Alignment Health Advantage 005 (PPO)

ALIGNMENT HEALTH ADVANTAGE PLAN INC · 2027 plan year

Plan ID H8832-005-000

Local PPO★ 4 CMS StarsNew for 2027
MOOP (in-network)
$4,451
MOOP (combined)
$8,950
Monthly premium
$160/mo
Part C $149.50 + Part D $10.50, before Extra Help
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H8832-005-000
Medical deductible
$0 — no deductible
Part D premium
$10.50/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More ALIGNMENT HEALTH ADVANTAGE PLAN INC plans in CA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$500 per stay
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$120/day for days 1–10, $0 after
Worldwide Urgent Care CoverageNo charge

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$20
Mental Health — Group Sessions$20
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Vision — Eyeglass FramesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Supervised Exercise Therapy (SET)No charge
Skilled Nursing Facility (SNF)$0/day for days 1–20, $100/day for days 21–51, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Emergency Services$130
Urgently Needed Services$20
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist Services$35
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$40
Psychiatric Services — Group Sessions$40
Physical Therapy & Speech-Language PathologyNo charge
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services20% coinsurance
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$150
Therapeutic Radiology20% coinsurance
X-Ray Services$15
Outpatient Hospital Services$300
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)$200
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$40
Substance Abuse — Group Sessions$40
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$250
Air Ambulance$250
Durable Medical Equipment (DME)0%-20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors20% coinsurance
Dialysis Services20% coinsurance
Other Supplemental Benefit$75
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Dental — Medicare-Covered ServicesNo charge
Remote Access TechnologiesNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge

Service area

  • CA: 2 counties

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