D-SNP Plan Costs & Benefits

Alterwood Advantage Dual Secure is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Alterwood Advantage Dual Secure does allow out-of-network care for emergencies and out-of-area dialysis.

Costs vary widely from plan to plan. It is beneficial to compare costs, including premiums, deductibles, and copays, and apply them to your personal situation.

Healthcare Service	Member Cost
Health plan deductible	$0
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)	$8,300 In-network
Doctor Visits
Primary	$0 copay
Wellness programs (e.g., fitness, nursing hotline)	Covered
Preventive care	$0 copay
Mental Health Services
Outpatient group therapy visit	$0 copay (authorization required)
Inpatient hospital - psychiatric	$0 copay (authorization required)
Outpatient individual therapy visit	$0 copay (authorization required)
Outpatient individual therapy visit with a psychiatrist	$0 copay (authorization required)
Rehabilitation Services
Physical therapy and speech and language therapy visit	$0 copay (authorization required)
Medical Equipment / Supplies
Prosthetics (e.g., braces, artificial limbs)	$0 copay (authorization required)
Diabetes supplies	$0 copay (authorization required)
Diagnostic Procedures / Lab Services / Imaging
Lab services	$0 copay (authorization required)
Diagnostic radiology services (e.g., MRI)	$0 copay (authorization required)
Diagnostic tests and procedures	$0 copay (authorization required)
Medicare Part B Drugs
Chemotherapy	$0 copay (authorization required)
Foot Care (podiatry Services)
Routine foot care	$0 copay (limits may apply)
Hearing
Hearing aids	$0 copay (limits may apply)
Fitting/evaluation	$0 copay (limits may apply)
Preventive Dental
Fluoride treatment	$0 copay (limits may apply)
Cleaning	$0 copay (limits may apply)
Dental x-ray(s)	$0 copay (limits may apply)
Comprehensive Dental
Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay (authorization required, limits may apply)
Restorative services	$0 copay (authorization required, limits may apply)
Diagnostic services	Not covered
Endodontics	$0 copay (authorization required, limits may apply)
Non-routine services	Not covered
Periodontics	$0 copay (authorization required, limits may apply)
Vision
Eyeglass frames	$0 copay (limits may apply)
Eyeglass lenses	$0 copay (limits may apply)
Eyeglasses (frames and lenses)	$0 copay (limits may apply)
Upgrades	Not covered
Routine eye exam	$0 copay (limits may apply)
Other	Not covered
Emergency Care / Urgent Care
Emergency	$0 copay
Ground ambulance	$0 copay
Inpatient hospital coverage	$0 copay
Outpatient hospital coverage	$0 copay
Skilled Nursing Facility	$0 copay
Optional supplemental benefits	No

Prescription Costs & Benefits

A basic benefit Part D plan is bundled with this health plan. This simply means that Alterwood Advantage Dual Secure covers the minimum amount required by Medicare, whereas enhanced benefit plans cover more of the overall costs and may include more benefits.

Prescription Drug Plan Premium

Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.

Prescription Drug Plan Deductible

The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before Alterwood Advantage begins paying its share.

Prescription Drug Plan Out-of-Pocket Costs

In addition to the plan's monthly premium and deductible, Alterwood Advantage Dual Secure has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.

CMS 5-Star Rating

Each year Medicare rates D-SNP plans, like Alterwood Advantage Dual Secure, in nine categories. Medicare's plan ratings help consumers understand the quality of care and service they can expect if they qualify and choose to enroll.

Do You Qualify to Join Alterwood Advantage Dual Secure?

Unfortunately, not everyone on Medicare will qualify to join Alterwood Advantage Dual Secure. To join a 2023 Medicare Special Needs Plan in Cecil County, Maryland you must be eligible for both Medicare and Medicaid. To qualify for Medicare, you must be age 65 or older. People with SSDI benefits for a disability qualify after 24 months.

Maryland Medicaid eligibility is based on your income and assets. Here are Maryland's Medicaid thresholds.

If you don't qualify for Alterwood Advantage Dual Secure, or another Medicare Special Needs Plan in your area, Medicare Advantage plans available in Cecil County, Maryland may be another option.

Contact Alterwood Advantage

The Medicare SNP Plans for Cecil County, Maryland information on this page originates from Medicare.gov and was last updated by All Medicare on February 2, 2023.