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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 2025, 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 2025.
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. Additionally, this plan comes with a Part B Premium reduction of $0.20. 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 $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 $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 Select (HMO) plan has a $295.00 deductible for prescription drugs. After the deductible is met, you'll pay a copay or coinsurance depending on the drug tier and pharmacy used. For drugs in the Standard Pharmacy, you will pay no copay for Preferred Generic drugs, a $47.00 copay for Standard Generic drugs, and a $100.00 copay for Preferred Brand drugs. Non-Preferred drugs have a 29% coinsurance. Once your total yearly drug costs reach $2000.00, you enter the Catastrophic Coverage Phase and pay nothing for covered drugs.
Additional Benefits
The Alterwood Advantage Select (HMO) plan offers a range of benefits, including coverage for inpatient hospital stays, outpatient services, and emergency care. Primary care physician services are covered with no copay, and other services such as hearing, vision, and dental care are also available with varying copays and coinsurance. This plan also includes coverage for home health services with no copay, and skilled nursing facility stays. Diagnostic and radiological services, home infusion, and medical equipment are also covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $425 copay for days 1-4 and no copay for days 5-90 for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services with the Alterwood Advantage Select (HMO) plan includes coverage for Outpatient Hospital Services with a $400 copay, Observation Services with a $250 copay, Ambulatory Surgical Center (ASC) Services with a $195 copay, and Outpatient Substance Abuse Services with a $45 copay for individual sessions and a $35 copay for group sessions. Outpatient Blood Services are also covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Alterwood Advantage Select (HMO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services. Ground ambulance services have a $240 copay, while air ambulance services have a $300 copay. Transportation Services to a plan-approved health-related location are covered for 10 one-way trips per year, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the Alterwood Advantage Select (HMO) plan. Emergency Services have a $110 copay and no coinsurance, and Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The Alterwood Advantage Select (HMO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a $25 copay, mental health specialty services with a $45 copay for individual sessions and a $35 copay for group sessions, podiatry services with a $35 copay, other health care professional services with a copay between $20 and $35, psychiatric services with a $45 copay for individual sessions and a $35 copay for group sessions, physical therapy and speech-language pathology services with a $50 copay, additional telehealth benefits with no copay, and opioid treatment program services with a $35 copay. Prior authorization may be required for some services.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, and additional preventive services are offered. Annual physical exams, health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The Alterwood Advantage Select (HMO) plan covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a copay between $475 and $1950 for all types of hearing aids, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a $40 copay, and routine eye exams with no copay. Eyewear is covered with 20% coinsurance for contact lenses, and there is a combined maximum benefit of $400 per year for all eyewear. Upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $40 copay. Other Dental Services include Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, Orthodontic Services, Restorative Services with a 20% coinsurance, Adjunctive General Services with a 20% coinsurance, Endodontics with a 20% coinsurance, Periodontics with a 20% coinsurance, Prosthodontics (removable) with a 20% coinsurance, and Oral and Maxillofacial Surgery with a 20% coinsurance. Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Alterwood Advantage Select (HMO) plan. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Alterwood Advantage Select (HMO) plan. This plan requires prior authorization and has a 20% coinsurance.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered items. Diabetic Equipment has a coinsurance, and Diabetic Supplies have a 0-20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered, including diagnostic procedures and tests with a $15 copay, lab services with no copay, and outpatient X-ray services with a $20 copay. Diagnostic radiological services have a $210 copay, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Alterwood Advantage Select (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Alterwood Advantage Select (HMO) plan. However, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Alterwood Advantage Select (HMO) plan with prior authorization required. For days 1-20, there is no copay, but for days 21-100, there is a $214 copay.
Other Services See details
The Alterwood Advantage Select (HMO) plan covers over-the-counter (OTC) items, including nicotine replacement therapy and Naloxone, and meal benefits following surgery or inpatient hospitalization, for a chronic illness, or for a medical condition. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and various other services are not covered by this plan.
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