Alignment Health Freedom (PPO)

Alignment Health Freedom (PPO) is a PPO plan offered by Alignment Health Advantage Plan Inc available for the 2026 plan year to people living in Stanislaus, San Joaquin and San Diego. CMS star rating not available for 2026.

It's important to know that Alignment Health Freedom (PPO) 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 Freedom (PPO).

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 Freedom (PPO) plan features an enhanced alternative drug benefit with a $615 annual prescription drug deductible. After meeting this deductible, you will pay a 25% coinsurance for preferred generic, standard generic, and non-preferred drugs, and a 30% coinsurance for preferred brand drugs at standard pharmacies and through standard mail. Notably, there is no copay for specialty tier drugs during this initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, individuals who qualify for the low-income subsidy can receive a reduced Part D premium of $12.

Additional Benefits

The Alignment Health Freedom (PPO) plan generally offers a consistent cost structure for medical services, featuring no copay and a twenty percent coinsurance for primary care, specialist visits, outpatient procedures, and diagnostic services. Emergency care, ambulance services, and medical equipment also carry no copay and a twenty percent coinsurance, while standard preventive care and annual physicals are fully covered with no copay or coinsurance. Inpatient hospital stays and skilled nursing facility care are available with Medicare-defined copays and coinsurance. For supplemental care, this plan provides routine hearing and vision coverage, including a five hundred dollar eyewear allowance every two years, alongside dental benefits that feature a three hundred dollar maximum benefit every three months for select services. Additionally, members can access up to fifty one-way transportation trips annually and home health services, though cardiac rehabilitation and over-the-counter items are not covered. Prior authorizations or doctor referrals are required for many of these specialized and outpatient services.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.