Anthem I MyCare Ohio Full Dual Advantage (HMO D-SNP)
Available to residents of Summit County, OH for 2026. Contract H2628, plan 001, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $615.00Tier 1 and 6 exempt |
| Plan type | Dual-eligible SNP |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H2628-001-0 |
| Offered by | Anthem Blue Cross and Blue Shield |
| Parent organization | Elevance Health, Inc. |
| Formulary drugs | 3,554 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H2628 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | 25% |
| Tier 3 | 25% |
| Tier 4 | 25% |
| Tier 5 | 25% |
| Tier 6 | $0.00 |
Also available in 87 other OH counties
- Adams
- Allen
- Ashland
- Ashtabula
- Athens
- Auglaize
- Belmont
- Brown
- Butler
- Carroll
- Champaign
- Clark
- Clermont
- Clinton
- Columbiana
- Coshocton
- Crawford
- Cuyahoga
- Darke
- Defiance
- Delaware
- Erie
- Fairfield
- Fayette
- Franklin
- Fulton
- Gallia
- Geauga
- Greene
- Guernsey
- Hamilton
- Hancock
- Hardin
- Harrison
- Henry
- Highland
- Hocking
- Holmes
- Huron
- Jackson
- Jefferson
- Knox
- Lake
- Lawrence
- Licking
- Logan
- Lorain
- Lucas
- Madison
- Mahoning
- Marion
- Medina
- Meigs
- Mercer
- Miami
- Monroe
- Montgomery
- Morgan
- Morrow
- Muskingum
Plan facts come from the CMS quarterly prescription drug plan public use files.