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Align Kidney Care (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Align Kidney Care (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Align Kidney Care (HMO C-SNP) in 2025, please refer to our full plan details page.
Align Kidney Care (HMO C-SNP) is a HMO C-SNP plan offered by Curana Health Holdings, LLC available for enrollment in 2025 to people living in California (partial). The overall rating for this plan is not yet available for 2025.
It's important to know that Align Kidney Care (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Align Kidney Care (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Align Kidney Care (HMO C-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Align Kidney Care (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.70. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Align Kidney Care (HMO C-SNP) plan has a $590 deductible for prescription drugs. During the initial coverage phase, after you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $15 copay at a standard pharmacy, while non-preferred drugs have a 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. This plan may have a reduced premium if you qualify for the low-income subsidy; the Part D premium would be $29.70.
Additional Benefits
The Align Kidney Care (HMO C-SNP) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with varying coinsurance amounts. Emergency and urgently needed services have copays, while primary care, home health, and several other services are covered. The plan also includes coverage for hearing, vision, and dental services, and offers benefits like home infusion and dialysis services, with coinsurance requirements. This plan provides coverage for medical equipment, diagnostic and radiological services, and skilled nursing facility services. However, it does not cover annual physical exams, cardiac rehabilitation, and certain other services. The plan also offers over-the-counter (OTC) items and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered, but the specific cost-sharing details like coinsurance and deductible amounts are not provided. Additional days, non-Medicare covered stays, and upgrades for both acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, with a 20% coinsurance, and observation services, with a $100 copay per stay and Ambulatory Surgical Center (ASC) services, with a coinsurance between 20% and 20%. Outpatient Substance Abuse Services are covered with a coinsurance between 20% and 20% for both individual and group sessions. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Align Kidney Care (HMO C-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Align Kidney Care (HMO C-SNP) plan, including both ground and air ambulance services, each with a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Align Kidney Care (HMO C-SNP) plan, with a $90 copay and no coinsurance, and Urgently Needed Services are covered with a $25 copay and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The Align Kidney Care (HMO C-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services are covered with a 20% coinsurance, and Routine Chiropractic Care is not covered. Physical Therapy and Speech-Language Pathology Services have a 20% coinsurance.
Preventive Services See details
The Align Kidney Care (HMO C-SNP) plan covers preventive services, but does not cover annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services. This plan also covers glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit.
Hearing Services See details
Hearing services include routine hearing exams with a coinsurance of at most 20% and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a maximum benefit of $2000 every two years, however, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are also covered.
Vision Services See details
Vision services, including routine eye exams and eyewear, are covered. Eye exams have a 20% coinsurance, and eyewear, including contact lenses, has a 20% coinsurance with a combined maximum plan benefit of $150 per year.
Dental Services See details
Dental Services are covered, with 20% coinsurance for Medicare Dental Services, and other dental services like oral exams, dental x-rays, and cleanings are covered. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for all home infusion services.
Dialysis Services See details
Dialysis Services are covered by the Align Kidney Care (HMO C-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the Align Kidney Care (HMO C-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, while Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Align Kidney Care (HMO C-SNP) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Align Kidney Care (HMO C-SNP) plan with no copay or coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Align Kidney Care (HMO C-SNP) plan. Prior authorization is required for these services, but they are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays, and non-Medicare-covered SNF stays are not covered. There is coinsurance for SNF services, and prior authorization is required.
Other Services See details
The Align Kidney Care (HMO C-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits, but does not cover Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. The plan offers OTC items, including Nicotine Replacement Therapy (NRT).
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