Anthem I MyCare Ohio Full Dual Support (HMO D-SNP)
Available to residents of Seneca County, OH for 2027. Contract H2628, plan 001, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Renewed for 2027. CMS carries this plan forward from 2026.
Plan details
| Monthly premium (Part C + D) | $0.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $0.00 |
| In-network out-of-pocket maximum | $9,850.00 |
| Drug deductible | $105.00Tier 1 and 2 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO D-SNP |
| Special needs plan | Dual-eligible SNP |
| D-SNP integration status | Fully Integrated (FIDE) |
| Zero-dollar cost sharing D-SNP | Yes |
| Contract / plan | H2628-001-0 |
| Offered by | Anthem Blue Cross and Blue Shield |
| Parent organization | Elevance Health, Inc. |
| Formulary tiers | 5 |
| Member services | (833)668-2193TTY 711 |
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 · Preferred Generic | $0.00 |
| Tier 2 · Generic | $0.00 |
| Tier 3 · Preferred Brand | 25% |
| Tier 4 · Non-Preferred Drug | 25% |
| Tier 5 · Specialty Tier | 32% |
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 | 4 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 H2628 shares it.
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 plan Landscape file and the CMS plan benefit package (PBP) files.