Alignment Health Heart & Diabetes (HMO C-SNP)

ALIGNMENT HEALTH PLAN · 2026 plan year

Plan ID H3815-010-000

HMO★ 4 CMS StarsChronic or Disabling Condition SNP
MOOP (in-network)
$1,499
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H3815-010-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$0/yr
Also owed
Your Medicare Part B premium, paid separately

More ALIGNMENT HEALTH PLAN plans in CA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$100/day for days 1–3, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Additional Days (Psychiatric)No charge
Inpatient Hospital — Psychiatric$250 per stay
Worldwide Urgent Care CoverageNo charge

Pharmacy

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

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Cardiac & Pulmonary RehabilitationSee plan details
Primary Care Physician ServicesNo charge
Prosthetics & OrthoticsSee plan details
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Vision — EyewearNo charge
Partial Hospitalization Program$15
Ambulance ServicesSee plan details
Vision — EyewearSee plan details
Ground Ambulance$100
Air Ambulance$100
Skilled Nursing Facility (SNF)$0/day for days 1–31, $50/day for days 32–100
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$70
Urgently Needed ServicesNo charge
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Intensive Outpatient Program (IOP)$15
Home Health ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist Services$3
Podiatry ServicesNo charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
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 RadiologyNo charge
Therapeutic Radiology20% coinsurance
X-Ray ServicesNo charge
Outpatient Hospital ServicesNo charge
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)No charge
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$15
Substance Abuse — Group Sessions$15
Outpatient Blood ServicesNo charge
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)0%-20% coinsurance
Prosthetic DevicesNo charge
Medical SuppliesNo charge
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & InsertsNo charge
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Other Supplemental BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Diabetic SuppliesNo charge
Personal Emergency Response System (PERS)No charge
In-Home Support ServicesNo charge
Caregiver Support ServicesNo 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)
Dental — Medicare-Covered ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services$20-$400
Dental — Endodontics (Root Canal)$25-$350
Dental — Periodontics (Gum Care)$15-$550
Dental — Removable Prosthodontics (Dentures)$20-$570
Dental — Fixed Prosthodontics (Bridges)$40-$400
Dental — Oral & Maxillofacial Surgery$25-$250
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge

Service area

  • CA: 19 counties

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