Anthem Dual Advantage (HMO D-SNP)
Available to residents of White County, IN for 2027. Contract H0629, plan 002, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Consolidated into another plan for 2027. CMS crosswalks 2026’s Anthem Full Dual Advantage (HMO D-SNP) (H0629-001-0) into this plan, so its members move here unless they choose otherwise.
Plan details
| Monthly premium (Part C + D) | $14.20 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $14.20 |
| In-network out-of-pocket maximum | $9,850.00 |
| Drug deductible | $700.00Tier 1 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO D-SNP |
| Special needs plan | Dual-eligible SNP |
| D-SNP integration status | Coordination Only (CO) |
| Zero-dollar cost sharing D-SNP | No |
| Contract / plan | H0629-002-0 |
| Offered by | Anthem Blue Cross and Blue Shield |
| Parent organization | Elevance Health, Inc. |
| Formulary tiers | 5 |
| Member services | (833)668-2409TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H0629 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $0.00 |
| Tier 2 · Generic | 25% |
| Tier 3 · Preferred Brand | 25% |
| Tier 4 · Non-Preferred Drug | 25% |
| Tier 5 · Specialty Tier | 25% |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | too new |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | too new |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H0629 shares it.
Also available in 91 other IN counties
- Adams
- Allen
- Bartholomew
- Benton
- Blackford
- Boone
- Brown
- Carroll
- Cass
- Clark
- Clay
- Clinton
- Crawford
- Daviess
- Dearborn
- Decatur
- DeKalb
- Delaware
- Dubois
- Elkhart
- Fayette
- Floyd
- Fountain
- Franklin
- Fulton
- Gibson
- Grant
- Greene
- Hamilton
- Hancock
- Harrison
- Hendricks
- Henry
- Howard
- Huntington
- Jackson
- Jasper
- Jay
- Jefferson
- Jennings
- Johnson
- Knox
- Kosciusko
- Lagrange
- Lake
- La Porte
- Lawrence
- Madison
- Marion
- Marshall
- Martin
- Miami
- Monroe
- Montgomery
- Morgan
- Newton
- Noble
- Ohio
- Orange
- Owen
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.