Alterwood Advantage
Alterwood Advantage is a privately held Maryland Medicare Advantage plan operator offering HMO and D-SNP products across 21 counties, serving individual Medicare and dual-eligible beneficiaries through direct, broker, and CMS enrollment channels.
- Company typePrivate
- Founded2013
- HeadquartersTowson, United States
- Headcount51–100
- GTM typeB2C
- OfferingServices
What Alterwood Advantage does
Alterwood Advantage is a privately held Maryland-based Medicare Advantage organization headquartered in Towson (with operational offices in Owings Mills and Timonium) that designs, distributes, and administers HMO and HMO-SNP health plans to Medicare beneficiaries across 21 Maryland counties. The company's management team previously formed the Medicaid MCO Riverside Health in Maryland in 2013 and applies similar operating principles — competitive provider rates, expeditious clean-claim payment, and in-house core operations — to the MA market. The portfolio for the 2026 plan year comprises eight products spanning standard HMOs (Select, Choice, Choice Plus, Freedom) and Dual-Eligible Special Needs Plans (Dual Secure, Dual Value), including Baltimore City-specific variants, with monthly premiums ranging from $0 to $122 and supplemental benefits such as dental, vision, hearing, transportation, OTC allowances, fitness reimbursements, and Flex Cards.
Underlying technology is operational rather than model-driven: secure provider and member web portals (my.alterwoodadvantage.com and my.alterwood360.com), e-prescribing through the provider network, PBM services via MedImpact, mail-order through Birdi, OTC fulfillment via NationsBenefits, electronic claims through Availity, Part D prior authorizations through Elixir Solutions, and CMS IRE review via MAXIMUS, supplemented by the SafeHealth API for interoperability and HEDIS-based quality reporting. The Quality Improvement Program, Medication Therapy Management Program, and telephone-based Health Risk Assessment are core clinical programs that integrate care, pharmacy, and utilization management.
Revenue is generated through Medicare Advantage capitation: monthly member premiums for standard plans ($0-$122) and $0 premiums for D-SNP plans serving Medicaid-eligible beneficiaries, combined with CMS subsidies. Distribution is multi-channel, combining a licensed in-house phone sales force (1-866-550-0560), online enrollment through the corporate website and CMS Medicare Online Enrollment Center, paper-based mail enrollment, and a contracted broker/agency channel with CRM-enabled lead distribution. The customer base is geographically restricted to Maryland residents in the approved service area, with no disclosed enrollment or revenue figures.
Alterwood Advantage firmographics
Firmographics- Name
- Alterwood Advantage
- Legal name
- Alterwood Advantage
- Website
- https://alterwoodadvantage.com
- Company type
- Private
- Founded year
- 2013
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Alterwood Advantage is a privately held Maryland Medicare Advantage plan operator offering HMO and D-SNP products across 21 counties, serving individual Medicare and dual-eligible beneficiaries through direct, broker, and CMS enrollment channels.
- Ownership category
- akta.pro rank
Alterwood Advantage industry classification
Industry- Product category
- Medicare Advantage Health Insurance
- NAICS
- Insurance and Employee Benefit Funds (5251)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- MA HMO Plans (HLAEACAA)
- akta.pro secondary industries
- MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI), MA Risk Adjustment (HCC/RAF) & Stars Performance Programs (HLAEACAL)
Keywords
Where Alterwood Advantage is headquartered
LocationHeadquarters
- HQ city
- Towson
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
Alterwood Advantage business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Supply Chain, Marketing or Sales, Technology or R&D, Infrastructure
Revenue model
- Medicare Advantage Premium Revenue: Alterwood Advantage generates revenue through Medicare Advantage plan premiums. They offer multiple plan types including HMO plans with varying monthly premiums ($0 to $122) and dual-eligible SNP plans with $0 premiums for Medicaid recipients. The company collects premiums from Medicare beneficiaries and CMS subsidies.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Alterwood Advantage Select (HMO) - $0 monthly premium plan |
| Subscription | Monthly | Alterwood Advantage Choice (HMO) - $30 monthly premium |
| Subscription | Monthly | Alterwood Advantage Choice Plus (HMO) - $122 monthly premium |
| Subscription | Monthly | Alterwood Advantage Dual Value (HMO D-SNP) - $0 premium for dual eligible |
| Subscription | Monthly | Alterwood Advantage Dual Secure (HMO D-SNP) - $0 premium for dual eligible |
| Subscription | Monthly | Alterwood Advantage Freedom (HMO) - Medical only plan with Part B giveback |
Go-to-market motion2 records
Distribution channels3 records
Marketing channels4 records
Alterwood Advantage product offering
Product offeringCore offering
Alterwood Advantage is a Maryland-based Medicare Advantage organization that sells HMO and HMO-SNP health plans to Medicare beneficiaries across 21 Maryland counties. The company offers six core plan products (Select, Choice, Choice Plus, Freedom, Dual Secure, Dual Value) plus Baltimore City regional variants, bundling medical, hospital, Part D prescription drug coverage, and supplemental benefits such as dental, vision, hearing, transportation, OTC allowances, fitness, and Flex Cards. It also operates Provider and Member web portals and clinical programs including Medication Therapy Management, Health Risk Assessment, and a Quality Improvement Program.
