Medicare Advantage plan
Anthem Dual Advantage (HMO D-SNP)
| Plan details | |
|---|---|
| Plan ID | H5422-018-0 |
| Sold by | Anthem Blue Cross and Blue Shield |
| Plan type | HMO |
| Category | SNP |
| SNP type | Dual-Eligible |
| Overall star rating | 3.5 |
| Health star rating | 3.5 |
| Drug star rating | 3.5 |
| Monthly premium (consolidated) | $0 |
| Part C premium (monthly) | $0 |
| Part D deductible (annual) | $105 |
| Max out-of-pocket, in network (annual) | $9,850 |
| Drug benefit | Enhanced Alternative |
| Service area | Note: Offered only in the 150 counties listed here. Medicare Advantage plans are sold by county, so a plan with the same name under a different contract is a different plan with its own costs.; States: GA; County count: 150; Counties by state: GA: Appling, Atkinson, Bacon, Baker, Baldwin, Banks, Barrow, Bartow, Ben Hill, Berrien, Bibb, Bleckley, Brantley, Brooks, Bryan, Bulloch, Burke, Butts, Camden, Candler, Carroll, Catoosa, Charlton, Chatham, Chattahoochee, Chattooga, Cherokee, Clarke, Clayton, Clinch, Cobb, Coffee, Colquitt, Columbia, Cook, Coweta, Crawford, Crisp, Dade, Dawson, DeKalb, Decatur, Dodge, Dooly, Douglas, Echols, Effingham, Elbert, Emanuel, Evans, Fannin, Fayette, Floyd, Forsyth, Franklin, Fulton, Gilmer, Glascock, Gordon, Grady, Greene, Gwinnett, Habersham, Hall, Hancock, Haralson, Harris, Hart, Heard, Henry, Houston, Irwin, Jackson, Jasper, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Lamar, Lanier, Laurens, Liberty, Lincoln, Long, Lowndes, Lumpkin, Macon, Madison, Marion, McDuffie, McIntosh, Meriwether, Miller, Mitchell, Monroe, Montgomery, Morgan, Murray, Muscogee, Newton, Oconee, Oglethorpe, Paulding, Peach, Pickens, Pierce, Pike, Polk, Pulaski, Putnam, Quitman, Rabun, Randolph, Richmond, Rockdale, Schley, Screven, Spalding, Stephens, Stewart, Talbot, Taliaferro, Tattnall, Taylor, Telfair, Thomas, Tift, Toombs, Towns, Treutlen, Troup, Turner, Twiggs, Union, Upson, Walker, Walton, Ware, Warren, Washington, Wayne, Webster, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, Worth |
| Premium note | The same premium applies in every county in the service area below (verified across all county rows in the CMS file). |
Plan year 2027 · Source: CMS · Checked October 29, 2026 Plan ID: H5422-018-0 · Sold by Anthem Blue Cross and Blue Shield
What this plan is
This is a special needs plan for people who have both Medicare and Medicaid. In Medicare's files it is called a dual-eligible plan, or D-SNP for short. It is sold as an HMO in Georgia, which means your care stays inside the plan's network and you choose a main doctor. It covers both medical care and prescription drugs in one plan.
Only people who have both Medicare and Medicaid can join a plan of this kind, and the state must still list you as having Medicaid when you join. If your Medicaid ends, the plan can end too, so keep your state case up to date.
The same plan name can appear under other Anthem contracts in other states, and those versions are different plans with their own costs. The numbers on this page belong to this contract only. See the Anthem Blue Cross and Blue Shield company page for its full list of plans, or all companies compared for the whole field.
Medicare rates this plan's contract 3.5 out of 5 stars overall for 2027, with 3.5 stars for health care and 3.5 stars for drug care.
What it costs
- Monthly premium: $0. You still pay your Part B premium each month, unless your Medicaid program pays it for you, just as with any Medicare Advantage plan.
- Yearly limit on in-network care: $9,850. Once your copays and coinsurance for Part A and Part B care reach this amount in a year, you pay nothing more for covered in-network care that year. Many people in a dual plan pay far less than this cap, since Medicaid helps with their costs.
- Drug deductible: $105 a year, well under the $700 top amount for 2027. Your drug copays then depend on which tier each of your drugs sits on in the plan's drug list, and help from the Extra Help program can cut them more.
A $0 premium does not mean $0 care, because copays for visits, hospital stays, and drugs can still add up across the year. The yearly limit above is the cap on the medical side of that cost.
Where it is sold
This plan is sold in 150 counties in Georgia, and the full county list is in this page's data record. A plan with the same name under a different contract is a different plan with its own costs, even when the company name on the card looks the same.
Before you join
Before you join, check that your doctors are in the network, that your drugs are on the plan's drug list, and that the state still shows you as having Medicaid. Care and Living Guide does not sell or enroll anyone in a plan, so to sign up or check your own case, use Medicare.gov, call 1-800-MEDICARE, or talk with a licensed insurance agent.
More detail about this plan
The full cost picture: the premium above adds up to $0 over a full year, before any copays. Copays for visits, hospital stays, and drugs sit on top of that, and the yearly limit above caps what you pay for covered in-network medical care. It does not cap drug costs or the premium itself.
Extra benefits: Medicare's Landscape file does not list this plan's dental, vision, hearing, fitness, over-the-counter, or transportation amounts. Those amounts live in the plan's Summary of Benefits and Evidence of Coverage, which Medicare.gov links from this plan's page. This page leaves the amounts blank until the CMS Plan Benefits Package files are loaded, rather than copying numbers from ads.
Drugs: this plan has its own drug list, called a formulary. A drug can sit on a different cost tier from one plan to the next, so check each drug you take on Medicare.gov's Plan Finder or in the plan's formulary before you join.
You can join most Medicare Advantage plans for 2027 during the yearly enrollment period, October 15 to December 7, 2026. If you already have a Medicare Advantage plan, you can switch plans or go back to Original Medicare from January 1 to March 31. A move or another big life change can open a special window of its own. To join, use Medicare.gov, call 1-800-MEDICARE, or talk with a licensed insurance agent. Care and Living Guide does not sell or enroll anyone in a plan.
The plan's official phone number and website are listed on its Medicare.gov plan page, checked October 31, 2026. Detail sources for this section: Medicare.gov (Plan Finder, plan pages, enrollment guidance) and SSA.gov (enrollment periods). Those sources add context only. Every figure on this page still comes from CMS.
Care and Living Guide is not connected with or endorsed by the U.S. government or the federal Medicare program. For official information visit Medicare.gov or call 1-800-MEDICARE.
Care and Living Guide is not connected with or endorsed by the U.S. government or the federal Medicare program. For official information visit Medicare.gov or call 1-800-MEDICARE.