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Submission: On March 26 via manual from US — Scanned from DE
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A non-government resource for the Medicare community Powered by Q1Group LLC A non-government Medicare community resource * Menu ☰ * Home * Contact * MAPD * PDP * 2024 * 2025 * FAQs * Articles * Search ⌕ * -- 2024 Medicare Part D Plan Links -- Find a 2024 Prescription Only (PDP) Plan Highlights of 2024 Plans by State Find a 2024 Health/Drug (MAPD) Plan PDP Plan Change from 2023 to 2024 MA Plan Change from 2023 to 2024 Q1Rx: Find a 2024 Plan by Drug Cost Browse a 2024 Formulary (Drug List) 2024 Part D Donut Hole Calculator 2024 Search by Plan ID -- 2025 Medicare Part D Information -- * Contact * 2024 * 2025 * FAQs * Articles * Latest Medicare News * Search ⌕ Close × * 2024 Medicare Part D Rx plans * Rx plan changes 2023 to 2024 * 2024 Medicare Advantage plans * MA plan changes 2023 to 2024 * Browse any 2024 Drug Formulary * Q1Rx: Compare 2024 Rx Drug Costs * 2024 Medicare & You Guide * Newsletter Sign-up * 2025 Plan Info Reminder Service * Special Features * Find a 2024 Part D Plan (Rx Only) * Find a 2024 Medicare Advantage Plan (Health and Health w/Rx Plans) * Browse Any 2024 Medicare Plan Formulary (or Drug List) * Q1Rx Drug-Finder: Compare Drug Cost Across all 2024 Medicare Plans * 2024 Plan Overview by State * PDP and MAPD Overview by State * PDP Overview by CMS Region * Medicare Part D * Latest Medicare News * What is Medicare Part D? * 2024 Medicare Part D Plan Information * 2024 Part D Plan Facts & Figures * 2024 Facts & Figures in Plain Text * PDP-Compare: How will each 2023 Part D Plan Change in 2024? * MA-Compare: Review Changes in each 2023 Medicare Advantage Plan for 2024 * Find a 2024 Medicare Part D Plan (PDP-Finder: Rx Only) * Find a 2024 Medicare Advantage Plan (Health and Health w/Rx Plans) * Browse Any 2024 Medicare Plan Formulary (Drug List) * Q1Rx 2024 Medicare Part D or Medicare Advantage Plan Finder by Drug * 2024 Part D Plan (PDP) Overview by State * 2024 Overview by CMS PDP Region * 2024 PDP & MAPD Overview by State * Medicare Star Quality Ratings 2024 * Guided Help Finding a 2024 Medicare Prescription Drug Plan * 2024 Part D Plan - Quick Search * Search for 2024 Medicare Plans by Plan ID * Search for 2024 Medicare Plans by Formulary ID * 2024 PDP-Planner & Donut Hole Calculator * 2024 Medicare Prescription Drug Plan (PDP) Benefit Details * 2024 Medicare Advantage Plan Benefit Details * 2024 MAPD Plan Benefits in Plain Text * 2025 Medicare Part D Plan Information * Enrollment Tips: Choosing a plan * How do Medicare Part D plans work? * Medicare plan quality and CMS Star Ratings * Which Drugs are Covered? * Which Drugs are Excluded? * Formulary Exceptions (Coverage Determinations), Appeals & Grievances * Important Dates * The Late Enrollment Penalty * After Enrollment into Part D * Understanding Your Explanation of Benefits * IRMAA: Higher premiums for higher incomes * Calculating Out-of-Pocket Costs * The Donut Hole and Beyond * Donut Hole Calculator * Medicaid, "Extra Help" and LIS * Medicare Advantage Plans * 2024 Medicare Advantage Plans State Overview * 2024 Medicare Advantage Plan Benefit Details * Find a 2024 Medicare Advantage Plan by Drug Costs * Medicare Overview * Medicare & You Handbook * Guide to Rx Coverage * Plan Archives * Support Center Close × Medicare Part D 2024 Medicare Part D Plan Information 2024 Medicare Advantage Plan Benefit Details Earth video More Videos 0 seconds of 30 secondsVolume 0% Press shift question mark to access a list of keyboard shortcuts Keyboard ShortcutsEnabledDisabled Play/PauseSPACE Increase Volume↑ Decrease Volume↓ Seek Forward→ Seek Backward← Captions On/Offc Fullscreen/Exit Fullscreenf Mute/Unmutem Decrease Caption Size- Increase Caption Size+ or = Seek %0-9 Next Up q1medicare 00:30 facebook twitter Email pinterest Linkhttps://playthetunes.com/songs-about-running-away/ Copied Live 00:00 00:37 00:30 2024 MEDICARE ADVANTAGE PLAN BENEFIT DETAILS FOR THE ANTHEM FULL DUAL ADVANTAGE (HMO D-SNP) - H3447-045-0 2024 Medicare Advantage Plan Details Medicare Plan Name:Anthem Full Dual Advantage (HMO D-SNP) Location:Patrick, Virginia Click to see other locations Plan ID:H3447 - 045 - 0 Click to see other plansMember Services:1-844-395-1019 TTY users 711 Medicare Contact Information:Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance Email a copy of the Anthem Full Dual Advantage (HMO D-SNP) benefit details — Medicare