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

Alignment Health Heart & Diabetes Care (HMO C-SNP) is a HMO C-SNP plan offered by Alignment Healthcare USA, LLC available for enrollment in 2026 to people living in LA, OC, Riv, SB, SD. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Alignment Health Heart & Diabetes Care (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 Care (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 Care (HMO C-SNP) Medicare plan features an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will pay set copayments or coinsurance for your medications until your total drug costs reach $2,100. If you qualify for the low-income subsidy, your Part D premium is reduced to no cost. Under this plan, standard retail and mail-order pharmacy costs for a 30-day supply include a $5 copay for Tier 1 preferred generics and Tier 5 specialty drugs, and a $30 copay for Tier 2 standard generics. Tier 3 preferred brands require 40% coinsurance, while Tier 4 non-preferred drugs require 33% coinsurance. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs.

Additional Benefits

The Alignment Health Heart & Diabetes Care (HMO C-SNP) plan covers essential medical services with clear copays, including outpatient hospital visits for a $200 copay and ambulatory surgical services for a $100 copay. Emergency services require a $120 copay, while ground ambulance transportation has a $100 copay, with both fees waived upon hospital admission. Skilled nursing facility stays require a daily copay of $20 for days one through 20 and $100 for days 21 through 100 with no coinsurance. Preventive care, annual physicals, and routine dental services are fully covered with no copay and no coinsurance. The plan also features valuable everyday benefits, such as a $200 annual eyewear allowance, routine hearing exams, a $25 monthly over-the-counter reimbursement, and up to 50 one-way trips to approved locations. Specialty care like dialysis services requires a 20% coinsurance and no copay, while durable medical equipment is covered with no copay and up to 20% coinsurance.