Alignment Health Heart & Diabetes Care (HMO C-SNP)

ALIGNMENT HEALTH PLAN · 2026 plan year

Plan ID H3815-048-000

HMO★ 4 CMS StarsChronic or Disabling Condition SNP
MOOP (in-network)
$1,990
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H3815-048-000
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 — Additional Days (Psychiatric)No charge
Worldwide Urgent Care CoverageNo charge
Inpatient Hospital — Acute$100/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$250 per stay

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

Other

BenefitIn-network
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 — EyewearNo charge
Vision — EyewearSee plan details
Hearing — Fitting & Evaluation for Hearing AidNo charge
Skilled Nursing Facility (SNF)$20/day for days 1–20, $100/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$120
Urgently Needed ServicesNo charge
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Partial Hospitalization Program$15
Intensive Outpatient Program (IOP)$15
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist ServicesNo charge
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
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic RadiologyNo charge
Therapeutic Radiology20% coinsurance
X-Ray ServicesNo charge
Outpatient Hospital Services$200
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)$100
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$15
Substance Abuse — Group Sessions$15
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$100
Air Ambulance$125
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
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
Chiropractic ServicesNo charge
Diagnostic Procedures & TestsNo charge
Prosthetics & OrthoticsSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Diabetic SuppliesNo charge

Service area

  • CA: 14 counties

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