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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 2025, 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 2025.
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 $36.90. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 Value (HMO D-SNP) plan has a $590 deductible for prescription drugs. Once you meet the deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2000. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you have LIS, your monthly premium for Part D is $36.90.
Additional Benefits
The Alterwood Advantage Dual Value (HMO D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays. You'll have no copay for primary care visits, but specialist visits have a $20 copay. The plan also covers hearing, vision, and dental services with specific copays and coinsurance, as well as medical equipment and home health services. This plan provides coverage for emergency and urgent care services, with copays for ambulance services. It also includes benefits for home infusion, dialysis, and skilled nursing facilities, each with their own cost-sharing structure. The plan also covers preventive services and other services.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For days 1-6, the copay is $320, and for days 7-90, there is no copay. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered, along with non-Medicare-covered stays and upgrades.
Outpatient Services See details
Outpatient Services for the Alterwood Advantage Dual Value (HMO D-SNP) plan include coverage for outpatient hospital services with a $320 copay, observation services with a $200 copay, ambulatory surgical center services with a $110 copay, and outpatient substance abuse services with a $30 copay for individual sessions and a $20 copay for group sessions. Outpatient blood services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Alterwood Advantage Dual Value (HMO D-SNP) plan, and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Ground ambulance services have a $290 copay, and air ambulance services have a $300 copay, while transportation services to any health-related location are limited to 20 one-way trips per year, and transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services include a $110 copay with no coinsurance, while Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Alterwood Advantage Dual Value (HMO D-SNP) plan covers primary care physician services with no copay, and chiropractic services with a $15 copay. Occupational therapy services have a $20 copay, while specialist visits cost $20. Mental health and psychiatric individual sessions have a $30 copay, and group sessions have a $20 copay. Podiatry services have a $25 copay. Other health care professional services and opioid treatment program services have a $20 copay. Physical therapy and speech-language pathology services also have a $20 copay, and additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, additional services, and kidney disease education services. The plan does not cover annual physical exams, and certain additional services like health education, in-home safety assessments, and others.
Hearing Services See details
Hearing Services includes hearing exams with a $40 copay, routine hearing exams with no copay for one exam per year, and fitting/evaluation for hearing aids with no copay for four visits every three years. Prescription hearing aids are covered with a maximum benefit of $1350 every three years, while inner ear, outer ear, and over-the-ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a $40 copay, and routine eye exams have no copay. Eyewear has a 20% coinsurance.
Dental Services See details
Dental Services include coverage for Medicare dental services with a $40 copay, and other dental services with a $2,500 maximum benefit per year. Oral exams, dental x-rays, cleaning, and fluoride treatments are covered, and some services require prior authorization. Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), and Orthodontics are not covered.
Home Infusion bundled Services See details
The Alterwood Advantage Dual Value (HMO D-SNP) plan covers Home Infusion bundled Services, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the Alterwood Advantage Dual Value (HMO D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered. Durable Medical Equipment (DME) has a 20% coinsurance, and requires authorization. Prosthetics/Medical Supplies - Non-Medicare benefit has a coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies. Diabetic Supplies have a 0-20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Alterwood Advantage Dual Value (HMO D-SNP) plan. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Alterwood Advantage Dual Value (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 cover any of the specific services. The copay for these services is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Alterwood Advantage Dual Value (HMO D-SNP) plan, but require prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and Meal Benefit, but 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.
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