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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 2026, 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 2026.
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) prescription drug plan features an annual drug deductible of $300. For Tier 1 preferred generic drugs, members pay no copay for one-month, two-month, or three-month supplies at standard pharmacies and standard mail order. Tier 2 generic drugs are available with a copay of $15 for a one-month supply, $30 for a two-month supply, and $45 for a three-month supply. Tier 3 preferred brand drugs require a copay of $45 for a one-month supply, while Tier 4 non-preferred drugs carry a $95 copay for a one-month supply, with proportional copay increases for longer supply terms. For Tier 5 specialty drugs, there is a 29% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
KeyCare Advantage Plus (HMO C-SNP) offers affordable access to essential medical services, featuring no copay for primary care visits and specialist copays ranging from no copay up to $20. Inpatient hospital stays require a $300 daily copay for the first 5 days and no copay for days 6 through 90, while emergency room visits carry a $95 copay. Outpatient services generally require a 20% coinsurance, though certain procedures, home health care, and skilled nursing facility stays are available with no copay. The plan also provides robust supplemental coverage, including dental services with no copay and a $2,000 annual limit for non-Medicare dental care. Vision and hearing benefits feature no copay for routine exams, alongside a generous $1,150 annual allowance for eyewear and prescription hearing aids. Additionally, members can access covered over-the-counter items and diabetic equipment with no copay or coinsurance.
Inpatient Hospital See details
KeyCare Advantage Plus (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $300 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered as prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services covered by KeyCare Advantage Plus (HMO C-SNP) generally require a 20% coinsurance, with copays ranging from no copay up to $225 depending on the service. Ambulatory surgical center visits, outpatient substance abuse sessions, and blood services feature no copay, while outpatient hospital and observation services may require a copay of $0 to $225.
Partial Hospitalization See details
KeyCare Advantage Plus (HMO C-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization may be required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services under KeyCare Advantage Plus (HMO C-SNP) require prior authorization for ambulance trips, costing a $250 copay for ground ambulance and 20% coinsurance for air ambulance. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
KeyCare Advantage Plus (HMO C-SNP) covers emergency services with a $95 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with copays waived if admitted to the hospital within three days. Some worldwide services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
KeyCare Advantage Plus (HMO C-SNP) offers primary care, podiatry, and opioid treatment with no copay and no coinsurance, while specialist visits carry a $0 to $20 copay and no coinsurance. Physical, speech, and occupational therapies require a $30 copay with no coinsurance, whereas mental health, psychiatric, and telehealth services feature up to a 20% coinsurance. Chiropractic care is partially covered, excluding non-routine services, and costs a $20 copay and 20% coinsurance for up to six annual routine visits.
Preventive Services See details
Preventive services are partially covered by KeyCare Advantage Plus (HMO C-SNP) with no copay and no coinsurance for covered benefits, such as kidney disease education, in-home support, and memory fitness. However, several sub-services are not covered, including annual physical exams, health education, in-home safety assessments, personal emergency response systems, and weight management programs.
Hearing Services See details
Hearing services are covered by KeyCare Advantage Plus (HMO C-SNP) with no deductible, offering exams with no copay and a 20% coinsurance for routine visits. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $1,150 annual limit, though inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
KeyCare Advantage Plus (HMO C-SNP) provides partially covered vision services, featuring one routine eye exam every two years with no copay or coinsurance, though other eye exam services are not covered. Eyewear is also partially covered with no copay up to a $1,150 annual limit, offering covered eyeglasses (lenses and frames) and contact lenses with a 20% coinsurance, while individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
KeyCare Advantage Plus (HMO C-SNP) covers Medicare dental services with no copay and a 20% coinsurance, and other dental services with no copay or coinsurance up to a $2,000 annual limit. While many preventive and comprehensive services are covered, this benefit is partially covered as it excludes other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
KeyCare Advantage Plus (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance up to 20%, while Part B insulin requires a $35 copay and up to 20% coinsurance.
Dialysis Services See details
KeyCare Advantage Plus (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is partially covered by KeyCare Advantage Plus (HMO C-SNP), with no copay and a 20% coinsurance for durable medical equipment and prosthetics. Diabetic equipment is available with no copay and no coinsurance, though diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under KeyCare Advantage Plus (HMO C-SNP) and require prior authorization, though lab services are not covered. Covered diagnostic procedures and therapeutic radiological services require a 20% coinsurance with no copay, while outpatient x-rays require a $15.00 copay.
Home Health Services See details
Home Health Services are covered by KeyCare Advantage Plus (HMO C-SNP) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under KeyCare Advantage Plus (HMO C-SNP) with no copay and 20% coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by KeyCare Advantage Plus (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required and Medicare-defined cost sharing applies. This benefit does not require a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
KeyCare Advantage Plus (HMO C-SNP) partially covers other services, offering reimbursement for over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
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