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Alterwood Advantage Choice Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alterwood Advantage Choice Plus (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alterwood Advantage Choice Plus (HMO) in 2026, please refer to our full plan details page.
Alterwood Advantage Choice Plus (HMO) is a HMO plan offered by LifeBridge Health, Inc. available for enrollment in 2025 to people living in Select Maryland Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Alterwood Advantage Choice Plus (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Alterwood Advantage Choice Plus (HMO).
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 Alterwood Advantage Choice Plus (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $122.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6500.00 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 Alterwood Advantage Choice Plus (HMO) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. This plan provides an affordable and straightforward option for managing routine prescriptions. For higher-tier medications, standard pharmacy and standard mail-order costs for a one-month supply are $47 for Tier 3 preferred brands and $100 for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply, while Tier 6 supplemental drugs have a $10 copay. Multi-month supply options are also available for Tier 3 and Tier 4 prescriptions to help manage long-term medication costs.
Additional Benefits
The Alterwood Advantage Choice Plus (HMO) offers comprehensive medical coverage with no copay and no coinsurance for primary care, specialist visits, telehealth, and home health services. For hospital care, inpatient stays require a $325 copay per admission with no coinsurance, while outpatient hospital services feature copays ranging from $195 to $490. Emergency care is available with a $115 copay, and urgently needed care requires no copay. Supplemental benefits include routine vision, hearing, and preventive dental care with no copay or coinsurance. Comprehensive dental services are covered up to a $5,000 yearly maximum, and eyewear features a $275 maximum benefit every two years. Members also benefit from a $500 annual fitness allowance, as well as over-the-counter items and recovery meals with no copay.
Inpatient Hospital See details
Alterwood Advantage Choice Plus (HMO) covers inpatient acute and psychiatric hospital stays with a $325 copay per admission and no coinsurance, though prior authorization is required. This benefit is partially covered, as additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Alterwood Advantage Choice Plus (HMO) with no coinsurance, featuring a $50 copay for ambulatory surgical center services and no copay or deductible for blood services. Outpatient hospital services have copays ranging from $195 to $490, while outpatient substance abuse sessions carry a $20 to $30 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by Alterwood Advantage Choice Plus (HMO) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Alterwood Advantage Choice Plus (HMO) covers ambulance services with no coinsurance, requiring a $240 copay for ground transport and a $300 copay for air transport. Transportation services are partially covered with no copay and no coinsurance for up to 10 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Alterwood Advantage Choice Plus (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with no copay and no coinsurance. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered under this plan.
Primary Care See details
Alterwood Advantage Choice Plus (HMO) covers primary care, specialist visits, and telehealth with no copay and no coinsurance. Other covered services, including physical therapy, chiropractic care, podiatry, and mental health services, require no coinsurance and have copays ranging from $0 to $35.
Preventive Services See details
Preventive services are partially covered under the Alterwood Advantage Choice Plus (HMO) with no copay and no coinsurance for covered benefits like kidney disease education, glaucoma screenings, and a fitness benefit of up to $500 annually. However, several sub-services are not covered, including annual physical exams, health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Alterwood Advantage Choice Plus (HMO) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $475 to $1,950, but over-the-counter, inner ear, outer ear, and over-the-ear devices are not covered.
Vision Services See details
Alterwood Advantage Choice Plus (HMO) partially covers vision services, offering one annual routine eye exam with no copay or coinsurance, while other eye exam services and eyewear upgrades are not covered. Covered eyewear, including eyeglasses and contact lenses, features no copay, a 20% coinsurance for contact lenses, and a combined maximum benefit of $275 every two years.
Dental Services See details
Alterwood Advantage Choice Plus (HMO) covers dental services up to a $5,000 yearly maximum, offering Medicare-covered dental for a $40 copay and no coinsurance, and preventive services with no copay and no coinsurance. Select comprehensive services are covered with no copay and a 20% coinsurance, though the plan is only partially covered as implants, orthodontics, fixed prosthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Alterwood Advantage Choice Plus (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other Part B drugs require a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Alterwood Advantage Choice Plus (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Alterwood Advantage Choice Plus (HMO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and a 20% coinsurance. Diabetic supplies feature a coinsurance ranging from no coinsurance up to 20%, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Alterwood Advantage Choice Plus (HMO) covers diagnostic and radiological services, which require prior authorization. Members pay no copay and no coinsurance for diagnostic procedures, tests, and lab services, while outpatient X-rays carry a $10 copay, diagnostic radiology has a $150 copay, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Alterwood Advantage Choice Plus (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Alterwood Advantage Choice Plus (HMO) with no coinsurance, although some services are not covered, including standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy for PAD ($20 copay).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Alterwood Advantage Choice Plus (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
Alterwood Advantage Choice Plus (HMO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. The covered meal benefit supports recovery after surgery or hospitalization and during chronic illness, and the OTC benefit includes nicotine replacement therapy and naloxone.
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