Product overview
Alterwood Advantage is a Maryland-based Medicare Advantage organization offering eight distinct health plan products: Select (HMO), Choice (HMO), Choice Plus (HMO), Freedom (HMO), Dual Secure (HMO D-SNP), and Dual Value (HMO D-SNP), with regional Baltimore City variants for Select and Choice plans. All plans except Freedom include Medicare Part D prescription drug coverage. The portfolio includes both standard Medicare Advantage HMOs for general Medicare beneficiaries and Dual Eligible Special Needs Plans (D-SNPs) for those with both Medicare and Medicaid. Supplemental benefits vary by plan and include dental, vision, hearing, transportation, over-the-counter allowances, fitness programs, and flex cards. The company also operates digital platforms including a Provider Portal for claims and authorization management, a Member Portal for account access, a Medication Therapy Management Program for medication optimization, and a Health Risk Assessment program for personalized care planning.
Differentiator
Problem solved
Functional benefit
Products and services
- Alterwood Advantage Select (HMO) A Medicare Advantage HMO plan with $0 monthly premium offering medical coverage, hospital expenses, doctor visits, and prescription drug coverage (Part D) for Maryland Medicare beneficiaries, with extra benefits including dental, vision, hearing, fitness programs, and transportation.
- Alterwood Advantage Select – Baltimore City (HMO) A Baltimore City-specific regional variant of the Select HMO plan with $0 premium, offering medical, hospital, and Part D drug coverage plus supplemental dental, vision, hearing, and fitness benefits for Baltimore City Medicare beneficiaries.
- Alterwood Advantage Choice (HMO) An all-inclusive Medicare Advantage HMO plan with a $30 monthly premium covering medical, hospital, prescription drugs (Part D), and supplemental benefits including dental, vision, hearing, OTC allowance, and transportation for Maryland Medicare beneficiaries.
- Alterwood Advantage Choice – Baltimore City (HMO) A Baltimore City-specific variant of the Choice HMO plan with a $40 monthly premium, providing medical, hospital, and Part D prescription drug coverage plus supplemental benefits.
- Alterwood Advantage Choice Plus (HMO) A premium-tier Medicare Advantage HMO plan with a $122 monthly premium offering the same coverage as Choice with lower cost-shares, additional lifestyle medications (erectile dysfunction medication, vitamins), and a $500 annual fitness reimbursement.
- Alterwood Advantage Freedom (HMO) A medical-only Medicare Advantage HMO plan without Part D prescription drug coverage, designed for beneficiaries with additional coverage such as VA benefits, offering up to a $75 monthly Part B giveback and supplemental dental, vision, hearing, and OTC benefits.
- Alterwood Advantage Dual Secure (HMO D-SNP) A Dual Eligible Special Needs Plan (D-SNP) for Medicare beneficiaries who also have Medicaid, providing $0 cost-sharing for most services, transportation (24 one-way trips), dental ($2,250 allowance), vision ($300 allowance), and a $100 monthly Flex Card.
- Alterwood Advantage Dual Value (HMO D-SNP) A Dual Eligible Special Needs Plan (D-SNP) for Medicare and Medicaid beneficiaries offering enhanced extra benefits including dental ($1,900 allowance), vision ($400 allowance), hearing aids ($1,350 allowance), transportation (22 one-way trips), and a $70 monthly Flex Card.
- Alterwood Advantage Provider Portal
- Alterwood Advantage Member Portal A secure member portal (my.alterwood360.com) for plan members to access their accounts, view benefits, and manage their healthcare coverage.
Companies that use Alterwood Advantage
Customer profileSegments1 record
Ideal customer profiles2 records
Alterwood Advantage technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration6 records
Feature3 records
Alterwood Advantage partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered core.
- MedImpactcoreMedImpact provides pharmacy benefits management services for Alterwood Advantage, including network pharmacy access (60,000+ pharmacies nationwide), mail order pharmacy services, and prescription drug coverage administration. They handle Part D appeals processing and quality assurance for pharmacy network credentialing.
- Birdi (Mail Order Pharmacy)coreBirdi provides mail order prescription services for Alterwood Advantage members. Members can mail completed order forms with prescriptions to Birdi's Novi, MI facility. Providers can fax prescriptions directly to Birdi.
