To be eligible for Alterwood Advantage Dual Secure, you must have Medicare Part A and Part B, have Medicaid through the State of Maryland, and reside within one of the following Maryland counties: Anne Arundel, Baltimore, Caroline, Carroll, Cecil, Charles, Dorchester, Harford, Howard, Kent, Montgomery, Queen Anne’s, Somerset, Talbot, Washington, Wicomico, and Worcester.
Benefits | Description |
---|---|
Monthly Premium | $0 - $37 Premium may be reduced if you receive “Extra Help” or through the Maryland Senior Prescription Drug Assistance Program (SPDAP). |
Medicaid Eligibility | Full Benefit Dual Eligible (FBDE) Qualified Medicare Beneficiary (QMB) |
Deductible | $0 – No Deductible |
Maximum Out-of-Pocket (MOOP) | $7,550 |
Primary Care Physician Visit | $0 copay – no referrals required |
Specialist Visit | $0 copay – no referrals required |
Preventive Services | $0 copay |
Telehealth | $0 copay for eligible services |
Inpatient Hospital Stay | Days 1 – 6: $0 copay per day Days 7 – 90: $0 copay per day |
Outpatient Hospital Facility | $0 copay |
Ambulatory Surgical Center | $0 copay |
Emergency Care | $0 copay |
Urgent Care | $0 copay |
Diagnostic Tests & Labs | $0 copay |
X-Rays | $0 copay |
Diabetic Supplies, Shoes, & Inserts | $0 copay |
Durable Medical Equipment | $0 copay |
Additional Benefits | Description |
---|---|
Preventive Dental | $0 copay per visit & $2,500 annual allowance for all dental services |
Comprehensive Dental | $0 copay per visit & $2,500 annual allowance for all dental services |
Vision | Routine Exam: $0 copay, 1 per year $400 allowance every 2 years towards eyewear |
Hearing | Routine Exam: $0 copay, 1 per year Hearing Aids: $1,350 allowance every 3 years |
Transportation | $0 copay, 36 one-way trips |
Over-the-Counter (OTC) Products & Essential Food Pantry Items | $100 quarterly allowance through plan’s catalog |
Podiatry Services | Medicare-Covered: $0 copay Routine Care: $0 copay, 6 per year |
Chiropractic Services | Medicare-Covered: $0 copay Routine Care: $0 copay, 4 per year Chiropractic Evaluation: $0 copay, 1 per year |
Prescription Coverage | Description | |
---|---|---|
Deductible | $0 – No Deductible | |
30-day Supply | 90-day Supply | |
Generics | $0, $1.35, or $3.95 | $0, $1.35, or $3.95 |
(Depending on your level of Extra Help) | ||
All Other Drugs | $0, $4.00, $9.85 | $0, $4.00, $9.85 |
(Depending on your level of Extra Help) |