Alterwood Advantage Freedom (HMO)

This is a medical-only plan. It does not include Medicare Part D drug coverage.

To be eligible for Alterwood Advantage Freedom, 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.

Monthly Premium$0
Medicare Part B Giveback$40 per month
Deductible$0 – No Deductible
Maximum Out-of-Pocket (MOOP)$7,550
Primary Care Physician Visit$15 copay – no referrals required
Specialist Visit$40 copay – no referrals required
Preventive Services$0 copay
Telehealth$0 copay for eligible services
Inpatient Hospital StayDays 1 - 6: $335 copay per day
Days 7 - 90: $0 copay per day
Outpatient Hospital Facility$300 copay
Ambulatory Surgical Center$245 copay
Emergency Care$90 copay
Urgent Care$40 copay
Diagnostic Tests & Labs$0 copay
X-Rays$20 copay
Diabetic Supplies, Shoes, & Inserts0% - 20% coinsurance
Durable Medical Equipment20% coinsurance

Additional BenefitsDescription
Preventive Dental$0 copay per visit & $1,000 annual allowance for all dental services
Comprehensive Dental20% coinsurance per visit & $1,000 annual allowance for all dental services
VisionRoutine Exam: $0 copay, 1 per year
$150 annual allowance towards eyewear
HearingRoutine Exam: $0 copay, 1 per year
Hearing Aids: $475 - $1,950 copay per hearing aid
Chiropractic ServicesMedicare-Covered: $20 copay
Routine Care: $20 copay, 4 per year
Chiropractic Evaluation: $0 copay, 1 per year

Prescription CoverageDescription
Not Covered

Plan Documents

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