Plan Features — Monthly Premium:$0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible:$0 for people who qualify for both Medicare and Medicaid. Annual Initial Coverage Limit (ICL):$5,030 Health Plan Type:Local HMO Special Needs Plan (SNP) Eligibility Requirement:Dual-Eligible Additional Gap Coverage?No additional gap coverage, only the Donut Hole DiscountTotal Number of Formulary Drugs:3,592 drugsBrowse the Anthem Full Dual Advantage (HMO D-SNP) FormularyThis plan has 6 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase:$0.00$0.00$0.00$0.00$0.00 • Number of Drugs per Tier:2245518211043678 Plan Offers Mail Order?YesMedicare Plan Pharmacy Numbers: BIN: 020115 PCN: IS See BIN/PCNs for all plans Number of Members enrolled in this plan in Virginia:1,445 members Number of Members enrolled in this plan in (H3447 - 045):2,825 members Plan’s Summary Star Rating: 3.5 out of 5 Stars.• Customer Service Rating: 4 out of 5 Stars.• Member Experience Rating: 4 out of 5 Stars.• Drug Cost Accuracy Rating: 3 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: ❔ Total PremiumPart C PremiumPart D Base PremiumPart D Supplemental Premium $38.50$0.00$38.50$0.00 Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ $0.00 Total Monthly Premium with LIS (Parts C & D): $0.00 — Plan Health Benefits — ** Base Plan ** Premium • Health plan premium: $0 • Drug plan premium: $0 • You must continue to pay your Part B premium. • Part B premium reduction: No Deductible • Health plan deductible: $0 • Other health plan deductibles: In-network: No • Drug plan deductible: $545.00 annual deductible Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) • $8,850 In-network Optional supplemental benefits • No Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions? • In-network: No Doctor visits • Primary: $0 copay • Specialist: $0 copay (authorization and referral required) Diagnostic procedures/lab services/imaging • Diagnostic tests and procedures: $0 copay (authorization required) • Lab services: $0 copay (authorization required) • Diagnostic radiology services (e.g., MRI): $0 copay (authorization required) • Outpatient x-rays: $0 copay (authorization required) Emergency care/Urgent care • Emergency: $0 copay • Urgent care: $0 copay Inpatient hospital coverage • $0 copay (authorization required) Outpatient hospital coverage • $0 copay (authorization required) Skilled Nursing Facility • $0 copay (authorization required) Preventive care • $0 copay Ground ambulance • $0 copay Rehabilitation services • Occupational therapy visit: $0 copay (authorization required) • Physical therapy and speech and language therapy visit: $0 copay (authorization required) Mental health services • Inpatient hospital - psychiatric: $0 copay (authorization required) • Outpatient group therapy visit with a psychiatrist: $0 copay (authorization required) • Outpatient individual therapy visit with a psychiatrist: $0 copay (authorization required) • Outpatient group therapy visit: $0 copay (authorization required) • Outpatient individual therapy visit: $0 copay (authorization required) Medical equipment/supplies • Durable medical equipment (e.g., wheelchairs, oxygen): $0 copay (authorization required) • Prosthetics (e.g., braces, artificial limbs): $0 copay (authorization required) • Diabetes supplies: $0 copay Hearing • Hearing exam: $0 copay (authorization required) • Fitting/evaluation: $0 copay (limits apply, authorization required) • Hearing aids: $0 copay (limits apply, authorization required) Preventive dental • Oral exam: $0 copay (limits apply) • Cleaning: $0 copay (limits apply) • Fluoride treatment: $0 copay (limits apply) • Dental x-ray(s): $0 copay (limits apply) Comprehensive dental • Non-routine services: $0 copay (limits apply, authorization required) • Diagnostic services: $0 copay (limits apply, authorization required) • Restorative services: $0 copay (limits apply, authorization required) • Endodontics: $0 copay (limits apply, authorization required) • Periodontics: $0 copay (limits apply, authorization required) • Extractions: $0 copay (limits apply, authorization required) • Prosthodontics, other oral/maxillofacial surgery, other services: $0 copay (limits apply, authorization required) Vision • Routine eye exam: $0 copay (limits apply) • Other: Not covered • Contact lenses: $0 copay (limits apply) • Eyeglasses (frames and lenses): $0 copay (limits apply) • Eyeglass frames: $0 copay (limits apply) • Eyeglass lenses: $0 copay (limits apply) • Upgrades: Not covered