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Alignment Health Platinum + Instacart (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Alignment Health Platinum + Instacart (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Alignment Health Platinum + Instacart (HMO) in 2026, please refer to our full plan details page.
Alignment Health Platinum + Instacart (HMO) is a HMO plan offered by Alignment Healthcare USA, LLC available for enrollment in 2026 to people living in Washoe. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that Alignment Health Platinum + Instacart (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 Platinum + Instacart (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.
For Alignment Health Platinum + Instacart (HMO), 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 $2200.00 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:
Sign up for Alignment Health Platinum + Instacart (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Alignment Health Platinum + Instacart (HMO) Medicare plan features a $0 prescription drug deductible, meaning your coverage begins immediately. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. Tier 6 select care drugs are also highly affordable, costing a $5 copay for a one-month supply, a $10 copay for a two-month supply, and no copay for a three-month supply. For Tier 3 preferred brand drugs, you can expect a copay of $40 for a one-month supply, $80 for a two-month supply, and $120 for a three-month supply. Tier 4 non-preferred drugs require a 32% coinsurance across all supply lengths, while Tier 5 specialty drugs require a 33% coinsurance for a one-month supply. These rates apply to both standard pharmacy and standard mail order options, helping you easily manage your healthcare budget.
Additional Benefits
The Alignment Health Platinum + Instacart (HMO) plan offers comprehensive medical coverage featuring no copays or coinsurance for primary care visits, preventive care, and home health services. Specialist visits require a low $15 copay, while emergency room visits carry a $120 copay that is waived if you are admitted. For inpatient hospital stays, members pay a $200 daily copay for the first five days with no coinsurance. Additional benefits include a $3,000 annual maximum for covered dental services and up to $300 yearly for eyewear with no copays or deductibles. Members also benefit from routine hearing exams at no cost, up to 24 one-way transportation trips to approved locations, and no-copay digital health support and over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are covered by Alignment Health Platinum + Instacart (HMO) with no coinsurance, requiring a $200 daily copay for days 1 through 5 of acute stays and a $120 daily copay for days 1 through 10 of psychiatric stays. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Alignment Health Platinum + Instacart (HMO) with no coinsurance, featuring a $150 copay for outpatient hospital and observation services, and a $100 copay for ambulatory surgical center services. Outpatient substance abuse services require a $25 copay per session with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Alignment Health Platinum + Instacart (HMO) with a $55 copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Alignment Health Platinum + Instacart (HMO) covers ambulance services with no coinsurance, requiring a $200 copay for ground and a $300 copay for air transport, both of which are waived if admitted. Transportation is partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Alignment Health Platinum + Instacart (HMO) covers emergency services with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 48 hours, and urgently needed services with no copay or coinsurance. Worldwide emergency and urgent services are partially covered up to a $25,000 maximum with no copay or coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Alignment Health Platinum + Instacart (HMO) provides primary care, telehealth, and physical, occupational, and speech therapies with no copay and no coinsurance. Specialist visits require a $15 copay with no coinsurance, psychiatric services require a $5 copay with no coinsurance, and podiatry, chiropractic, and mental health specialty services are not covered.
Preventive Services See details
Alignment Health Platinum + Instacart (HMO) provides preventive services with no copay and no coinsurance, though the benefit is only partially covered. Covered services include annual physical exams and glaucoma screenings, while services such as health education, weight management, nutritional benefits, and home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by Alignment Health Platinum + Instacart (HMO) with no deductibles, featuring one annual routine exam and one fitting evaluation with no copay and no coinsurance. Up to two prescription hearing aids are covered per year with no coinsurance and a copay ranging from $195.00 to $1,750.00, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Alignment Health Platinum + Instacart (HMO) partially covers vision services with no deductible, no copay, and no coinsurance, offering one routine eye exam and up to $300 for eyewear like contacts and eyeglasses annually. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Alignment Health Platinum + Instacart (HMO), offering a $3,000 maximum annual benefit with no copay and no coinsurance for covered services. While many diagnostic, preventive, and restorative services are covered, implants, orthodontics, maxillofacial prosthetics, adjunctive general services, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Alignment Health Platinum + Instacart (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs range from no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Alignment Health Platinum + Instacart (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
Medical equipment is covered by Alignment Health Platinum + Instacart (HMO) with no copays, though prior authorization is required for these services. Durable medical equipment features no coinsurance up to 20% coinsurance, prosthetics and medical supplies carry a 20% coinsurance, and diabetic equipment is partially covered with a 20% coinsurance for therapeutic shoes and inserts, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Alignment Health Platinum + Instacart (HMO), requiring prior authorization and referrals. Covered diagnostic services have no copay and no coinsurance, but diagnostic procedures, tests, and lab services are not covered. Radiological services have no copay, but therapeutic radiological services require a 20% coinsurance, while diagnostic radiological services and outpatient X-ray services are not covered.
Home Health Services See details
Alignment Health Platinum + Instacart (HMO) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Alignment Health Platinum + Instacart (HMO) offers some coverage for Cardiac Rehabilitation Services with no copay and no coinsurance, although prior authorization and referrals are required. However, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Alignment Health Platinum + Instacart (HMO) with no copay and no coinsurance, though additional days beyond the Medicare-covered limit are not covered. Prior authorization and referrals are required for these services, which can be accessed without a prior three-day inpatient hospital stay.
Other Services See details
Alignment Health Platinum + Instacart (HMO) partially covers other services, offering digital health technology support and over-the-counter (OTC) items with no copay and no coinsurance, and personalized health risk screenings with a $75 copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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