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

Anthem Dual Advantage, 2027

H5422Contract018Plan

HMO D-SNP · special needs plan, dual-eligible · 150 counties in Georgia

Run by Blue Cross Blue Shield Healthcare Plan of Georgia (contract H5422), sold as Anthem Blue Cross and Blue Shield, owned by Elevance Health, Inc.

Renews for 2027

2026 star rating, contract H5422: 3.5 of 5

Anthem Dual Advantage (H5422-018) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).

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
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$355	$105	down $250
Hospital stay, in network	$300 a day for days 1–6, then $0 a day for days 7–90	$405 a day for days 1–6, then $0 a day for days 7–90	up $525for a 5-day stay
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
Counties served	145	150	up 5
Drug tier 2, generic	25% of the cost	$0	changed
Drug tier 5, specialty tier	29% of the cost	32% of the cost	up 3 points
14 lines do not change
Monthly premium	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$40 copay	$40 copay	no change
Emergency room	$115 copay	$115 copay	no change
Medical deductible, in network	none	none	no change
Ground ambulance, in network	$275 copay	$275 copay	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$225 a year	$225 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
Drug tier 1, preferred generic	$0	$0	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	$0
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	29% of the cost	32% 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, 31 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 5 plans have a lower out-of-pocket limit, 25 the same. On the premium, 22 the same, 8 a higher one.

Out-of-pocket limits of the 31 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 $8,0003 plans

$8,000 to $10,000 (this plan)28 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 150 counties: $0 a month and $9,850.

Georgia

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

Who runs this plan?

Plan ID: H5422-018
Legal name of the contract: Blue Cross Blue Shield Healthcare Plan of Georgia
Sold as: Anthem Blue Cross and Blue Shield
Parent company: Elevance Health, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3 of 5
Members, September 2026: 1,597
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 Fulton, GAWhere 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 4 plans of contract H5422Same 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.