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2027 Medicare plans

Anthem Full Dual Advantage Aligned (HMO D-SNP)

Anthem Blue Cross · HMO D-SNP · 2027 coverage

Plan ID H4471_010_002 · Coverage begins January 1, 2027 · Information as of 2026-09-22

The big numbers

The plan premium is on top of your Part B premium.

Monthly premium
$0
Most you pay in a year for covered care in network
$9,850
Drug deductible
$105
Most you pay for covered drugs in a year
$2,400
Medicare star rating
3 of 5
See every category

This is a special needs plan. Only some people can join: Dual-Eligible.

In plain English

Compared with the 2 other plans in Santa Clara County that the same person could join.

What stands out

  • No monthly premium
  • Dental, vision and hearing extras included

Watch out for

  • You need a referral to see a specialist

What a year could cost

Premiums plus the plan’s copays for three example years. Medicines are not included.

  • A light year$0$0 in premiums + $0 for care2 checkups and 2 lab tests.Not counted, because the plan charges a percentage: Primary care visit, Lab tests.
  • A busier year$40$0 in premiums + $40 for care4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, X-rays.
  • A hard year$115$0 in premiums + $115 for care6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, MRI, CT and other scans, Ground ambulance, Hospital stay.

The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.

What you pay for care

Your cost each time, at doctors and hospitals in the plan’s network.

  • Primary care visit20%
  • Specialist visit20%Referral neededPlan approval may be needed
  • Urgent care$40
  • Emergency room$115Not charged if you stay in the hospital within 24 hours
  • Lab tests20%Referral neededPlan approval may be needed
More care: surgery, scans, mental health, therapy, home health and more
  • Outpatient surgery center20%Referral neededPlan approval may be needed
  • Outpatient hospital care20%
  • X-rays20%Referral neededPlan approval may be needed
  • MRI, CT and other scans20%Referral neededPlan approval may be needed
  • Ground ambulance20%Plan approval may be needed
  • Mental health therapy visit20%Referral neededPlan approval may be needed
  • Psychiatrist visit20%Referral neededPlan approval may be needed
  • Physical or speech therapy20%Referral neededPlan approval may be needed
  • Occupational therapy20%Referral neededPlan approval may be needed
  • Home health care$0Referral neededPlan approval may be needed
  • Medical equipment, like a walker or oxygen20%Plan approval may be needed
  • Kidney dialysis20%
  • Chemotherapy and radiation drugs0% to 20%Depends on the servicePlan approval may be needed
  • Other drugs given at a clinic0% to 20%Depends on the servicePlan approval may be needed
  • Heart rehab20%Plan approval may be needed
  • Foot doctor (podiatrist)20%Referral neededPlan approval may be needed
  • Chiropractor20%Referral neededPlan approval may be needed

From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 2 other plans in Santa Clara County that the same person could join. Ask the plan for its 2027 Evidence of Coverage booklet for the full rules.

Is my doctor in this plan?

Look up your doctors, then confirm with their office.

Add your doctors once. We’ll check them against each plan you look at.

Before you choose, call each doctor’s office and ask:

“Do you take Anthem Full Dual Advantage Aligned (HMO D-SNP), plan number H4471-010-002, for 2027?”

What medicines cost

The most you pay for covered drugs in 2027 is $2,400. After that, covered drugs cost $0 for the rest of the year.

Drug tierNetwork pharmacy
1Preferred Generic$0
2Generic$0
3Preferred BrandAfter the deductible25% of the price
4Non-Preferred DrugAfter the deductible25% of the price
5Specialty TierAfter the deductible32% of the price

For a 1-month supply. The $105 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.

Check my medicines

See if this plan covers each medicine you take in 2027, and what a month costs.

Type the name on the bottle. Add the strength to narrow it down.

Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.

Extras

Help Original Medicare doesn’t give you.

