Alignment Health Plan Medicare Advantage 2024 Review

Alignment Health Plan Medicare Advantage plans are available in six states and get average star ratings from CMS.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Updated
Edited by Holly Carey

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Alignment Health Plan Medicare Advantage - Chapter

Alignment Health Plan

3.96

CMS Star Rating

Alignment Health Plan sells Medicare Advantage plans in six states, and star ratings from CMS are about average.

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GET A QUOTE

from askchapter.org

States available

6 states


Members in high-rated plans

High (90% or more)


Member experience

2.38 (Below average)


States available

6 states


Members in high-rated plans

High (90% or more)


Member experience

2.38 (Below average)


Pros

  • Low-cost plans, and a lower average out-of-pocket max than most.
  • All plans include prescription drug coverage.
  • Some plans in 2024 will include Part B rebates.

Cons

  • Available in only 6 states.
  • Member experience ratings are below the average for major providers.

Alignment Health Plan Medicare Advantage plans are available in six states, and the provider’s star ratings from the Centers for Medicare & Medicaid Services (CMS) are average. Member experience ratings, however, fall below those of major providers. In 2024, members may have access to new benefit offerings, such as Medicare Part B premium rebates.

Here’s what you should know about Alignment Health Plan Medicare Advantage.

Alignment Health Plan Medicare Advantage pros and cons

Alignment Health Plan’s offerings have advantages and disadvantages.

Pros

  • Low-cost plans: Most Alignment Health Plan Medicare Advantage plans offer a $0 premium, and the average maximum out-of-pocket cost is lower than major providers. 

  • Part B help: Alignment’s smartHMO plans in 2024 will offer Medicare Part B rebates. 

  • Drug coverage: All Alignment Health Plan Medicare Advantage plans include prescription drug coverage.

  • Help for chronically ill: In 2024, Alignment will offer a $500+ quarterly allowance to members of some Dual-Eligible Special Needs Plans (D-SNPs) that they can use for things like groceries and home safety items. 

Cons

  • Limited availability: Alignment Health Plan offers Medicare Advantage plans in just six states: Arizona, California, Florida, Nevada, North Carolina and Texas. 

  • Below-average member experience marks: Average member experience ratings, including customer service and care coordination, for all Alignment Medicare Advantage plans fall below the average for major providers. 

Alignment Health Plan Medicare star ratings

Average star rating, weighted by enrollment: 3.96

The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data and weighted by enrollment, Alignment Health Plan’s 2024 Medicare Advantage plans get an average rating of 3.96 stars

Centers for Medicare & Medicaid Services. 2024 Star Ratings Data Tables (Oct 13 2023) (ZIP). Accessed Dec 1, 2023.
.

For comparison, the average star rating for plans from all providers is 4.04

Centers for Medicare & Medicaid Services. 10.13.23 Fact Sheet - 2024 Medicare Advantage and Part D Ratings (PDF). Accessed Dec 1, 2023.
.

You can find a plan’s rating with the Medicare plan finding tool.

What does Alignment Health Plan Medicare Advantage cost?

Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.

Premiums

One of the costs to consider is the plan’s premium. In 2024, nine out of 10 Alignment Health Plan Medicare Advantage plans that aren’t special needs plans (SNPs) have a $0 premium

Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005 (ZIP). Accessed Dec 1, 2023.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023 ($174.70 in 2024)

Centers for Medicare & Medicaid Services. Costs. Accessed Dec 1, 2023.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Alignment Health Plan plans or compare across carriers. You can also shop directly from Alignment Health Plan’s website by entering your ZIP code.

Still deciding on the right carrier? Compare Medicare Advantage plans

Available Medicare Advantage plans

There are a few kinds of Alignment Health Plan Medicare Advantage plans, and they vary in terms of structure, costs and benefits. Alignment Health Plan offers Medicare Advantage prescription drug plans (MAPDs).

Plan offerings include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.

Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Alignment Health Plan offers two types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Alignment Health Plan Medicare Advantage service area

Alignment Health Plan offers Medicare Advantage plans in six states: Arizona, California, Florida, Nevada, North Carolina and Texas. Alignment Health Plan covers 109,000 Medicare Advantage beneficiaries

.

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

Still deciding on the right carrier? Compare Medicare Advantage plans

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