Alignment Health Sutter Advantage +More (HMO)

Alignment Health Sutter Advantage +More (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in Sacramento, Placer & Yolo Counties. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Alignment Health Sutter Advantage +More (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 Sutter Advantage +More (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.

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 Sutter Advantage +More (HMO) Medicare plan offers an enhanced alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you pay a $5 copay for preferred generic and specialty tier drugs, and a $40 copay for standard generic drugs. For brand-name and non-preferred medications, you will pay a 32% coinsurance for preferred brands and a 33% coinsurance for non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Beneficiaries who qualify for the low-income subsidy can also benefit from a reduced Part D premium of $7.00.

Additional Benefits

The Alignment Health Sutter Advantage +More (HMO) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs, featuring a $5 copay for primary care visits and a $25 copay for specialists with no coinsurance. Inpatient acute hospital stays require a $185 daily copay for days one through five, while outpatient hospital services carry a $195 copay. Additionally, emergency room visits have a $120 copay, whereas urgently needed services require no copay. This plan also covers routine preventive care, annual physicals, and preventive dental services with no copays or coinsurance. Members benefit from a $100 eyewear allowance every two years, an annual routine hearing exam, and a $15 monthly over-the-counter allowance with no copay. Comprehensive dental care is available with various copays and no coinsurance, while durable medical equipment and dialysis services require coinsurance up to 20%.