  • Dental IncludedCleanings and exams: $0. Fillings, crowns and dentures: you pay $0.Cleanings and exams: plan pays up to $3,000 a year. Plan pays up to $3,000 a year for all dental.
  • Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $275 a year.
  • Hearing IncludedHearing test: $0. Hearing aids covered.Hearing aids: plan pays up to $3,000 a year, both ears.
  • Over-the-counter items IncludedCovered for things like vitamins, pain relief and bandages.
  • Fitness IncludedIncludes gym or fitness classes.
  • Rides to care Included96 one-way rides to medical visits a year.
  • Meals IncludedMeals for a short time, right after surgery or a hospital stay or for a long-term illness.
  • Help at home IncludedIncludes an emergency call button and home and bathroom safety items.Ask the plan who can get it.
  • Extra help for some members IncludedIf you have certain long-term health conditions: food and produce and general support for living.The plan decides who qualifies.
  • Other extras IncludedIncludes a nurse phone line or online visits and acupuncture.

What changed from 2026

  • 3 cost more or give less
  • 1 cost less or give more
  • 2 other changes
  • Most you pay in a yearYou pay more2026$9,2502027$9,850
  • Drug deductibleYou pay less2026$6152027$105
  • Medical equipment, like a walker or oxygenYou pay more20260% to 20%202720%
  • VisionLess help2026Yearly eye exam: $0. Glasses or contacts covered. Eyewear: plan pays up to $425 a year2027Yearly eye exam: $0. Glasses or contacts covered. Eyewear: plan pays up to $275 a year
  • MealsDifferent2026Meals for a short time, right after surgery or a hospital stay2027Meals for a short time, right after surgery or a hospital stay or for a long-term illness
  • Extra help for some membersDifferent2026If you have certain long-term health conditions: meals, food and produce and general support for living. The plan decides who qualifies2027If you have certain long-term health conditions: food and produce and general support for living. The plan decides who qualifies

See the 2026 plan

Medicare star ratings

Overall rating
3
Health plan rating
3.5
Drug plan rating
3

Each year Medicare rates plans from 1 to 5 stars. 5 stars is the best, in every row below. This plan was rated on 40 measures in 9 topics. The ratings look back at earlier care and service: most measures cover 2025, and member surveys were done in early 2026. Every plan under the same Anthem Blue Cross contract (H4471) shares these ratings.

