Anthem Dual Advantage (HMO D-SNP) in Lee County, Virginia — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Anthem Dual Advantage (HMO D-SNP) (H4694-002) is a $0-premium Medicare Advantage HMO D-SNP from Elevance Health, Inc. available in Lee County, Virginia in 2026, with a —-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $605 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Elevance Health, Inc. |
|---|---|
| Plan name | Anthem Dual Advantage (HMO D-SNP) |
| Contract ID | H4694 |
| Plan ID | 002 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | SNP |
| Plan type | HMO D-SNP |
| SNP | Yes — Dual-Eligible |
| Monthly consolidated premium | $0.00 |
| Part C premium | $0.00 |
| Part D basic premium | $4.70 |
| Part D total premium | $0.00 |
| Annual Part D deductible | $605.00 |
| Maximum out-of-pocket (in-network) | $9250.00 |
| Overall star rating | — |
How this plan is structured
- $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
- $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Lee County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Lee County
The CMS CY2026 Landscape file lists 47 Medicare Advantage plans in Lee County, Virginia, of which 0 carry a 5.0-star overall rating and 20 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $117.00 per month, and in-network out-of-pocket maximums range from $1800.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Lee County, Virginia.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4694-002.
- Call the plan (Elevance Health, Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H4694-002 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4694-002, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4694 are the contract number issued to the organization, and the three-digit 002 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is Anthem Dual Advantage (HMO D-SNP) an HMO or PPO?
Anthem Dual Advantage (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does Anthem Dual Advantage (HMO D-SNP) include prescription drug coverage?
Yes — Anthem Dual Advantage (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $605.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Anthem Dual Advantage (HMO D-SNP)?
The 2026 in-network maximum out-of-pocket limit for Anthem Dual Advantage (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.
What counties offer Anthem Dual Advantage (HMO D-SNP) (H4694-002)?
Anthem Dual Advantage (HMO D-SNP) (H4694-002) is offered in 133 Virginia counties: Accomack County, Albemarle County, Alexandria City County, Alleghany County, Amelia County, Amherst County, Appomattox County, Arlington County, Augusta County, Bath County, Bedford County, Bland County, Botetourt County, Bristol City County, Brunswick County, Buchanan County, Buckingham County, Buena Vista City County, Campbell County, Caroline County, Carroll County, Charles City County, Charlotte County, Charlottesville City County, Chesapeake City County, Chesterfield County, Clarke County, Colonial Heights City County, Covington City County, Craig County, Culpeper County, Cumberland County, Danville City County, Dickenson County, Dinwiddie County, Emporia City County, Essex County, Fairfax County, Fairfax City County, Falls Church City County, Fauquier County, Floyd County, Fluvanna County, Franklin County, Franklin City County, Frederick County, Fredericksburg City County, Galax City County, Giles County, Gloucester County, Goochland County, Grayson County, Greene County, Greensville County, Halifax County, Hampton City County, Hanover County, Harrisonburg City County, Henrico County, Henry County, Highland County, Hopewell City County, Isle of Wight County, James City County, King and Queen County, King George County, King William County, Lancaster County, Lee County, Lexington City County, Loudoun County, Louisa County, Lunenburg County, Lynchburg City County, Madison County, Manassas City County, Manassas Park City County, Martinsville City County, Mathews County, Mecklenburg County, Middlesex County, Montgomery County, Nelson County, New Kent County, Newport News City County, Norfolk City County, Northampton County, Northumberland County, Norton City County, Nottoway County, Orange County, Page County, Patrick County, Petersburg City County, Pittsylvania County, Poquoson City County, Portsmouth City County, Powhatan County, Prince Edward County, Prince George County, Prince William County, Pulaski County, Radford City County, Rappahannock County, Richmond County, Richmond City County, Roanoke County, Roanoke City County, Rockbridge County, Rockingham County, Russell County, Salem City County, Scott County, Shenandoah County, Smyth County, Southampton County, Spotsylvania County, Stafford County, Staunton City County, Suffolk City County, Surry County, Sussex County, Tazewell County, Virginia Beach City County, Warren County, Washington County, Waynesboro City County, Westmoreland County, Williamsburg City County, Winchester City County, Wise County, Wythe County, and York County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.