Alignment Health My Choice CalCare (HMO)

Alignment Health My Choice CalCare (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2026 to people living in NorCal and SoCal. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Alignment Health My Choice CalCare (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 CalCare (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 My Choice CalCare (HMO) plan features an Enhanced Alternative drug benefit with no prescription drug deductible, meaning your coverage begins immediately. During the initial coverage phase, you will pay a $3 copay for Tier 1 preferred generics, a $40 copay for Tier 2 standard generics, and a $100 copay for Tier 3 preferred brands at standard pharmacies or through standard mail. Tier 4 non-preferred drugs require a 33% coinsurance, while Tier 5 specialty drugs have a $5 copay, with these rates continuing until total drug costs reach $2,100. Once your annual out-of-pocket costs reach the $2,100 threshold, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy will benefit from a $0 Part D premium.

Additional Benefits

The Alignment Health My Choice CalCare (HMO) plan offers comprehensive medical coverage with low out-of-pocket costs, featuring no copays for preventive care and urgent care. Inpatient hospital stays require a $100 daily copay for the first five days, while emergency room visits have an $85 copay, and outpatient hospital services carry a $200 copay. Many services, including outpatient care, ambulance rides, and skilled nursing, are covered with no coinsurance, though dialysis and durable medical equipment require a 20% coinsurance. Beyond medical care, the plan provides routine vision exams with a $400 eyewear allowance every two years and routine hearing exams with prescription hearing aid coverage. Members also benefit from dental care, up to 50 one-way transportation trips per year, a $100 monthly over-the-counter allowance, and up to 12 acupuncture treatments. There are no plan deductibles for routine vision, hearing, or Part B insulin drugs, helping to keep your health costs predictable.