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Alterwood Advantage Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alterwood Advantage Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alterwood Advantage Select (HMO) in 2026, please refer to our full plan details page.
Alterwood Advantage Select (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 Select (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 Select (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 Select (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 a $295.00 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 $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 Select (HMO) prescription drug plan has an annual drug deductible of $295. Under this plan, there is no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month supplies for both generic tiers. Higher tier medications under this plan are subject to copays or coinsurance. Tier 3 preferred brand drugs carry a copay of $47 for one month, $94 for two months, and $141 for three months, while Tier 4 non-preferred drugs require a copay of $100, $200, or $300 respectively. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply at standard pharmacies and standard mail order.
Additional Benefits
The Alterwood Advantage Select (HMO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care doctor visits, preventive care, and home health services. Specialist visits require a $25 copay, while inpatient hospital stays feature a $395 daily copay for the first four days and no copay for days five through ninety. Emergency services carry a $115 copay, and urgent care visits are covered with no copay and no coinsurance. This plan also includes key supplemental benefits such as routine dental, vision, and hearing exams with no copay and no coinsurance. Comprehensive dental services are covered up to a $3,400 annual limit with a 20% coinsurance, and prescription hearing aids are available with copays ranging from $475 to $1,950. Additionally, over-the-counter items and post-hospitalization meals are provided with no copay, while medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Alterwood Advantage Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $395 daily copay for days 1 through 4 and no copay for days 5 through 90. This benefit is partially covered, as prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Alterwood Advantage Select (HMO) covers outpatient services with no coinsurance, featuring copays of $325 to $625 for outpatient hospital services, $250 to $625 per stay for observation services, and $50 for ambulatory surgical center visits. Outpatient substance abuse sessions carry a $35 to $45 copay with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Alterwood Advantage Select (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Alterwood Advantage Select (HMO) partially covers Ambulance and Transportation Services, offering ground ambulance services for a $240 copay and air ambulance services for a $300 copay, both with no coinsurance. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Alterwood Advantage Select (HMO) with a $115 copay and no coinsurance, while urgently needed services require no copay and no coinsurance. Although 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 Select (HMO) covers primary care physician services and telehealth with no copay and no coinsurance, while specialist visits require a $25 copay and no coinsurance. Other covered services, including physical therapy, chiropractic care, and mental health services, have copays ranging from $15 to $50 with no coinsurance, with some services requiring prior authorization.
Preventive Services See details
Preventive Services are partially covered by Alterwood Advantage Select (HMO) with no copay and no coinsurance for covered benefits like kidney disease education, glaucoma screenings, and a $500 annual fitness benefit. However, several sub-services are not covered under this plan, including annual physical exams, health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Alterwood Advantage Select (HMO) covers Medicare-covered hearing exams with a $40 copay and no coinsurance, while routine exams and up to four fitting evaluations annually 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 aids per year, though inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Alterwood Advantage Select (HMO) covers vision services with no deductible, offering one routine eye exam per year with no copay and no coinsurance, though other eye exams are not covered. Eyewear is covered with no copay and a 20% coinsurance for contact lenses up to a $225 annual limit, but upgrades are not covered.
Dental Services See details
Alterwood Advantage Select (HMO) partially covers dental services up to a $3,400 annual limit, featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care. Covered comprehensive services require no copay and a 20% coinsurance, while other diagnostic services, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Alterwood Advantage Select (HMO) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Alterwood Advantage Select (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Alterwood Advantage Select (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic equipment, with no copays and a 20% coinsurance for most items. Diabetic supplies feature coinsurance ranging from no coinsurance to 20%, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Alterwood Advantage Select (HMO) covers diagnostic and radiological services, though prior authorization is required. Diagnostic procedures have a $15 copay with no coinsurance, lab services have no copay, outpatient X-rays require a $20 copay, and diagnostic radiological services start at a $165 copay, while therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
Alterwood Advantage Select (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under the Alterwood Advantage Select (HMO) plan with no coinsurance. However, standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and SET for PAD services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Alterwood Advantage Select (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance and does not require a prior three-day hospital stay, although prior authorization is required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond Medicare coverage are not covered.
Other Services See details
Other services are partially covered by Alterwood Advantage Select (HMO), offering over-the-counter (OTC) items and limited-duration meal benefits with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit includes nicotine replacement therapy and naloxone, while meals are covered following surgery, hospitalization, or for chronic illnesses.
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