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Alignment Health the ONE + Walgreens (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health the ONE + Walgreens (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health the ONE + Walgreens (HMO) in 2026, please refer to our full plan details page.
Alignment Health the ONE + Walgreens (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in Maricopa. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Alignment Health the ONE + Walgreens (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Alignment Health the ONE + Walgreens (HMO).
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 Alignment Health the ONE + Walgreens (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3499.00 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:
Sign up for Alignment Health the ONE + Walgreens (HMO)
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Drug Coverage
The Alignment Health the ONE + Walgreens (HMO) plan features an Enhanced Alternative drug benefit with no prescription drug deductible, allowing your coverage to begin right away. During the initial coverage phase, standard pharmacy and standard mail orders incur a $3 copay for Tier 1 preferred generics, a $45 copay for Tier 2 standard generics, and a $5 copay for Tier 5 specialty drugs. Tier 3 preferred brands and Tier 4 non-preferred drugs require a 40% and 33% coinsurance, respectively, up to a total drug cost limit of $2,100. After reaching the $2,100 out-of-pocket threshold, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescriptions. Additionally, beneficiaries who qualify for the low-income subsidy, or Extra Help, will see their Part D premium reduced to $0.
Additional Benefits
The Alignment Health the ONE + Walgreens (HMO) plan offers structured coverage for core medical needs, featuring a $225 daily copay for acute inpatient hospital stays for days 1 through 5 and no copay for days 6 through 90. Outpatient hospital services carry a $150 copay, while emergency room visits require a $125 copay which is waived if you are admitted. Additionally, skilled nursing facility stays are covered with no copay for the first 20 days, followed by a $100 daily copay for days 21 through 100. For supplemental care, the plan provides a $2,000 annual limit on comprehensive dental services and a $300 yearly allowance for eyewear with routine eye exams featuring no deductible. Members also benefit from a $40 monthly over-the-counter allowance and routine hearing exams with no copay. To help you reach medical appointments, the plan covers up to 24 one-way transportation trips to approved locations each year.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by Alignment Health the ONE + Walgreens (HMO), excluding upgrades and non-Medicare-covered stays. For acute care, there is a $225 daily copay for days 1 through 5 and no copay for days 6 through 90, while psychiatric care requires a $120 daily copay for days 1 through 10 and no copay for days 11 through 90, both with no coinsurance.
Outpatient Services See details
Outpatient services are covered by Alignment Health the ONE + Walgreens (HMO) with no coinsurance, featuring a $150 copay for outpatient hospital services and a $100 copay for ambulatory surgical center services. Outpatient substance abuse services require a $50 copay, and outpatient blood services are covered with no copay and no deductible.
Partial Hospitalization See details
Alignment Health the ONE + Walgreens (HMO) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization and a doctor referral are required to access these services.
Ambulance and Transportation Services See details
Alignment Health the ONE + Walgreens (HMO) covers ground and air ambulance services with a $200 copay and no coinsurance, which is waived if you are admitted to the hospital. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations, while transportation to any other health-related location is not covered.
Emergency Services See details
Alignment Health the ONE + Walgreens (HMO) covers emergency services with a $125 copay and no coinsurance, which is waived if you are admitted to the hospital within 48 hours, and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent care are partially covered up to a $10,000 maximum benefit, but worldwide emergency transportation is not covered.
Primary Care See details
Alignment Health the ONE + Walgreens (HMO) partially covers Primary Care, as podiatry services and mental health specialty services are not covered. Covered psychiatric services require a $20 copay and no coinsurance, opioid treatment requires a 20% coinsurance and no copay, and other covered services like chiropractic care have no listed copay or coinsurance.
Preventive Services See details
Preventive services are covered by Alignment Health the ONE + Walgreens (HMO) with no copay and no coinsurance for Medicare-covered zero-dollar services. This benefit is partially covered, as sub-services including health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Alignment Health the ONE + Walgreens (HMO), including one routine exam and one fitting evaluation annually with no deductible. Up to two prescription hearing aids (all types) are covered each year with a copay ranging from $195 to $1,750 and no coinsurance, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Alignment Health the ONE + Walgreens (HMO), offering no deductible for an annual routine eye exam and a $300 yearly allowance for eyewear, though upgrades are not covered. Under this plan, members are covered for one routine eye exam and one pair of contacts or eyeglasses (lenses and frames) each year.
Dental Services See details
Dental services are partially covered by Alignment Health the ONE + Walgreens (HMO), with a $2,000 annual limit on comprehensive care, though implant services, orthodontics, adjunctive general services, and maxillofacial prosthetics are not covered. Preventive services feature no coinsurance and require copays of $10 for exams and fluoride, $20 for cleanings, and $30 for X-rays.
Home Infusion bundled Services See details
Alignment Health the ONE + Walgreens (HMO) covers home infusion bundled services, requiring prior authorization and offering chemotherapy, radiation, and other Part B drugs with no copay and no coinsurance to 20% coinsurance. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Alignment Health the ONE + Walgreens (HMO) covers Dialysis Services with a $30 copay and no coinsurance. Prior authorization and a doctor referral are required to receive these covered services.
Medical Equipment See details
Medical Equipment is partially covered by Alignment Health the ONE + Walgreens (HMO) because diabetic supplies are not covered. Covered items, including durable medical equipment, prosthetics, and therapeutic shoes, require no copay and carry a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Alignment Health the ONE + Walgreens (HMO), with covered therapeutic radiological services requiring a 20% coinsurance and no copay. Diagnostic procedures and tests, lab services, diagnostic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by Alignment Health the ONE + Walgreens (HMO) with no copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Alignment Health the ONE + Walgreens (HMO) plan, as none of the sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by Alignment Health the ONE + Walgreens (HMO) with no copay and no coinsurance for days 1 through 20, followed by a $100 daily copay and no coinsurance for days 21 through 100. Prior authorization and a doctor referral are required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Alignment Health the ONE + Walgreens (HMO) offers partial coverage for other services, excluding meal benefits and Dual Eligible SNPs with Highly Integrated Services. Covered benefits include acupuncture, digital health support, and a monthly $40 over-the-counter allowance with no copay or coinsurance, while personalized health risk screenings require a $75 copay and no coinsurance.
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