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KeyCare Advantage Plus (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for KeyCare Advantage Plus (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on KeyCare Advantage Plus (HMO C-SNP) in 2025, please refer to our full plan details page.
KeyCare Advantage Plus (HMO C-SNP) is a HMO C-SNP plan offered by ISNP Holdings, LLC available for enrollment in 2025 to people living in Maryland (partial). This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that KeyCare Advantage Plus (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
KeyCare Advantage Plus (HMO C-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 KeyCare Advantage Plus (HMO C-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 KeyCare Advantage Plus (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $300.00 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 $6900.00 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 KeyCare Advantage Plus (HMO C-SNP) plan has a $300 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, you may pay a $15 copay for a preferred generic drug at a standard or mail-order pharmacy. For standard generic drugs, the copay is $45, and for preferred brand drugs, the copay is $95. If a drug is non-preferred, you will pay 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The KeyCare Advantage Plus (HMO C-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay for the first few days, while outpatient services typically involve a 20% coinsurance or a copay. Emergency and urgent care services have copays. This plan covers a variety of services, including primary care, preventive care with no copay, hearing and vision exams, and dental services with coinsurance. The plan also covers home health services with no cost to you. Additional benefits such as hearing aids, and dental services have annual maximums.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the KeyCare Advantage Plus (HMO C-SNP) plan. For days 1-5, there is a $300 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient services are covered by the KeyCare Advantage Plus (HMO C-SNP) plan, including outpatient hospital services and observation services, both with a 20% coinsurance. Outpatient Hospital Services have a copay between $0 and $225. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered, with a 20% coinsurance. Individual and group sessions for outpatient substance abuse are covered with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by KeyCare Advantage Plus (HMO C-SNP). Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under the KeyCare Advantage Plus (HMO C-SNP) plan. Emergency Services have a $95 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
KeyCare Advantage Plus (HMO C-SNP) covers Primary Care Physician Services, Chiropractic Services with 20% coinsurance and Routine Chiropractic Care with a $20 copay for 6 visits per year, Occupational Therapy Services with a $30 copay, Physician Specialist Services with a $0-$20 copay, Mental Health Specialty Services with 20% coinsurance for individual and group sessions, Podiatry Services, Other Health Care Professional services with 20% coinsurance, Psychiatric Services with 20% coinsurance for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $30 copay, Additional Telehealth Benefits with 20% coinsurance and a $0-$20 copay, and Opioid Treatment Program Services.
Preventive Services See details
The KeyCare Advantage Plus (HMO C-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional preventive services, though annual physical exams, health education, and several other services are not covered. This plan also covers kidney disease education services, glaucoma screenings, and other services with no copay.
Hearing Services See details
KeyCare Advantage Plus (HMO C-SNP) covers hearing exams with a coinsurance of at most 20%, and routine hearing exams once every two years. The plan also covers prescription hearing aids, with a maximum benefit of $1,000 per year for all types of hearing aids, but does not cover fitting/evaluation for hearing aids, prescription hearing aids - inner ear, outer ear, or over the ear, or OTC hearing aids.
Vision Services See details
Vision services include routine eye exams, and eyewear. Routine eye exams are covered once every two years. Eyewear, including contact lenses, has a 20% coinsurance, with a combined maximum benefit of $1000 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The KeyCare Advantage Plus (HMO C-SNP) plan covers dental services with 20% coinsurance for Medicare dental services, and other dental services have a $1650 maximum plan benefit coverage every year. Oral exams are covered with a limit of 2 per year, and dental x-rays are covered with a limit of 2, while fluoride treatments are covered with a limit of 1 every six months. Orthodontic services are covered under Diagnostic and Preventive Dental. Maxillofacial prosthetics, implant services, 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. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the KeyCare Advantage Plus (HMO C-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered under the KeyCare Advantage Plus (HMO C-SNP) plan, including Durable Medical Equipment (DME) with 20% coinsurance and no copay, and Prosthetics/Medical Supplies with coinsurance for Medicare-covered devices and supplies, with no copay. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the KeyCare Advantage Plus (HMO C-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services are not covered. Therapeutic Radiological Services also have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the KeyCare Advantage Plus (HMO C-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 covered, but specific services like Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, but the plan does not provide additional days beyond Medicare coverage or non-Medicare-covered stays. The plan charges the Medicare-defined cost share for tier 1, with coinsurance details available.
Other Services See details
The KeyCare Advantage Plus (HMO C-SNP) plan covers Over-the-Counter (OTC) items, but does not cover acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. The plan does provide OTC items as a supplemental benefit under Part C.
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