Medically-approved non-opioid pain management services • Chiropractic services: Not covered • Acupuncture: Some coverage • Therapeutic Massage: Not covered • Alternative Therapies: Not covered More benefits • Transportation services: Some coverage • Over-the-counter drug benefits: Some coverage • Meals for short duration: Some coverage • Annual physical exams: Some coverage • Telehealth: Some coverage • WorldWide emergency transportation: Some coverage • WorldWide emergency coverage: Some coverage • WorldWide emergency urgent care: Some coverage • Fitness Benefit: Some coverage • In-Home Support Services: Not covered • Bathroom Safety Devices: Some coverage • Health Education: Not covered • In-Home Safety Assessment: Not covered • Personal Emergency Response System (PERS): Some coverage • Medical Nutrition Therapy (MNT): Not covered • Post discharge In-Home Medication Reconciliation: Not covered • Re-admission Prevention: Not covered • Wigs for Hair Loss Related to Chemotherapy: Not covered • Weight Management Programs: Not covered • Adult Day Health Services: Not covered • Nutritional/Dietary Benefit: Not covered • Home-Based Palliative Care: Not covered • Support for Caregivers of Enrollees: Not covered • Additional Sessions of Smoking and Tobacco Cessation Counseling: Not covered • Enhanced Disease Management: Not covered • Telemonitoring Services: Not covered • Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline): Some coverage • Counseling Services: Not covered Wellness programs (e.g., fitness, nursing hotline) • Covered Transportation • $0 copay (limits apply) Foot care (podiatry services) • Foot exams and treatment: $0 copay (authorization required) • Routine foot care: $0 copay (limits apply, authorization required) Medicare Part B drugs • Part B Insulin drugs: $0 copay (authorization required) • Chemotherapy: $0 copay (authorization required) • Other Part B drugs: $0 copay (authorization required) * Top × search Custom Search Medicare Supplements fill the gaps in your Original Medicare 1. Enter Your ZIP Code: » Medicare Supplement FAQs Q1 Quick Links * Sign-up for our Medicare Part D Newsletter. * PDP-Facts: 2024 Medicare Part D plan Facts & Figures * 2024 PDP-Finder: Medicare Part D (Drug Only) Plan Finder * PDP-Compare: 2023/2024 Medicare Part D plan changes * 2024 MA-Finder: Medicare Advantage Plan Finder * MA plan changes 2023 to 2024 * Drug Finder: 2024 Medicare Part D drug search * Formulary Browser: View any 2024 Medicare plan's drug list * 2024 Browse Drugs By Letter * Guide to 2023/2024 Mailings from CMS, Social Security and Plans * Out-of-Pocket Cost Calculator * Q1Medicare FAQs: Most Read and Newest Questions & Answers * Q1Medicare News: Latest Articles * 2025 Medicare Part D Reminder Service * Sitemap * About Us * Newsletter Sign-up * Latest Medicare News * FAQs * Contact * Privacy Policy * Terms Of Use © Q1Group LLC 2005 - 2024 Tips & Disclaimers * Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group. * The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. * Medicare has neither reviewed nor endorsed the information on our site. * We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. * We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information. * Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes. * The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. * Limitations, copayments, and restrictions may apply. * We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. Statement required by Medicare: "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options." * When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium. * Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA. * Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA. * You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information. * If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office. * Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. * A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency. * Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. * Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. * Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. * Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. * Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan * There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information. * Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov. * Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696. Update Privacy Preferences A Raptive Partner Site