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Alterwood Advantage Choice (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alterwood Advantage Choice (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 (HMO) in 2026, please refer to our full plan details page.
Alterwood Advantage Choice (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 (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 (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 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. 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 $7500.00 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 (HMO) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay for one-month, two-month, or three-month supplies at standard pharmacies and through standard mail order. Tier 2 generic drugs are also highly affordable, requiring a flat $8.00 copay across all supply lengths. For brand-name and specialty medications, costs are structured by tier and supply duration. Tier 3 preferred brand drugs carry a $47.00 copay for a one-month supply, while Tier 4 non-preferred drugs cost $100.00 for a one-month supply, with both tiers offering proportional copays for longer fills. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The Alterwood Advantage Choice (HMO) plan offers robust medical coverage with no copay for primary care visits, telehealth services, and urgently needed care. Inpatient hospital stays require a daily copay of $350 for days 1 through 6, while specialist visits and emergency services carry low copays and no coinsurance. Outpatient hospital services and ambulance rides are also covered with flat copays and no coinsurance, helping keep your healthcare costs predictable. Additionally, members benefit from preventive dental, routine vision, and routine hearing exams with no copay, alongside a $3,300 annual dental maximum and a $200 fitness benefit. The plan also covers up to 10 one-way non-emergency medical transportation trips, home health services, and over-the-counter items with no copay or coinsurance. Other essential services, such as durable medical equipment and dialysis, are covered with a standard 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Alterwood Advantage Choice (HMO) with no coinsurance, requiring a daily copay of $350 for days 1 through 6 of acute stays and $335 for days 1 through 6 of psychiatric stays, with no copay for days 7 through 90. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Alterwood Advantage Choice (HMO) covers outpatient services with no coinsurance, featuring a $350 to $875 copay for outpatient hospital services and a $50 copay for ambulatory surgical center services. Outpatient substance abuse sessions have a $20 to $30 copay, while outpatient blood services are provided with no copay or deductible.
Partial Hospitalization See details
Alterwood Advantage Choice (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Alterwood Advantage Choice (HMO) covers ground ambulance services with a $240 copay and air ambulance services with a $300 copay, both with no coinsurance. The plan also includes up to 10 one-way transportation trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any other health-related location is not covered.
Emergency Services See details
Alterwood Advantage Choice (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services are covered with no copay and no coinsurance. Worldwide emergency services, including urgent care and emergency transportation abroad, are not covered.
Primary Care See details
Alterwood Advantage Choice (HMO) offers primary care physician services and telehealth benefits with no copay and no coinsurance. Other covered benefits, including specialist visits, physical therapy, chiropractic care, and mental health services, require copays ranging from $15 to $35 and no coinsurance.
Preventive Services See details
Preventive services are partially covered by Alterwood Advantage Choice (HMO) with no copay and no coinsurance, including kidney disease education, glaucoma screenings, and a $200 annual fitness benefit. Sub-services that are not covered include annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
Alterwood Advantage Choice (HMO) covers Medicare-covered hearing exams with a $40 copay and no coinsurance, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $475 to $1,950 for up to two devices per year, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Alterwood Advantage Choice (HMO), featuring one routine eye exam per year with no copay and no coinsurance, while other eye exam services and eyewear upgrades are not covered. Covered eyewear has no copay and a 20% coinsurance for contact lenses, up to a combined annual maximum benefit of $150.
Dental Services See details
Alterwood Advantage Choice (HMO) partially covers dental services up to a $3,300 annual maximum, offering Medicare-covered dental with a $40 copay and no coinsurance, preventive services with no copay and no coinsurance, and comprehensive services with no copay and 20% coinsurance. Sub-services that are not covered under this plan include other diagnostic, other preventive, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Alterwood Advantage Choice (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Alterwood Advantage Choice (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Alterwood Advantage Choice (HMO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic shoes, with no copay and a 20% coinsurance. Diabetic supplies are also covered with no copay and coinsurance ranging from no coinsurance up to 20%, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Alterwood Advantage Choice (HMO) covers diagnostic and radiological services with prior authorization, offering diagnostic tests, procedures, and lab services with no copay and no coinsurance. Outpatient X-rays require a $20 copay, diagnostic radiological services have a $225 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Alterwood Advantage Choice (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Alterwood Advantage Choice (HMO) covers Cardiac Rehabilitation Services with no coinsurance; however, while some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Alterwood Advantage Choice (HMO) covers skilled nursing facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Alterwood Advantage Choice (HMO) provides partial coverage for other services, offering a meal benefit and over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture is not covered under this plan.
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