Alterwood Advantage Choice (HMO)
Available to residents of Caroline County, MD for 2026. Contract H9306, plan 008, segment 1.
- ✉ Email a copy of the plan benefit details
- Plan health benefits
- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
- Other plans in Caroline County
- Plan website
- Browse the Alterwood Advantage Choice (HMO) formulary
Plan details
| Monthly premium (Part C + D) | $30.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $30.00? |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| Health plan deductible (in-network) | None |
| In-network out-of-pocket maximum | $7,500.00? |
| Drug deductible | $0.00 |
| Drug out-of-pocket threshold | $2,100.00 |
| Plan type | HMO? |
| Contract / plan | H9306-008-1 |
| Offered by | Alterwood Advantage |
| Parent organization | LifeBridge Health, Inc. |
| Formulary drugs | 3,248 |
| Formulary exception tier | 4? |
| Pharmacy search | www.alterwoodadvantage.com |
| Member services | (866)273-7834TTY 711 |
CMS star ratings
- Overall
- 3.5 out of 5 stars for Overall
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H9306 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $20 copay |
| Other health care professional | $20 copay(authorization required) |
| Additional telehealth services | $0 copay |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | Not covered |
| Kidney disease education | $0 copay |
| Glaucoma screening | $0 copay |
| Diabetes self-management training | $0 copay |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0 copay(authorization required) |
| Lab services | $0 copay(authorization required) |
| Diagnostic radiology (e.g. MRI, CT) | $165–$415 copay(authorization required) |
| Therapeutic radiology | 20% coinsurance(authorization required) |
| Outpatient x-rays | $20–$50 copay(authorization required) |
| Emergency and urgent care | |
| Emergency room | $115 copay |
| Urgent care | $0 copay |
| Worldwide emergency coverage | Not covered |
| Worldwide urgent care | Not covered |
| Worldwide emergency transportation | Not covered |
| Hospital care | |
| Inpatient hospital stay | $325 per day for days 1–6; $0 per day for days 7–90; varies by hospital tier(authorization required) |
| Outpatient hospital services | $325–$815 copay(authorization required) |
| Outpatient observation | $200–$500 copay |
| Ambulatory surgical center | $50 copay(authorization required) |
| Outpatient blood services | $0 copay |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per day for days 1–20; $218 per day for days 21–100(authorization required) |
| Home health care | $0 copay(authorization required) |
| Kidney dialysis | 20% coinsurance(authorization required) |
| Rehabilitation | |
| Occupational therapy | $30 copay(authorization required) |
| Physical therapy and speech-language therapy | $30 copay(authorization required) |
| Cardiac rehabilitation | $30 copay |
| Pulmonary rehabilitation | $25 copay |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $325 per day for days 1–6; $0 per day for days 7–90(authorization required) |
| Outpatient mental health, individual session | $30 copay(authorization required) |
| Outpatient mental health, group session | $20 copay(authorization required) |
| Psychiatrist, individual session | $30 copay(authorization required) |
| Psychiatrist, group session | $20 copay(authorization required) |
| Partial hospitalization | $55 copay(authorization required) |
| Intensive outpatient program | $55 copay(authorization required) |
| Outpatient substance use, individual session | $30 copay(authorization required) |
| Outpatient substance use, group session | $20 copay(authorization required) |
| Opioid treatment program | $35 copay(authorization required) |
| Ambulance and transportation | |
| Ground ambulance | $240 copay(authorization required) |
| Air ambulance | $300 copay(authorization required) |
| Transportation to plan-approved locations | $0 copay(limits apply) |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | 20% coinsurance(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) |
| Medical supplies | 20% coinsurance(authorization required) |
| Diabetes supplies | 0%–20% coinsurance(authorization required) |
| Diabetic therapeutic shoes or inserts | 20% coinsurance(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $15 copay(authorization required) |
