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Alignment Health the ONE + Walgreens (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health the ONE + Walgreens (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health the ONE + Walgreens (HMO-POS) in 2026, please refer to our full plan details page.
Alignment Health the ONE + Walgreens (HMO-POS) is a HMO-POS plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in El Paso & Hudspeth. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Alignment Health the ONE + Walgreens (HMO-POS) 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 the ONE + Walgreens (HMO-POS).
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 the ONE + Walgreens (HMO-POS), 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 $2950.00 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 the ONE + Walgreens (HMO-POS) medicare plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. You will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or through standard mail order. Tier 6 (Select Care) drugs are also highly affordable, costing a $5 copay for a 1-month supply, a $10 copay for a 2-month supply, and no copay for a 3-month supply. For Tier 3 (Preferred Brand) drugs, standard pharmacy and mail-order copays are $45 for a 1-month supply, $90 for a 2-month supply, and $135 for a 3-month supply. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 (Non-Preferred) drugs carrying a 32% coinsurance and Tier 5 (Specialty) drugs requiring a 33% coinsurance for a 1-month supply.
Additional Benefits
The Alignment Health the ONE + Walgreens (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, and outpatient hospital care. Patients will pay a $15 copay for specialist visits, a $100 copay for emergency room visits, and daily copays for inpatient hospital stays. Most diagnostic services, home health care, and urgent care visits are also available with no copay and no coinsurance. This plan also provides valuable supplemental benefits, including dental care with no copay up to a $2,500 annual maximum and routine vision exams with a $200 annual eyewear allowance. Members can access routine hearing exams and up to 34 one-way medical transportation trips per year with no copay. Other services, such as durable medical equipment, dialysis, and Part B drugs, may require up to a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Alignment Health the ONE + Walgreens (HMO-POS) with no coinsurance, though upgrades and non-Medicare-covered stays are excluded. Acute stays require no copay for days 1-2 and 8 and beyond, but have a $120 daily copay for days 3-7, while psychiatric stays have a $120 daily copay for days 1-10 and no copay for days 11-90.
Outpatient Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. Outpatient substance abuse services are also covered with no coinsurance and a $50 copay per individual or group session.
Partial Hospitalization See details
Partial hospitalization is covered by Alignment Health the ONE + Walgreens (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to receive this benefit.
Ambulance and Transportation Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers ground and air ambulance services with a $200 copay and no coinsurance, which is waived if you are admitted to the hospital. Transportation services are partially covered with no copay and no coinsurance for up to 34 one-way medical transport trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Alignment Health the ONE + Walgreens (HMO-POS) with a $100 copay (waived if admitted within 48 hours) and no coinsurance, while urgently needed services require no copay or coinsurance. Worldwide emergency and urgent care are also covered up to a $50,000 maximum with no copay or coinsurance, although worldwide emergency transportation is not covered.
Primary Care See details
Alignment Health the ONE + Walgreens (HMO-POS) covers primary care, therapies, and telehealth with no copay and no coinsurance, though chiropractic care is only partially covered because other chiropractic services are not covered. Specialist visits require a $15 copay, mental health and routine podiatry services carry a $5 copay, and psychiatric care has a $20 copay, all with no coinsurance. Opioid treatment is available with no copay and 20% coinsurance.
Preventive Services See details
Preventive services are covered by Alignment Health the ONE + Walgreens (HMO-POS) with no copay and no coinsurance, including annual physical exams and kidney disease education. Additional preventive services are only partially covered, as the plan excludes coverage for health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home or bathroom safety devices, and counseling.
Hearing Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $195 to $1,750, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Alignment Health the ONE + Walgreens (HMO-POS), offering one routine eye exam and up to $200 per year for eyewear with no copay and no coinsurance. Other eye exam services and eyewear upgrades are not covered by the plan.
Dental Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers dental services with no copay and no coinsurance up to a $2,500 annual maximum. While many preventive and comprehensive services are covered, this benefit is partially covered as it excludes other diagnostic, other preventive, adjunctive general, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Alignment Health the ONE + Walgreens (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy and other Part B drugs feature no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Alignment Health the ONE + Walgreens (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required for these services.
Medical Equipment See details
Alignment Health the ONE + Walgreens (HMO-POS) covers durable medical equipment with no copay and no coinsurance to 20% coinsurance, subject to prior authorization. Prosthetics, medical supplies, and diabetic therapeutic shoes are covered with no copay and 20% coinsurance, but diabetic equipment is only partially covered because diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Alignment Health the ONE + Walgreens (HMO-POS), requiring both prior authorization and a referral. Covered diagnostic services have no copay and no coinsurance, although diagnostic procedures, tests, and lab services are not covered. Radiological services feature no copay, but diagnostic and outpatient X-ray services are not covered, while therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered under the Alignment Health the ONE + Walgreens (HMO-POS) plan with no copay and no coinsurance. However, in practice, some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Alignment Health the ONE + Walgreens (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $100 daily copay for days 21 through 100 without requiring a prior three-day hospital stay. Prior authorization and referrals are required, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Alignment Health the ONE + Walgreens (HMO-POS) covers other services such as acupuncture, over-the-counter items, meals, and digital health technology support with no copay and no coinsurance. Personalized health risk screenings are also covered with a $75 copay and no coinsurance, while dual eligible SNPs with highly integrated services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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