Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Anthem Dual Advantage, 2027

H2628Contract005Plan

HMO D-SNP · special needs plan, dual-eligible · 88 counties in Ohio

Run by Community Insurance Company (contract H2628), sold as Anthem Blue Cross and Blue Shield, owned by Elevance Health, Inc.

Takes in 3 plans

2026 star rating, contract H2628: not rated (too new)

Anthem Dual Advantage (H2628-005) costs $0 a month in 2027, down $7.10 from 2026, with an in-network out-of-pocket limit of $7,100 ($6,750 in 2026). It takes in the members of H2628-001, H2628-003, H2628-004. Some of its 2026 members move to H2628-001, H2628-006, H2628-007 instead (CMS crosswalk).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
Monthly premium	$7.10	$0	down $7.10
In-network out-of-pocket limit	$6,750	$7,100	up $350
Drug deductible	$615	$325	down $290
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Drug tier 5, specialty tier	25% of the cost	29% of the cost	up 4 points
16 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$25 copay	$25 copay	no change
Emergency room	$130 copay	$130 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$435 a day for days 1–7, then $0 a day for days 8–90	$435 a day for days 1–7, then $0 a day for days 8–90	no change
Ground ambulance, in network	$260 copay	$260 copay	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$200 a year	$200 a year	no change
Hearing aids, yearly limit for both ears	$2,000 a year	$2,000 a year	no change
Over-the-counter items, yearly	not offered	not offered	no change
Counties served	88	88	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 2, generic	25% of the cost	25% of the cost	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 4, non-preferred drug	25% of the cost	25% of the cost	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	25% of the cost	25% of the cost
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	25% of the cost
Tier 5	Specialty Tier	25% of the cost	29% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 11 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 9 a higher one. On the premium, 6 the same, 4 a higher one.

Out-of-pocket limits of the 11 dual-eligible special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0000 plans

$6,000 to under $8,000 (this plan)2 plans

$8,000 to $10,0009 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 88 counties: $0 a month and $7,100.

Ohio

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where do its 2026 members go?

The CMS crosswalk moves the members of the 2026 plan into 4 plans for 2027. It names the plans but not which member goes to which; the counties show where each 2027 plan is sold, and the plan's Annual Notice of Change says which one is yours.

2027 plan	Sold in	Members in those counties, Sept. 2026	Premium 2027	Limit 2027
Anthem I MyCare Ohio Full Dual SupportH2628-001	88 of its 88 2026 counties, in Ohio	14,623	$0	$9,850
Stays in this plan	88 of its 88 2026 counties, in Ohio	14,623	$0	$7,100
Anthem Dual Advantage PlusH2628-006	88 of its 88 2026 counties, in Ohio	14,623	$0	$9,850
Anthem I MyCare Ohio Full Dual AdvantageH2628-007	88 of its 88 2026 counties, in Ohio	14,623	$0	$9,850

Where the plans are sold in the same counties, the member counts overlap, so they add up to more than the plan's members.

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).

Which 2026 plans move into it, and what changes for their members?

For 2027 this plan takes in the members of 3 other plans, beside its own 14,646 members. In 2027 it costs $0 a month with a $7,100 limit; each row compares that with the plan its members had in 2026.

2026 plan	Members, Sept. 2026	Members who move	Premium 2026	Premium change	Limit 2026	Limit change
Anthem I MyCare Ohio Full Dual AdvantageH2628-001	21,400	21,296	$25.70	down $25.70	$9,250	down $2,150
Anthem Full Dual AdvantageH2628-003	3,575	3,546	$0.20	down $0.20	$9,250	down $2,150
Anthem Full Dual Advantage 2H2628-004	3,407	3,381	$2.30	down $2.30	$9,250	down $2,150

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.

Who runs this plan?

Plan ID: H2628-005
Legal name of the contract: Community Insurance Company
Sold as: Anthem Blue Cross and Blue Shield
Parent company: Elevance Health, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: not rated (too new) overall; health plan not rated, drug plan not rated
Members, September 2026: 14,646
Plan website, as filed with CMS: https://shop.anthem.com/medicare

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Cuyahoga, OHWhere most of its members live; premiums and limits side by side
Every Anthem Blue Cross and Blue Shield plan for 2027Its contracts, counties and plans that end
The other 3 plans of contract H2628Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.