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AllCare Advantage Redwood Rx (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AllCare Advantage Redwood Rx (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AllCare Advantage Redwood Rx (HMO D-SNP) in 2025, please refer to our full plan details page.
AllCare Advantage Redwood Rx (HMO D-SNP) is a HMO D-SNP plan offered by AllCare Health, Inc. available for enrollment in 2025 to people living in Josephine, Jackson, Curry, Douglas*. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that AllCare Advantage Redwood Rx (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
AllCare Advantage Redwood Rx (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AllCare Advantage Redwood Rx (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For AllCare Advantage Redwood Rx (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.30. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AllCare Advantage Redwood Rx (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS) or "Extra Help". If you qualify for LIS, the monthly premium for Part D is $21.30. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The AllCare Advantage Redwood Rx (HMO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and emergency services have coinsurance. The plan covers several services, including vision and dental, with coinsurance, and offers no copays for home health services. Preventative services, home infusion, and dialysis services are also covered with coinsurance.
Inpatient Hospital See details
The AllCare Advantage Redwood Rx (HMO D-SNP) plan covers inpatient hospital stays, with a copay of $728 for days 1-3 and no copay for days 4-90 for acute care, and a copay of $678 for days 1-3 and no copay for days 4-90 for psychiatric care. Additional days, non-Medicare-covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services and observation services have a $200 copay and 20% coinsurance, while outpatient blood services have a 20% coinsurance. Ambulatory surgical center services, individual sessions for outpatient substance abuse, and group sessions for outpatient substance abuse have a coinsurance of 20%.
Partial Hospitalization See details
Partial Hospitalization is covered with a $60 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan. Ground and air ambulance services are covered with a 20% coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered. Emergency Services and Urgently Needed Services have a 20% coinsurance, and Worldwide Emergency Coverage has a $110 copay. Worldwide Urgent Coverage has a $45 copay, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The AllCare Advantage Redwood Rx (HMO D-SNP) plan covers primary care physician services with a coinsurance between 0% and 20%, chiropractic services with a 20% coinsurance, occupational therapy services with 20% coinsurance, and physician specialist services with a 20% coinsurance. The plan also covers physical therapy and speech-language pathology services with a 20% coinsurance, and additional telehealth benefits with a 20% coinsurance. Mental health and psychiatric individual and group sessions are not covered, and podiatry services are not covered.
Preventive Services See details
Preventive services, including Medicare-covered services and an annual physical exam, are covered. Additional preventive services are covered with prior authorization, and include coinsurance for weight management programs and alternative therapies.
Hearing Services See details
Hearing Services are partially covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan, with a coinsurance of at most 20% for hearing exams, but routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids are not covered. OTC hearing aids are also not covered.
Vision Services See details
Vision services are covered, including routine eye exams and eyewear. Eye exams have a 20% coinsurance, and you are covered for one routine eye exam every year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, also has a 20% coinsurance with a combined maximum of $200 every two years.
Dental Services See details
Dental Services are partially covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan. Medicare Dental Services are covered with 20% coinsurance, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. There is a coinsurance for the services, but the exact amount is not specified.
Dialysis Services See details
Dialysis Services are covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance, but Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. There is no copay for any of these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay for all diagnostic and radiological services. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, with a minimum coinsurance of 0%. Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of at most 20%, with a minimum coinsurance of 20%. Outpatient X-Ray Services have a coinsurance of at most 20%, with no coinsurance.
Home Health Services See details
Home Health Services are covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AllCare Advantage Redwood Rx (HMO D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The AllCare Advantage Redwood Rx (HMO D-SNP) plan covers acupuncture with prior authorization, and over-the-counter items including nicotine replacement therapy (NRT). The plan also offers a meal benefit for chronic illnesses with prior authorization; however, several other services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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