Alignment Health L.A. Premium Giveback (HMO)

Alignment Health L.A. Premium Giveback (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2026 to people living in Los Angeles. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Alignment Health L.A. Premium Giveback (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 L.A. Premium Giveback (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 L.A. Premium Giveback (HMO) plan offers an enhanced alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs and a $5 copay for Tier 5 specialty drugs at standard pharmacies and standard mail. Other tiers require a $42 copay for Tier 2 standard generics, a 45% coinsurance for Tier 3 preferred brands, and a 33% coinsurance for Tier 4 non-preferred drugs. These initial coverage rates apply until your total drug costs reach $2,100, at which point you enter the next phase. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy can benefit from reduced premium costs.

Additional Benefits

The Alignment Health L.A. Premium Giveback (HMO) plan offers affordable healthcare coverage with no copay for many essential services, including primary care, routine chiropractic visits, and urgently needed care. For hospital stays, acute inpatient services require no copay for days 1 to 5 and 11 to 90, though a $200 copay applies for days 6 to 10. Outpatient hospital services carry a $200 copay, while emergency room visits require a $150 copay, both with no coinsurance. Preventive care, including annual physicals and routine dental exams, is fully covered with no copay or coinsurance. Members also benefit from a $5 copay for specialist visits and physical therapy, alongside a $150 eyewear allowance every two years and an annual routine hearing exam with no deductible. Other specialized services like dialysis require no copay and a 20% coinsurance, while durable medical equipment features no copay and a 0% to 20% coinsurance.