusta, Bath, Bedford, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Campbell, Caroline, Carroll, Charles City, Charlotte, Charlottesville City, Chesapeake City, Chesterfield, Clarke, Colonial Heights City, Covington City, Craig, Culpeper, Cumberland, Danville City, Dickenson, Dinwiddie, Emporia City, Essex, Falls Church City, Fauquier, Floyd, Fluvanna, Franklin, Franklin City, Frederick, Fredericksburg City, Galax City, Giles, Gloucester, Goochland, Grayson, Greene, Greensville, Halifax, Hampton City, Hanover, Harrisonburg City, Henrico, Henry, Highland, Hopewell City, Isle of Wight, James City, King George, King William, King and Queen, Lancaster, Lee, Lexington City, Loudoun, Louisa, Lunenburg, Lynchburg City, Madison, Manassas City, Manassas Park City, Martinsville City, Mathews, Mecklenburg, Middlesex, Montgomery, Nelson, New Kent, Newport News City, Norfolk City, Northampton, Northumberland, Norton City, Nottoway, Orange, Page, Patrick, Petersburg City, Pittsylvania, Poquoson City, Portsmouth City, Powhatan, Prince Edward, Prince George, Pulaski, Radford City, Rappahannock, Richmond, Richmond City, Roanoke, Roanoke City, Rockbridge, Rockingham, Russell, Salem City, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Stafford, Staunton City, Suffolk City, Surry, Sussex, Tazewell, Virginia Beach City, Warren, Washington, Waynesboro City, Westmoreland, Williamsburg City, Winchester City, Wise, Wythe, York
Plan documents
Official 2026 documents for this plan:
Ready when you are.
No cost. No pressure. There is no obligation to enroll.One Advocate, for as long as you’re on Medicare.