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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Alterwood Advantage Select (HMO) is a HMO plan offered by Alterwood Advantage, Inc. available for the 2026 plan year 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
Health deductible: information not available.
This plan has a $295.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7500.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $7500.00 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) plan features an annual prescription drug deductible of $295. Under this plan, you will enjoy no copay for both Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This cost savings applies to one-month, two-month, and three-month supplies, helping you save on your everyday prescription needs. For higher-tier medications, standard pharmacies and mail-order services charge a $47 copay for a one-month supply of Tier 3 preferred brand drugs and a $100 copay for Tier 4 non-preferred drugs. Longer supplies of these medications scale proportionally, with a three-month supply costing $141 for Tier 3 and $300 for Tier 4. Specialty drugs in Tier 5 require a 29% coinsurance for a one-month supply.
Additional Benefits
The Alterwood Advantage Select (HMO) plan offers robust medical coverage with no copays for primary care visits, telehealth, and routine preventive services. For more intensive care, inpatient hospital stays require a $425 daily copay for the first four days followed by no copay, while emergency room visits carry a flat $115 copay. Outpatient hospital services and ambulance transport are also covered, though they require set copays with no coinsurance. This plan also features strong supplemental benefits, including a $3,200 annual dental limit with no copay for preventive care and a $225 annual eyewear allowance. Routine hearing and vision exams are available with no copay, and members can access over-the-counter items and post-discharge meals at no cost. Additionally, durable medical equipment and dialysis services are covered, typically requiring a 20% coinsurance.
Inpatient Hospital See details
Alterwood Advantage Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $425 daily copay for days 1 through 4 and no copay for days 5 through 90. 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 hospital services with a $400 to $1,000 copay and no coinsurance, and ambulatory surgical center services with a $50 copay and no coinsurance. Observation services require a $250 to $625 copay per stay with no coinsurance, while outpatient substance abuse services have a $35 to $45 copay with no coinsurance, and blood services require no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Alterwood Advantage Select (HMO) with a $55.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Alterwood Advantage Select (HMO) with no coinsurance, requiring a $240 copay for ground transport and a $300 copay for air transport. Although transportation is technically covered, some services are covered but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Alterwood Advantage Select (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with no copay or coinsurance. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Alterwood Advantage Select (HMO) offers primary care physician and telehealth services with no copay and no coinsurance. Specialist visits, physical therapy, chiropractic care, and mental health services are also covered with no coinsurance and copays ranging from $15 to $50, although some of these services require prior authorization.
Preventive Services See details
Preventive Services under the Alterwood Advantage Select (HMO) are partially covered with no copay and no coinsurance, including Medicare-covered preventive services, kidney disease education, and a fitness benefit of up to $500 annually. However, several additional services are not covered, such as annual physical exams, health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Hearing services offered by Alterwood Advantage Select (HMO) include Medicare-covered exams for a $40 copay, alongside routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $475 to $1,950 and no coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Alterwood Advantage Select (HMO) partially covers vision services, offering one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered up to a $225 annual limit with no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, though upgrades are not covered.
Dental Services See details
Dental Services are partially covered by Alterwood Advantage Select (HMO) up to a $3,200 annual limit, with Medicare-covered dental requiring a $40 copay and no coinsurance. Preventive services have no copay and no coinsurance, while covered comprehensive services require no copay and 20% coinsurance. Other diagnostic and preventive services, maxillofacial prosthetics, implants, fixed prosthodontics, 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 is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Alterwood Advantage Select (HMO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Alterwood Advantage Select (HMO) with no copay, though prior authorization is required for these services. Durable medical equipment, prosthetics, medical supplies, and diabetic shoes carry a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Alterwood Advantage Select (HMO) with prior authorization required. Diagnostic lab services have no copay and no coinsurance, diagnostic tests require a $15 copay with no coinsurance, outpatient X-rays require a $20 copay, diagnostic radiological services have a $165 minimum copay, and therapeutic radiological services require a 20% minimum coinsurance.
Home Health Services See details
Home health services are covered by Alterwood Advantage Select (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Alterwood Advantage Select (HMO) with no coinsurance, though only some services are covered in practice. Specifically, standard cardiac rehabilitation (which has a $30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy for peripheral artery disease ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Alterwood Advantage Select (HMO) 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 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Alterwood Advantage Select (HMO) 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.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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