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

Alignment Health Heart & Diabetes Plus (HMO C-SNP) is a HMO C-SNP plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in Maricopa, Pima, Santa Cruz. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Alignment Health Heart & Diabetes Plus (HMO C-SNP) 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 Heart & Diabetes Plus (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.

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:

Drug Coverage

The Alignment Health Heart & Diabetes Plus (HMO C-SNP) plan features an Enhanced Alternative prescription drug benefit with an annual deductible of $615.00. If you qualify for the low-income subsidy (LIS), your Part D premium is reduced to $17.00. After meeting the deductible, you will pay a 25% coinsurance for preferred generic, standard generic, and non-preferred drugs, and a 31% coinsurance for preferred brand drugs at standard pharmacies and mail-order services. Specialty tier drugs are covered with no copay during the initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. This plan structure helps manage prescription expenses with predictable cost-sharing percentages and a low catastrophic threshold.

Additional Benefits

The Alignment Health Heart & Diabetes Plus (HMO C-SNP) plan offers robust medical coverage with clear cost-sharing, featuring a $275 copay for the first six days of inpatient hospital stays and no copay for days seven through ninety. Most outpatient hospital services, partial hospitalizations, ambulance services, and dialysis require a 20% coinsurance and no copay, while urgent care services require no copay or coinsurance. Primary care therapies, diagnostics, and durable medical equipment also feature a 20% coinsurance with no copay. For routine and supplemental care, members enjoy preventive services and non-Medicare dental care with no copay or coinsurance, alongside a $3,800 annual dental limit and a $500 eyewear allowance every two years. Hearing services are covered with no deductible, and the plan provides up to 50 one-way transportation trips to approved locations. Additional benefits include a $200 monthly over-the-counter reimbursement, 12 acupuncture visits annually, and a $35 copay for Medicare Part B insulin.