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Alterwood Advantage Dual Secure (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alterwood Advantage Dual Secure (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alterwood Advantage Dual Secure (HMO D-SNP) in 2025, please refer to our full plan details page.
Alterwood Advantage Dual Secure (HMO D-SNP) is a HMO D-SNP 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 2025.
It's important to know that Alterwood Advantage Dual Secure (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:
Alterwood Advantage Dual Secure (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 Alterwood Advantage Dual Secure (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 Alterwood Advantage Dual Secure (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.70. You must continue to pay paying your reduced 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 $590.00 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 $9350.00 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 Dual Secure (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly Part D premium is $40.20. During the initial coverage phase, you will pay the cost-sharing amounts for your drugs until your total drug costs reach $2,000. Once you reach $2,000 in out-of-pocket drug costs, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The Alterwood Advantage Dual Secure (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Many services require a 20% coinsurance, including outpatient services, partial hospitalization, ambulance services, emergency services, primary care, and vision services. However, some services like routine eye exams, home health services, and diagnostic and radiological services have no copay, which means there is no cost to you. This plan also covers dental services with a maximum annual benefit, hearing services including hearing aids, and medical equipment with a coinsurance. Additionally, the plan covers home infusion services, dialysis, and offers transportation to health-related locations.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered by the Alterwood Advantage Dual Secure (HMO D-SNP) plan. Additional days, non-Medicare-covered stays, and upgrades for inpatient hospital services are not covered.
Outpatient Services See details
Outpatient Services are covered, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services. Outpatient Hospital Services and Observation Services have a 20% coinsurance. Individual and Group Sessions for Outpatient Substance Abuse have a 20% coinsurance. Outpatient Blood Services have a 20% coinsurance, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Alterwood Advantage Dual Secure (HMO D-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. Ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation services to a plan-approved health-related location are covered for up to 24 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Alterwood Advantage Dual Secure (HMO D-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, with no copay. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The Alterwood Advantage Dual Secure (HMO D-SNP) plan covers primary care services with a 20% coinsurance. Chiropractic Services are covered with a 20% coinsurance, and Routine Chiropractic Care and Other Chiropractic Services have no copay. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance, while Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance for individual and group sessions. Physician Specialist Services are covered with a 20% coinsurance. Podiatry Services have a 20% coinsurance for Routine Foot Care, and Medicare-covered Podiatry Services have no copay.
Preventive Services See details
The Alterwood Advantage Dual Secure (HMO D-SNP) plan covers preventive services, but 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, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, 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, and counseling services. Kidney disease education services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with a 20% coinsurance.
Hearing Services See details
Hearing Services include coverage for hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, but not for OTC hearing aids. Hearing exams have a coinsurance of at most 20%, and routine hearing exams have no copay. Fitting/evaluation for hearing aids also have no copay, and prescription hearing aids are covered up to a maximum of $1350 every three years. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include coverage for eye exams with 20% coinsurance, and routine eye exams with no copay. Eyewear is covered with 20% coinsurance, and contact lenses, eyeglass lenses, and eyeglass frames are covered. The plan offers a combined maximum benefit of $300.00 for all eyewear every two years. Upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services are covered up to a maximum of $2700 per year, including oral exams, dental x-rays, cleaning, and fluoride treatments, which are subject to certain visit limitations.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Alterwood Advantage Dual Secure (HMO D-SNP) plan, but require prior authorization. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, and Prosthetic Devices and Medical Supplies with 20% coinsurance. Diabetic Equipment is covered with a coinsurance that varies between 0% and 20%, depending on the specific supply or service.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered under the Alterwood Advantage Dual Secure (HMO D-SNP) plan. These services have no copay, but require a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Alterwood Advantage Dual Secure (HMO D-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 the plan does not specify the cost sharing details for this benefit. However, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not specify the cost sharing details such as copay and coinsurance. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the Alterwood Advantage Dual Secure (HMO D-SNP) plan, acupuncture, 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 are not covered. Over-the-counter (OTC) items and meal benefits are covered.
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