To be eligible for Alterwood Advantage Choice Plus, you must have Medicare Part A and Part B and reside within one of the following Maryland counties: Anne Arundel, Baltimore, Baltimore City, Caroline, Carroll, Cecil, Charles, Dorchester, Harford, Howard, Kent, Montgomery, Prince George’s, Queen Anne’s, Somerset, Talbot, Washington, Wicomico, and Worcester.
| Benefits | Description | |
|---|---|---|
| Monthly Premium | $125 Premium may be reduced if you receive “Extra Help” or through the Maryland Senior Prescription Drug Assistance Program (SPDAP). |
|
| Deductible | $0 – No Deductible | |
| Maximum Out-of-Pocket (MOOP) | $7,550 | |
| Primary Care Physician Visit | $0 copay – no referrals required | |
| Specialist Visit | $20 copay – no referrals required | |
| Preventive Services | $0 copay | |
| Telehealth | $0 copay for eligible services | |
| Inpatient Hospital Stay | $350 copay per stay | |
| Outpatient Hospital Facility | $150 copay | |
| Ambulatory Surgical Center | $100 copay | |
| Emergency Care | $90 copay | |
| Urgent Care | $20 copay | |
| Diagnostic Tests & Labs | $0 copay | |
| X-Rays | $10 copay | |
| Diabetic Supplies, Shoes, & Inserts | 0% - 20% coinsurance | |
| Durable Medical Equipment | 20% coinsurance | |
| Additional Benefits | Description |
|---|---|
| Preventive Dental | $0 copay per visit & $2,000 annual allowance for all dental services |
| Comprehensive Dental | 20% coinsurance per visit & $2,000 annual allowance for all dental services |
| Vision | Routine Exam: $0 copay, 1 per year $250 allowance every 2 years towards eyewear |
| Hearing | Routine Exam: $0 copay, 1 per year Hearing Aids: $475 - $1,950 copay per hearing aid |
| Lifestyle Medication | $10 copay per month supply for generic erectile dysfunction medication |
| Podiatry Services | Medicare-Covered: $40 copay Routine Care: $0 copay, 4 per year |
| Chiropractic Services | Medicare-Covered: $20 copay Routine Care: $20 copay, 4 per year Chiropractic Evaluation: $0 copay, 1 per year |
| Prescription Coverage | Description | |
|---|---|---|
| Deductible | $0 – No Deductible | |
| 30-day Supply | 90-day Supply | |
| Tier 1 – Preferred Generics | $0 copay | $0 copay |
| Tier 2 – Generics | $0 copay | $0 copay |
| Tier 3 – Preferred Brands | $47 copay | $94 copay |
| Tier 4 – Non-Preferred Drugs | $100 copay | $300 copay |
| Tier 5 – Specialty | 33% coinsurance | Not Covered |