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Alignment Health My Choice Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health My Choice Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health My Choice Select (HMO) in 2025, please refer to our full plan details page.
Alignment Health My Choice Select (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in Los Angeles, Orange, Riverside, San Bernardino. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Alignment Health My Choice Select (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 My Choice Select (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 My Choice Select (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 $798.00 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 Alignment Health My Choice Select (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your drugs, depending on the tier and pharmacy. For example, standard generic drugs have a $30 copay, while preferred brand drugs have a $100 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Alignment Health My Choice Select (HMO) plan offers a range of benefits, including inpatient and outpatient hospital services, with copays varying by service. The plan also covers primary care, preventive services, hearing, vision, dental, and home health services. Many services like hearing exams, eye exams, and home health services have no copay. Additional benefits include ambulance services, emergency services, and transportation to health-related locations. The plan also covers medical equipment, diagnostic and radiological services, and skilled nursing facility services. Other covered services include acupuncture, over-the-counter items, and meal benefits for chronic conditions, with specific copays and coinsurance applying to certain services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For Inpatient Hospital Psychiatric, you will pay a $120 copay for days 1-10, and no copay for days 11-90. Additional days for Inpatient Hospital Psychiatric are covered for up to 40 days per benefit period. Non-Medicare-covered stays and upgrades for inpatient hospital acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Individual and group sessions for outpatient substance abuse have a copay between $50 and $50, and the three-pint deductible is waived for outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered, and requires prior authorization and a doctor referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and Air Ambulance Services have a $75 copay, and there is no coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 22 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage are covered by the Alignment Health My Choice Select (HMO) plan. Emergency Services have a $70 copay and no coinsurance, and Worldwide Emergency Services have a maximum plan benefit coverage of $25,000. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Alignment Health My Choice Select (HMO) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, podiatry services, other health care professionals, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services, physician specialist services, mental health specialty services, podiatry services, other health care professionals, psychiatric services, and opioid treatment program services require prior authorization and a doctor referral. Individual and group sessions for mental health specialty services are not covered. Individual and group sessions for psychiatric services have a $20 copay. Opioid treatment program services have a 20% coinsurance. Occupational therapy, physical therapy, and speech-language pathology services have no copay or coinsurance.
Preventive Services See details
The Alignment Health My Choice Select (HMO) plan covers preventive services, including annual physical exams, and other services like glaucoma screenings and diabetes self-management training. The plan also covers Personal Emergency Response System (PERS), In-Home Support Services, Support for Caregivers of Enrollees (up to $300 per year), and Fitness Benefit, but does not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with services not usually covered by Medicare plans. Routine hearing exams and fitting/evaluation for hearing aids are covered for one visit every year with no copay, while prescription hearing aids have a copay between $195 and $1750 for two visits every year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Alignment Health My Choice Select (HMO) plan covers vision services including eye exams, with no copay. Eyewear is covered with a combined maximum benefit of $200.00 every year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are covered. Upgrades are not covered.
Dental Services See details
The Alignment Health My Choice Select (HMO) plan covers dental services including oral exams (1 every six months), dental x-rays (1 every three years), prophylaxis (cleaning) (1 every six months), and fluoride treatments (1 every six months). Restorative Services have a copay of $20-$400, Endodontics have a copay of $25-$350, Periodontics have a copay of $15-$550, Prosthodontics (removable) have a copay of $20-$570, Prosthodontics (fixed) have a copay of $40-$400, and Oral and Maxillofacial Surgery have a copay of $25-$250. Orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Alignment Health My Choice Select (HMO) plan, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%, while other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Alignment Health My Choice Select (HMO) plan. The copay for Dialysis Services is $30, and a referral and prior authorization from your doctor are required.
Medical Equipment See details
Medical Equipment is covered by the Alignment Health My Choice Select (HMO) plan, with Durable Medical Equipment (DME) subject to a 0-20% coinsurance and Prosthetic Devices subject to 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Medical Supplies and Diabetic Therapeutic Shoes/Inserts are also covered, both subject to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Alignment Health My Choice Select (HMO) plan, with no copay. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, and Outpatient X-Ray Services are not covered, while Therapeutic Radiological Services are covered with a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Alignment Health My Choice Select (HMO) plan with no copay and no coinsurance, but authorization and a referral are required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization and a doctor referral. There is no copay for days 1-20, and a $30 copay for days 21-100.
Other Services See details
The Alignment Health My Choice Select (HMO) plan covers acupuncture with no copay, over-the-counter items with a $20 monthly maximum, and meal benefits for chronic illness or medical conditions. Some other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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