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Alignment Health Dual Select+ (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health Dual Select+ (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health Dual Select+ (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Alignment Health Dual Select+ (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Alignment Healthcare USA, LLC available for enrollment in 2025 to people living in El Paso, Hudspeth. The overall rating for this plan is not yet available for 2025.
It's important to know that Alignment Health Dual Select+ (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Alignment Health Dual Select+ (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Alignment Health Dual Select+ (HMO-POS D-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.
For Alignment Health Dual Select+ (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.30. 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 $590.00 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 $2900.00 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 Dual Select+ (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you'll pay the costs for your drugs. Once your total drug costs reach $2000, you'll enter the next phase of coverage. If you qualify for the low-income subsidy, your monthly premium for Part D is $18.30.
Additional Benefits
The Alignment Health Dual Select+ (HMO-POS D-SNP) plan offers a comprehensive suite of benefits with varying cost-sharing. The plan covers a range of services, including inpatient hospital stays with a copay, outpatient services, and partial hospitalization with a $100 copay. Emergency services have a copay of $135 and worldwide emergency coverage has a copay of $50. Additional benefits include coverage for ambulance and transportation services, primary care, preventive services, hearing, vision, and dental services, and home infusion. The plan also offers coverage for medical equipment, home health, and skilled nursing facility stays with copays and coinsurance depending on the service. There is also coverage for acupuncture, over-the-counter items, a meal benefit, and digital health technology support.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital Psychiatric services, with a $320 copay for days 1-5 and no copay for days 6-90, as well as 40 additional days for Inpatient Hospital Psychiatric. Inpatient Hospital-Acute services are covered, but additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, are covered; however, Individual and Group Sessions for Outpatient Substance Abuse are not covered. Prior authorization and a doctor referral are required for covered services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Alignment Health Dual Select+ (HMO-POS D-SNP) plan and requires prior authorization and a doctor referral. The copay for this benefit is $100.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services. Ground ambulance services have a $100 copay, while air ambulance services have 20% coinsurance. Transportation Services to a plan-approved health-related location are also covered, with up to 50 one-way trips per year. Transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered, including Worldwide Emergency Coverage. Emergency Services have a $135 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $50 copay. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic services require prior authorization and a doctor referral, with up to 12 routine chiropractic visits per year. Individual and group sessions for Mental Health Specialty Services and Psychiatric Services, Podiatry Services, and Individual Sessions for Mental Health Specialty Services are not covered.
Preventive Services See details
Preventive Services include coverage for services such as annual physical exams, glaucoma screenings, and diabetes self-management training. Other services, such as health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
Hearing Services are covered, including routine hearing exams and fitting/evaluation for hearing aids, with one visit covered per year. Prescription hearing aids are partially covered, but not for inner ear, outer ear, or over the ear hearing aids.
Vision Services See details
Vision Services include routine eye exams with no copay and eyewear with a combined maximum plan benefit of $400 every two years. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered, with a limit of one pair or set every two years, and no copay. Upgrades are not covered.
Dental Services See details
The Alignment Health Dual Select+ (HMO-POS D-SNP) plan offers a dental benefit with a maximum of $3,500 per year, covering oral exams (1 visit every six months), dental X-rays (1 every three years), prophylaxis (cleaning) (1 visit every six months), and fluoride treatments (1 per year). Restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral/maxillofacial surgery are also covered, but adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered, and a doctor referral is required. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetic Devices with a 10% coinsurance; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. There is no copay for these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Alignment Health Dual Select+ (HMO-POS D-SNP) plan, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by the Alignment Health Dual Select+ (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover the following sub-services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. For days 1-20, there is a $20 copay, and for days 21-100, there is a $203 copay; additional days beyond Medicare-covered SNF stays, as well as non-Medicare-covered stays, are not covered.
Other Services See details
The Alignment Health Dual Select+ (HMO-POS D-SNP) plan covers acupuncture with a limit of 12 treatments per year, and over-the-counter (OTC) items with a maximum benefit of $125.00 every month, including nicotine replacement therapy and Naloxone coverage. The plan also offers a meal benefit for chronic illnesses and medical conditions, and digital health technology support. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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