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Alterwood Advantage Dual Value (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alterwood Advantage Dual Value (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 Value (HMO D-SNP) in 2026, please refer to our full plan details page.
Alterwood Advantage Dual Value (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 2026.
It's important to know that Alterwood Advantage Dual Value (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 Value (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 Value (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 Value (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.20. 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 $615.00 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 $9250.00 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 Value (HMO D-SNP) prescription drug coverage includes an annual drug deductible of $615. This deductible represents the amount you will need to pay out-of-pocket for your medications before the plan's coverage begins. Detailed information regarding specific drug tiers, copays, and coinsurance rates is not available for this plan. To determine your exact prescription costs, you will need to verify your specific medications with the plan provider to see how they apply to the deductible.
Additional Benefits
The Alterwood Advantage Dual Value (HMO D-SNP) plan offers comprehensive medical coverage featuring no copays and no coinsurance for primary care, telehealth, preventive care, and home health services. For specialized medical needs, members can expect predictable flat copayments and no coinsurance for specialist visits, emergency care, and inpatient hospital stays. Diagnostic services, physical therapies, and skilled nursing facility stays are also covered, typically requiring a copay and no coinsurance. Members also benefit from valuable supplemental coverage, including routine dental, vision, and hearing care with no copays and generous allowances. The plan covers routine transportation with no copay for up to 22 one-way trips per year, alongside no-copay benefits for over-the-counter items and meals. Durable medical equipment and dialysis services are covered with no copay and a standard 20 percent coinsurance.
Inpatient Hospital See details
Inpatient hospital and psychiatric services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no coinsurance, requiring a $320 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Alterwood Advantage Dual Value (HMO D-SNP) covers outpatient hospital services with a $320 to $800 copay and no coinsurance, observation services with a $200 to $500 copay, and ambulatory surgical center visits with a $50 copay and no coinsurance. Outpatient substance abuse services require a $20 to $30 copay and no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Alterwood Advantage Dual Value (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Alterwood Advantage Dual Value (HMO D-SNP), with no coinsurance required for any of these services. Ground ambulance services require a $290 copay and air ambulance services require a $300 copay, while up to 22 one-way transportation trips per year to plan-approved locations have no copay, but transportation to any health-related location is not covered.
Emergency Services See details
Alterwood Advantage Dual Value (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with no copay and no coinsurance. While some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Alterwood Advantage Dual Value (HMO D-SNP) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits, physical, occupational, and speech therapies require a $20 copay and no coinsurance, while other specialty services like chiropractic care, podiatry, and mental health sessions range from a $15 to $30 copay with no coinsurance.
Preventive Services See details
Preventive services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no copay and no coinsurance, including Medicare-covered zero-dollar preventive services, kidney disease education, and diabetes self-management training. While a fitness benefit is covered up to $200 annually, several services are not covered under this benefit, including annual physical exams, health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Alterwood Advantage Dual Value (HMO D-SNP) covers hearing services, including Medicare-covered exams for a $40 copay and no coinsurance, and routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,350 limit every three years, but OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Alterwood Advantage Dual Value (HMO D-SNP), offering one routine eye exam per year with no copay or coinsurance, though other eye exam services are not covered. Eyewear is covered up to a $400 limit every two years with no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, while eyewear upgrades are not covered.
Dental Services See details
Alterwood Advantage Dual Value (HMO D-SNP) provides partially covered dental services with an annual maximum benefit of $1,900, requiring a $40 copay and no coinsurance for Medicare-covered dental services, and no copay or coinsurance for other covered services. Non-covered services include other diagnostic, other preventive, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no copay, while Medicare Part B chemotherapy and other drugs require a 0% to 20% coinsurance. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Alterwood Advantage Dual Value (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic services, with no copay and a 20% coinsurance. Diabetic supplies feature no copay and between no coinsurance and 20% coinsurance, with prior authorization required for all medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Alterwood Advantage Dual Value (HMO D-SNP) plan, requiring prior authorization for all services. Diagnostic procedures, tests, and lab services feature no copay and no coinsurance, while outpatient x-rays require a $15 copay, diagnostic radiological services have a minimum $175 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Alterwood Advantage Dual Value (HMO D-SNP) with no copay and no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Alterwood Advantage Dual Value (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Alterwood Advantage Dual Value (HMO D-SNP) provides partial coverage for other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan.
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