  • Staying healthy: screenings, tests and vaccines4 measures3
    • Breast cancer screeningMedicare’s name: Breast Cancer Screening · Measured: 20252
    • Colon cancer screeningMedicare’s name: Colorectal Cancer Screening · Measured: 20252
    • Flu shotsMedicare’s name: Annual Flu Vaccine · Measured: March to May 20264
    • Doctors talking with members about physical activityMedicare’s name: Monitoring Physical Activity · Measured: July 14 to November 3, 20253
  • Managing long-term conditions13 measures3
    • Care plans for special needs plan membersMedicare’s name: Special Needs Plan (SNP) Care Management · Measured: 20253
    • Yearly review of all your medicinesMedicare’s name: Care for Older Adults - Medication Review · Measured: 20254
    • Check of how well you manage daily activitiesMedicare’s name: Care for Older Adults - Functional Status Assessment · Measured: 20252
    • Bone care for women after a fractureMedicare’s name: Osteoporosis Management in Women who had a Fracture · Measured: 20252
    • Eye exams for people with diabetesMedicare’s name: Diabetes Care - Eye Exam · Measured: 20253
    • Blood sugar under control, for people with diabetesMedicare’s name: Diabetes Care - Blood Sugar Controlled · Measured: 20253
    • Kidney checks for people with diabetesMedicare’s name: Kidney Health Evaluation for Patients with Diabetes · Measured: 20254
    • Blood pressure under controlMedicare’s name: Controlling High Blood Pressure · Measured: 20252
    • Help to lower the risk of fallingMedicare’s name: Reducing the Risk of Falling · Measured: July 14 to November 3, 20254
    • Avoiding a return to the hospital soon after a stayMedicare’s name: Plan All-Cause Readmissions · Measured: 20253
    • Statins for people with heart or blood vessel diseaseMedicare’s name: Statin Therapy for Patients with Cardiovascular Disease · Measured: 20253
    • Care after leaving the hospitalMedicare’s name: Transitions of Care · Measured: 20253
    • Follow-up after an emergency room visit, for people with several long-term conditionsMedicare’s name: Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · Measured: 20251
  • What members say about the health plan4 measures2
    • Getting needed careMedicare’s name: Getting Needed Care · Measured: March to May 20261
    • Customer serviceMedicare’s name: Customer Service · Measured: March to May 20261
    • Members’ rating of their health careMedicare’s name: Rating of Health Care Quality · Measured: March to May 20261
    • Members’ rating of the health planMedicare’s name: Rating of Health Plan · Measured: March to May 20263
  • Complaints, members leaving, and improvement3 measures4
    • Few complaints about the planMedicare’s name: Complaints about the Health Plan · Measured: 20253
    • Few members choosing to leaveMedicare’s name: Members Choosing to Leave the Plan · Measured: 20254
    • Improvement since earlier yearsMedicare’s name: Health Plan Quality Improvement · Measured: Not Applicable5
  • Customer service and appeals3 measures5
    • Deciding appeals on timeMedicare’s name: Plan Makes Timely Decisions about Appeals · Measured: 20255
    • Appeal decisions an independent reviewer agrees withMedicare’s name: Reviewing Appeals Decisions · Measured: 20255
    • Interpreters and TTY on the phone lineMedicare’s name: Call Center - Foreign Language Interpreter and TTY Availability · Measured: February to May 20265
  • Drug plan customer service1 measure5
    • Interpreters and TTY on the phone lineMedicare’s name: Call Center - Foreign Language Interpreter and TTY Availability · Measured: February to May 20265
  • Drug plan complaints, members leaving, and improvement3 measures3
    • Few complaints about the drug planMedicare’s name: Complaints about the Drug Plan · Measured: 20253
    • Few members choosing to leaveMedicare’s name: Members Choosing to Leave the Plan · Measured: 20254
    • Improvement since earlier yearsMedicare’s name: Drug Plan Quality Improvement · Measured: Not Applicable2
  • What members say about the drug plan2 measures3
    • Members’ rating of the drug planMedicare’s name: Rating of Drug Plan · Measured: March to June 20263
    • Getting needed prescription drugsMedicare’s name: Getting Needed Prescription Drugs · Measured: March to June 20262
  • Drug safety and accurate drug prices7 measures3
    • Drug prices shown on Medicare’s Plan Finder are accurateMedicare’s name: MPF Price Accuracy · Measured: January 1 to September 30, 20255
    • Members taking diabetes medicines as prescribedMedicare’s name: Medication Adherence for Diabetes Medications · Measured: 20253
    • Members taking blood pressure medicines as prescribedMedicare’s name: Medication Adherence for Hypertension (RAS antagonists) · Measured: 20252
    • Members taking cholesterol medicines (statins) as prescribedMedicare’s name: Medication Adherence for Cholesterol (Statins) · Measured: 20252
    • Statins for people with diabetesMedicare’s name: Statin Use in Persons with Diabetes (SUPD) · Measured: 20254
    • Avoiding opioids together with benzodiazepinesMedicare’s name: Concurrent Use of Opioids and Benzodiazepines (COB) · Measured: 20254
    • Avoiding several anticholinergic medicines at onceMedicare’s name: Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · Measured: 20253

From Medicare’s 2027 Star Ratings, released October 8, 2026. A rating is one thing to weigh, next to your doctors, your medicines and your costs.

Help paying for this plan

Programs that can lower your Medicare costs if your income is limited.

Extra Help with drug costs

The drug part of this plan’s premium is already $0, so Extra Help would not lower the premium.

Extra Help also lowers what you pay for each medicine.

See who can get Extra Help

Help with your Part B premium

A Medicare Savings Program can pay your Part B premium, and for some people more of their Medicare costs.

See who can get a Medicare Savings Program

Contact the plan

From the details the plan filed with Medicare for 2027. To check whether a doctor takes this plan, call the doctor’s office, not the plan.