- MAXIMUS Federal ServicescoreMAXIMUS Federal Services serves as the CMS Independent Review Entity (IRE) for second-level review of payment appeals. When Alterwood Advantage upholds an initial determination, cases are forwarded to MAXIMUS for independent review.
- URACcoreURAC is the independent accrediting organization for healthcare utilization management. Alterwood Advantage maintains URAC accreditation for Health Utilization Management, effective 10/01/2026.
Scale indicators2 records
Recent moves7 records
Expansion highlights5 records
Alterwood Advantage competitors and assessment
Company assessmentBroad incumbents
- Humana: Top-3 national MA carrier with a heavy broker-driven distribution model and broad HMO plan portfolio in Maryland; competes head-to-head with Alterwood's broker channel and HMO products.
- UnitedHealthcare: Largest U.S. Medicare Advantage carrier offering AARP-branded HMO and PPO plans across Maryland; competes directly with Alterwood for the same beneficiary pool but at vastly greater scale.
- Cigna Healthcare: National health insurer with Medicare Advantage HMO offerings; competes with Alterwood in Maryland counties and benefits from broader portfolio scale.
- Aetna (CVS Health): National MA carrier leveraging CVS retail footprint and integrated PBM; offers HMO Medicare Advantage plans in Maryland overlapping with Alterwood's product set.
Direct peers
- Kaiser Permanente: Operates integrated HMO Medicare Advantage plans with provider-owned delivery model, directly competing with Alterwood's HMO offerings in Maryland markets where Kaiser has presence.
Regional players
- Maryland Physicians Care: Maryland-based Medicaid MCO and Medicare Advantage plan with overlapping provider networks and state-contracted experience similar to Alterwood's management background.
- Priority Partners: Maryland Medicaid managed care organization with growing Medicare presence; competes for dual-eligible beneficiaries in the same Maryland counties where Alterwood's D-SNPs operate.
- Johns Hopkins Health Plans: Maryland-based provider-sponsored health plan offering Medicare Advantage products with deep ties to the Johns Hopkins provider network; directly competes in the same Maryland counties as Alterwood.
- CareFirst BlueCross BlueShield: Maryland-anchored Blue Cross Blue Shield licensee offering Medicare Advantage plans; the dominant regional incumbent that Alterwood must displace for local market share.
Emerging players
- Clover Health: Technology-forward MA plan focused on Medicare beneficiaries, using clinical software and provider enablement; an emerging peer with overlapping MA-only target market though operating in different geographies.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat3 records
Key risks6 records
Key highlights6 records
Customer concentration
Alterwood Advantage social profiles
Digital presenceAlterwood Advantage compliance and trust
Trust signalCompliance2 records
Alterwood Advantage financial estimates
Financial estimateRevenue estimate
Valuation estimate
Alterwood Advantage leadership team
Management profileNumber of profiles
Alterwood Advantage funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Alterwood Advantage M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Alterwood Advantage
What does Alterwood Advantage do?
Alterwood Advantage is a Maryland-based Medicare Advantage organization that sells HMO and HMO-SNP health plans to Medicare beneficiaries across 21 Maryland counties. The company offers six core plan products (Select, Choice, Choice Plus, Freedom, Dual Secure, Dual Value) plus Baltimore City regional variants, bundling medical, hospital, Part D prescription drug coverage, and supplemental benefits such as dental, vision, hearing, transportation, OTC allowances, fitness, and Flex Cards. It also operates Provider and Member web portals and clinical programs including Medication Therapy Management, Health Risk Assessment, and a Quality Improvement Program.
Is Alterwood Advantage a public or private company?
Alterwood Advantage is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Alterwood Advantage founded?
Alterwood Advantage was founded in 2013. It employs 51 to 100 people.
Where is Alterwood Advantage based?
Alterwood Advantage is headquartered in Towson, United States, in the North America region.
How does Alterwood Advantage make money?
One revenue line is on record: medicare Advantage Premium Revenue.
Who are Alterwood Advantage's main competitors?
Broad incumbents on record are Humana, UnitedHealthcare, Cigna Healthcare and Aetna (CVS Health). Kaiser Permanente is listed as a direct peer. Regional players are Maryland Physicians Care, Priority Partners, Johns Hopkins Health Plans and CareFirst BlueCross BlueShield. Clover Health is listed as an emerging player.
Does Alterwood Advantage have an API?
No public API is recorded for Alterwood Advantage.
What industry is Alterwood Advantage in?
Alterwood Advantage's product category is Medicare Advantage Health Insurance. Its primary akta.pro industry code is HLAEACAA, MA HMO Plans, with a secondary code of HLAEACAI, MA Chronic Condition Management & Supplemental Benefits (SSBCI). Its NAICS code is 5251 and its SIC code is 6321.