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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 2026, 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 2.5 out of 5 stars in 2026.
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 $10.50. 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 $615.00 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 $9250.00 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 features an annual prescription drug deductible of $615. This means you will pay the cost of your prescription medications up to this amount before your plan coverage begins to pay. Knowing this deductible is a crucial first step in estimating your yearly out-of-pocket healthcare expenses with this Medicare plan. Detailed information regarding specific drug tiers, copayments, and coinsurance is currently unavailable for this plan. To find out how much your specific medications will cost and which tiers they fall under, you will need to verify the plan's formulary directly.
Additional Benefits
The AllCare Advantage Redwood Rx (HMO D-SNP) offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. Inpatient hospital stays require daily copays depending on the length of stay, while outpatient hospital services generally carry a $200 copay and 20% coinsurance. Emergency and ambulance services are also covered, typically requiring no copay and a 20% coinsurance. For supplemental care, this plan provides no copay and no coinsurance for diagnostic tests, lab services, and up to $460 annually for corrective eyewear. However, routine dental and hearing exams, as well as hearing aids, are not covered, though Medicare-covered dental services are available with no copay and a 20% coinsurance. Durable medical equipment and dialysis are also covered with no copay and coinsurance ranging up to 20%.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AllCare Advantage Redwood Rx (HMO D-SNP) with no coinsurance, excluding upgrades, additional days, and non-Medicare-covered stays. Medicare-covered acute stays require a $2,230 copay for day 1, no copay for days 2 through 3, and a $69 daily copay for days 4 through 90, while psychiatric stays require a $693 copay for days 1 through 3 and no copay for days 4 through 90.
Outpatient Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) covers outpatient hospital and observation services with a $200 copay and 20% coinsurance. Ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services are covered with no copay and 20% coinsurance.
Partial Hospitalization See details
AllCare Advantage Redwood Rx (HMO D-SNP) covers partial hospitalization services with prior authorization required. Depending on your coverage, you will pay either a $60 copay with no coinsurance, or no copay with a 20% coinsurance.
Ambulance and Transportation Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) covers Medicare-approved ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AllCare Advantage Redwood Rx (HMO D-SNP) with a 20% coinsurance and no copay up to a maximum of $115 per visit, which is waived if you are admitted to the hospital within 48 hours. Urgently needed services require a 20% coinsurance and no copay up to $40 per visit, but worldwide emergency, urgent care, and emergency transportation services are not covered.
Primary Care See details
Primary care benefits under the AllCare Advantage Redwood Rx (HMO D-SNP) are covered with no copay and coinsurance ranging from no coinsurance to 20% for doctor visits, physical therapy, and telehealth, while podiatry is not covered. Some chiropractic, mental health, and psychiatric services are covered, but routine chiropractic care, individual and group mental health sessions, and psychiatric sessions are not covered.
Preventive Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive services are partially covered with no copay or coinsurance, though sub-services such as fitness benefits, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services under AllCare Advantage Redwood Rx (HMO D-SNP) cover diagnostic hearing exams with no copay, no coinsurance, and no deductible, although a referral is required. While some hearing aid benefits are technically covered, routine hearing exams, fitting evaluations, and all prescription and over-the-counter (OTC) hearing aids are not covered in practice.
Vision Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) offers partially covered vision services, which exclude routine and other eye exams but cover eyewear with no copay and no coinsurance. Covered eyewear, including contact lenses, eyeglasses, frames, lenses, and upgrades, has a combined maximum plan benefit of $460 every year.
Dental Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) partially covers dental services, offering coverage only for Medicare-covered dental services with no copay and a 20% coinsurance, subject to prior authorization and referral requirements. Routine and comprehensive dental services, including oral exams, cleanings, x-rays, and orthodontic services, are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AllCare Advantage Redwood Rx (HMO D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have no copay and no coinsurance, while other Medicare Part B chemotherapy, radiation, and prescription drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the AllCare Advantage Redwood Rx (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is partially covered by AllCare Advantage Redwood Rx (HMO D-SNP), featuring durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic equipment is covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AllCare Advantage Redwood Rx (HMO D-SNP) with prior authorization required and no copays. There is no coinsurance for diagnostic procedures, lab services, and outpatient X-rays, while diagnostic and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AllCare Advantage Redwood Rx (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no copay under the AllCare Advantage Redwood Rx (HMO D-SNP) plan, meaning some services are covered. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance and prior authorization.
Skilled Nursing Facility (SNF) See details
AllCare Advantage Redwood Rx (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and days 64 through 100, while days 21 through 63 require a $218 daily copay; additional days beyond the 100-day Medicare-covered limit are not covered.
Other Services See details
AllCare Advantage Redwood Rx (HMO D-SNP) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and highly integrated services for dual-eligible SNPs are not covered.
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* 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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