| Routine chiropractic care | $15 copay(authorization required, limits apply) |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | $35 copay |
| Routine foot care | $35 copay(limits apply) |
| Dental? | |
| Medicare-covered dental services | $40 copay |
| Preventive dental plan limit | $3,600 plan limit every year |
| Oral exams | $0 copay(limits apply) |
| Cleanings | $0 copay(limits apply) |
| Fluoride treatment | $0 copay(limits apply) |
| Dental x-rays | $0 copay(limits apply) |
| Other diagnostic dental services | Not covered |
| Other preventive dental services | Not covered |
| Restorative services (fillings, crowns) | 20% coinsurance(authorization required, limits apply) |
| Endodontics (root canals) | 20% coinsurance(authorization required, limits apply) |
| Periodontics (gum disease) | 20% coinsurance(authorization required, limits apply) |
| Dentures and other removable prosthodontics | 20% coinsurance(authorization required, limits apply) |
| Maxillofacial prosthetics | Not covered |
| Implants | Not covered |
| Bridges and other fixed prosthodontics | Not covered |
| Oral and maxillofacial surgery | 20% coinsurance(authorization required, limits apply) |
| Orthodontics | Not covered |
| Adjunctive general services | 20% coinsurance(authorization required, limits apply) |
| Vision? | |
| Eye exam (Medicare-covered) | $40 copay |
| Routine eye exam | $0 copay(limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | 20% coinsurance(limits apply) |
| Eyewear plan limit | $150 plan limit every year |
| Contact lenses | $0 copay(limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(limits apply) |
| Eyeglass lenses | $0 copay(limits apply) |
| Eyeglass frames | $0 copay(limits apply) |
| Eyewear upgrades | Not covered |
| Hearing? | |
| Hearing exam (Medicare-covered) | $40 copay |
| Routine hearing exam | $0 copay(limits apply) |
| Hearing aid fitting and evaluation | $0 copay(limits apply) |
| Hearing aids (all types) | $475–$1,950 copay(limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Medicare Part B drugs | |
| Part B insulin | $35 copay(authorization required, step therapy may apply) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other Part B drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | Covered (allowance not stated) |
| Meals after a hospital stay or for a chronic condition | $0 copay |
| Fitness benefit | $0 copay(limits apply) |
| Health education | Not covered |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | Not covered |
| Enhanced disease management | Not covered |
| Telemonitoring | Not covered |
| Remote access technologies (web/phone, nurse line) | Not covered |
| Home and bathroom safety devices | Not covered |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | $0 copay(limits apply) |
| Wigs for hair loss from chemotherapy | Not covered |
| Weight management programs | Not covered |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | Not covered |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $8.00 |
| Tier 3 | $47.00 |
| Tier 4 | $100.00 |
| Tier 5 | 33% |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $8.00 | $8.00 | $8.00 | $8.00 | $8.00 | $8.00 |
| Tier 3: Preferred Brand | $47.00 | $47.00 | $47.00 | $141.00 | $141.00 | $141.00 |
| Tier 4: Non-Preferred Drug | $100.00 | $100.00 | $100.00 | $300.00 | $300.00 | $300.00 |
| Tier 5: Specialty Tier | 33% | 33% | 33% | n/a | n/a | n/a |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 5: Specialty Tier | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Also available in 18 other MD counties
Benefits in plain text
Alterwood Advantage Choice (HMO) (H9306-008-1) is a 2026 HMO Medicare Advantage plan offered by Alterwood Advantage, available to residents of Caroline County, MD.
The monthly premium is $30.00 (Part C and Part D together).
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
There is no in-network deductible for health services.
Its in-network out-of-pocket maximum is $7,500.00.
The drug deductible is $0.00.
The plan's formulary lists 3,248 drugs.
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: $0.00; tier 2: $8.00; tier 3: $47.00; tier 4: $100.00; tier 5: 33%.
CMS gives the plan's contract (H9306) an overall rating of 3.5 out of 5 stars.
Email a copy of the plan benefit details
Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.