Medicare Advantage · Local PPO
Anthem Blue Cross and Blue Shield
Plan year 2026

Anthem Full Dual Advantage (PPO D-SNP) H2836-006

3.0 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$35.80
+ your Part B premium
Max out-of-pocket
$9,250
in-network annual cap
Primary care
$0
per visit copay
Specialist
$0
per visit
Eligibility required for this D-SNP
You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.
Integration status
CO
Common dual-eligibility labels

These definitions are educational. They do not confirm which Medicaid categories this specific plan accepts.

FBDE
Full Medicaid benefits in addition to Medicare.
QMB+
QMB help with Medicare costs plus full Medicaid benefits.
SLMB+
SLMB help with the Part B premium plus full Medicaid benefits.
QMB
Help with Medicare premiums and Medicare-covered cost sharing.
Check the Summary of Benefits or Evidence of Coverage for the exact Medicaid levels this plan accepts.
Could a Medicare Savings Program help?

Medicare Savings Programs are run by each state. The 2026 federal baseline monthly income limits are:

  • QMB: $1,350 for one person or $1,824 for a married couple
  • SLMB: $1,616 for one person or $2,184 for a married couple
  • QI: $1,816 for one person or $2,455 for a married couple
Alaska, Hawaii, and some states use different limits or resource rules. Qualifying for an MSP does not by itself confirm eligibility for this D-SNP. Apply through your state Medicaid office.
Learn about QMB, SLMB, and QI

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$615
Inpatient hospital
$0
no limit on covered hospital days
Inpatient mental health
$0
no limit on covered hospital days
Outpatient surgery
$0
Emergency room
$0
Urgent care
$0

This plan is for people with Medicaid. What you pay depends on your Medicaid level: with QMB, your share of Medicare-covered services is covered; with full Medicaid benefits, your state may also cover Medicaid-covered services. Your state Medicaid office can confirm your level — or call us at 1-866-764-3312 (TTY 711) and a Licensed Medicare Advisor will help confirm it and discuss this plan's details with you. If you lose Medicaid eligibility, you may be billed the plan's cost sharing.

What's included, and what it's actually worth7 benefits included. Tap any card for the detail

Hearing

$3,000/yr hearing aid allowance
Hearing aid allowance$3,000/yr hearing aid allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Dental

$1,500/yr preventive dental allowance
Details$1,500/yr preventive dental allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$150/quarter OTC allowance
Prepaid card$150/quarter OTC allowance

Vision

$350/yr eyewear allowance
Eyewear allowance$350/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$0 copay
In-network$0 copay per visit
Inpatient Hospital$0
In-network$0
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$0 copay
In-network$0 copay per procedure
Mental Health$0
Inpatient psychiatric$0
Fitness$0 fitness benefit
Transportation60 one-way trips/year
Trips per year60 one-way trips/year
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
25%
Generic
Tier 3
25%
Preferred Brand· after deductible
Tier 4
25%
Non-Pref Brand· after deductible
Tier 5
25%
Specialty· after deductible
Tier 6
$0
Tier 6· after deductible

Our take

Where this plan shines

See your primary doctor for $0.
The specialist copay ($0) is among the more affordable options.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Anthem Full Dual Advantage (PPO D-SNP) (Local PPO)

What does Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) cover?

Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) is a Dual Eligible Special Needs Plan, a Medicare Advantage plan for people who have Medicare and a Medicaid category the plan accepts. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($1,500/yr preventive dental allowance), vision ($350/yr eyewear allowance), hearing ($3,000/yr hearing aid allowance), and over-the-counter (OTC) ($150/quarter OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) cost in 2026?

The published 2026 monthly plan premium for Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) is $35.80. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $615. The in-network medical out-of-pocket maximum is $9,250; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $0. Member costs can depend on the Medicaid category the plan accepts and verifies. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Anthem Full Dual Advantage (PPO D-SNP) (Local PPO)?

CMS lists Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) as a Local PPO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Do I qualify for Anthem Full Dual Advantage (PPO D-SNP) (Local PPO)?

Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) is listed in the current plan record as a D-SNP. You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.

Learn about Medicare Savings Programs

What extra benefits does Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) offer for dual-eligible members?

The current plan record for Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) lists dental ($1,500/yr preventive dental allowance), vision ($350/yr eyewear allowance), hearing ($3,000/yr hearing aid allowance), over-the-counter (OTC) ($150/quarter OTC allowance), and fitness ($0 fitness benefit). Member costs can depend on the Medicaid category the plan accepts and verifies. The record identifies Part D prescription drug coverage. Review the plan documents for benefit limits, eligibility rules, and how Medicare and Medicaid coverage work together.

When can I enroll in Anthem Full Dual Advantage (PPO D-SNP) (Local PPO)?

Anthem Full Dual Advantage (PPO D-SNP) (Local PPO) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a D-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Dual Eligible Special Needs Plan directory. This plan is offered in Connecticut. Plan availability can vary by county.

Helpful next steps

Anthem Full Dual Advantage H2836-006 (PPO D-SNP) — 2026 Medicare Plan