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Alignment Health Honor+ Plan (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health Honor+ Plan (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health Honor+ Plan (HMO) in 2026, please refer to our full plan details page.
Alignment Health Honor+ Plan (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 Honor+ Plan (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 Honor+ Plan (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 Honor+ Plan (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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 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 Honor+ Plan (HMO) features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you pay a 25% coinsurance for preferred generic, standard generic, and non-preferred drugs at standard pharmacies or through standard mail. Preferred brand drugs require a 30% coinsurance, while specialty tier drugs are covered with no copay. This coverage phase continues until your yearly out-of-pocket drug costs reach $2,100.00, at which point you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs. Additionally, individuals who qualify for Extra Help or the low-income subsidy can see their Part D costs reduced to no cost.
Additional Benefits
The Alignment Health Honor+ Plan (HMO) offers robust medical coverage with many essential services featuring no copay and a 20% coinsurance, including dialysis, ambulance transport, and durable medical equipment. Emergency care is also covered with no copay and a 20% coinsurance, while routine preventive and dental care require no copay or coinsurance. Primary care visits are covered, and specialized therapies require no copay and a 20% coinsurance. For routine wellness, the plan includes yearly vision and hearing exams with no deductible, plus a $500 eyewear allowance every two years. Members also receive up to 50 one-way trips to approved health locations and a $100 monthly reimbursement allowance for over-the-counter items. While inpatient care and skilled nursing services require Medicare-defined copays and coinsurance, these additional benefits provide valuable everyday savings.
Inpatient Hospital See details
Alignment Health Honor+ Plan (HMO) partially covers inpatient hospital acute and psychiatric services, which require prior authorization, doctor referrals, and Medicare-defined copays and coinsurance. Additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
Alignment Health Honor+ Plan (HMO) covers outpatient services, including hospital, observation, and ambulatory surgical center services, which require prior authorization and a doctor referral. Outpatient blood services and substance abuse sessions are covered with no copay and a 20% coinsurance, with no deductible required for blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the Alignment Health Honor+ Plan (HMO), with prior authorization and a doctor referral required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by the Alignment Health Honor+ Plan (HMO), as transportation to any health-related location is not covered. Ground and air ambulance services require a 20% coinsurance and no copay, while up to 50 one-way trips to plan-approved health-related locations are covered.
Emergency Services See details
The Alignment Health Honor+ Plan (HMO) covers emergency and urgently needed services with a 20% coinsurance and no copay, with the emergency coinsurance waived if you are admitted to the hospital within three days. Worldwide emergency and urgent care are partially covered up to a $10,000 maximum limit with a $75 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Primary care benefits are partially covered by the Alignment Health Honor+ Plan (HMO), with no copays and a 20% coinsurance required for occupational, physical, psychiatric, and mental health specialty therapies. While primary care visits, telehealth, and routine chiropractic services are covered, podiatry services are not covered.
Preventive Services See details
Preventive services are covered by the Alignment Health Honor+ Plan (HMO), featuring annual physical exams and Medicare-covered zero-dollar services with no copay. Additional preventive benefits are partially covered, offering personal emergency response systems, therapeutic massage, and caregiver support, while services such as health education and weight management are not covered.
Hearing Services See details
Alignment Health Honor+ Plan (HMO) covers one routine hearing exam and one fitting evaluation per year with no deductible, though specific copay and coinsurance details are not provided. For prescription hearing aids, some services are covered but all types, inner ear, outer ear, and over the ear models are not covered, and over-the-counter hearing aids are also excluded.
Vision Services See details
Vision services are partially covered by the Alignment Health Honor+ Plan (HMO), which offers one routine eye exam per year with no deductible and a $500 combined maximum benefit for eyewear every two years. Covered eyewear includes contacts, eyeglasses, lenses, and frames, though eyewear upgrades are not covered.
Dental Services See details
Alignment Health Honor+ Plan (HMO) covers dental services with a 20% coinsurance and no copay for Medicare-covered dental care, and no copay or coinsurance for covered preventive and restorative services. This is a partially covered benefit, as adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Alignment Health Honor+ Plan (HMO) with prior authorization, requiring no copay and between no coinsurance and 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are covered under this benefit with a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Alignment Health Honor+ Plan (HMO) with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive these services.
Medical Equipment See details
Medical Equipment is partially covered under the Alignment Health Honor+ Plan (HMO), as diabetic supplies are not covered. Covered benefits—including durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes—require prior authorization and feature no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
Alignment Health Honor+ Plan (HMO) partially covers Diagnostic and Radiological Services, 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 under the Alignment Health Honor+ Plan (HMO), with both prior authorization and a doctor referral required to access these benefits.
Cardiac Rehabilitation Services See details
Alignment Health Honor+ Plan (HMO) indicates some services are covered for Cardiac Rehabilitation, but in practice, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Alignment Health Honor+ Plan (HMO) with Medicare-defined copays and coinsurance, requiring prior authorization, a doctor referral, and a 3-day prior inpatient hospital stay. This benefit is partially covered, as additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the Alignment Health Honor+ Plan (HMO), which excludes Dual Eligible SNPs with Highly Integrated Services. Covered benefits include meal programs, digital health technology support, up to 12 acupuncture visits per year with a doctor's referral, and a $100 monthly over-the-counter reimbursement allowance, though specific copay and coinsurance amounts are not specified.
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