Alignment Health Plan Medicare Advantage plans are available in six states and get average star ratings from CMS.
Jul 2, 2024 Written by Kate Ashford, CSA® Lead Writer Kate Ashford, CSA®
Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 20 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Assigning Editor Holly Carey
Assigning Editor | Medicare
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Alignment Health Plan sells Medicare Advantage plans in six states, and star ratings from CMS are about average.
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Pros & ConsMembers in high-rated plans
Percentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (90% or more)
The average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.36 (Below average)
Members in high-rated plans
Percentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (90% or more)
The average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.36 (Below average)
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.
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Alignment Health Plan’s offerings have advantages and disadvantages.
Plans are cheap: Most Alignment Health Plan Medicare Advantage plans offer a $0 premium, and the average maximum out-of-pocket cost is lower than major providers.
Some plans offer Part B help: Alignment’s smartHMO plans offer Medicare Part B rebates.
All plans have drug coverage: All Alignment Health Plan Medicare Advantage plans include prescription drug coverage.
There's help for the chronically ill: Alignment offers 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.
Availability is limited: Alignment Health Plan offers Medicare Advantage plans in just six states: Arizona, California, Florida, Nevada, North Carolina and Texas.
Members aren't super impressed: Average member experience ratings, including customer service and care coordination, for all Alignment Medicare Advantage plans fall below the average for major providers.
Average star rating, weighted by enrollment: 3.95
Alignment Health Plan Medicare Advantage plans are rated slightly below the industry average, with an average rating of 3.95 stars out of 5 from CMS for 2024, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 4.04 [0]
Centers for Medicare & Medicaid Services . 2024 Star Ratings Data Tables (Oct 13 2023) (ZIP). Accessed Jun 28, 2024.
CMS 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.
You can find a plan’s rating with the Medicare plan finding tool .
Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.
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 [0]
Centers for Medicare & Medicaid Services . CY2024_Landscape_Files_Final_20240314 (ZIP). Accessed Jun 28, 2024.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024 [0]
Centers for Medicare & Medicaid Services . Costs. Accessed Jun 28, 2024., 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 .)
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.
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-POS plansHMO 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.
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
M-F 9am-9pm ET, Sa 10am-9pm ET Speak to a licensed insurance agent on askchapter.org GET A QUOTEWe will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
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Speak to a licensed insurance agent on askchapter.org M-F 9am-9pm ET, Sa 10am-9pm ETAlignment Health Plan offers Medicare Advantage plans in six states: Arizona, California, Florida, Nevada, North Carolina and Texas.
Alignment Health Plan covers 144,000 Medicare Advantage beneficiaries [0]
Alignment Healthcare is a health insurance company headquartered in Orange, California, that provides Medicare Advantage plans. In 2014, Alignment Healthcare announced the acquisition of Citizens Choice Health Plan, a California Medicare Advantage plan that changed its name to Alignment Health Plan in 2015.
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.
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).
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Kate Ashford is a certified senior advisor (CSA)® and personal finance writer at NerdWallet specializing in Medicare and retirement topics. See full bio.
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