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KeyCare Advantage Community (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for KeyCare Advantage Community (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on KeyCare Advantage Community (HMO I-SNP) in 2025, please refer to our full plan details page.
KeyCare Advantage Community (HMO I-SNP) is a HMO I-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 Community (HMO I-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 Community (HMO I-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 Community (HMO I-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 Community (HMO I-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 $5000.00 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 Community (HMO I-SNP) plan has a $300 deductible for prescription drugs. After meeting the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For generic drugs, you will pay a $15 copay at a standard pharmacy and $45 copay for standard generic drugs. For preferred brand drugs, the copay is $95. Non-preferred drugs have a 29% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The KeyCare Advantage Community (HMO I-SNP) plan covers inpatient hospital stays, with a copay of $300 for days 1-5, and no copay for days 6-90. Outpatient services have a 20% coinsurance, with copays varying from $0 to $225. This plan also covers emergency services with a $95 copay and offers coverage for primary care, preventive services, hearing, vision, dental, and other services, each with specific cost-sharing details.
Inpatient Hospital See details
Inpatient Hospital services are covered under the KeyCare Advantage Community (HMO I-SNP) plan, with a copay of $300 for days 1-5, and no copay for days 6-90. Additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a 20% coinsurance and a copay between $0 and $225 for outpatient hospital services, and a 20% coinsurance for observation services. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the KeyCare Advantage Community (HMO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground Ambulance Services have a $250 copay, while Air Ambulance Services have 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the KeyCare Advantage Community (HMO I-SNP) plan, with a $95 copay and no coinsurance. Urgently Needed Services are also covered, with a $40 copay and no coinsurance, but Worldwide Emergency Services are not covered.
Primary Care See details
KeyCare Advantage Community (HMO I-SNP) covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Routine Chiropractic Care has a $20 copay and 20% coinsurance, while Individual and Group Sessions for Mental Health and Psychiatric Services have 20% coinsurance. Physician Specialist Services have a $20 copay, and Physical Therapy and Speech-Language Pathology Services have a $30 copay. Additional Telehealth Benefits have a 20% coinsurance and a copay between $0 and $20.
Preventive Services See details
The KeyCare Advantage Community (HMO I-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional preventive services like In-Home Support Services and a Fitness Benefit with no copay. The plan does not cover annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services include Routine Hearing Exams with a coinsurance of at most 20% for one exam every two years and Prescription Hearing Aids (all types), with a maximum plan benefit of $1000 every year. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC Hearing Aids are not covered.
Vision Services See details
Vision Services include coverage for routine eye exams once every two years, with no copay or deductible. Eyewear is covered with a 20% coinsurance for contact lenses, and has a combined maximum plan benefit coverage amount of $1000 per year. Eyeglasses (lenses and frames) and contact lenses are covered, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance after prior authorization. Other dental services are covered up to a maximum of $1750 per year, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Orthodontic services are covered under diagnostic and preventive dental, while 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, Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the KeyCare Advantage Community (HMO I-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Equipment. 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 includes coverage for all diagnostic services with no copay and at most 20% coinsurance for diagnostic procedures and tests, while lab services are not covered. Radiological Services includes coverage for diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, with at most 20% coinsurance for diagnostic and therapeutic radiological services, and a $15 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the KeyCare Advantage Community (HMO I-SNP) plan with no copay or coinsurance, but authorization is required. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the KeyCare Advantage Community (HMO I-SNP) plan. This includes Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, Additional Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, and Pulmonary Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but this plan does not offer additional days beyond Medicare-covered for SNF, or non-Medicare-covered stays for SNF. Prior authorization is required, and you will pay the Medicare-defined cost share for tier 1.
Other Services See details
The KeyCare Advantage Community (HMO I-SNP) plan covers Over-the-Counter (OTC) Items, but does not cover Acupuncture, Meal Benefit, 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 not cover all drugs on the CMS OTC list.
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