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Alignment Health Plan
Plan ID: H5296-7-0
Alignment Health Platinum + Instacart (HMO)
2024 Alignment Health Platinum + Instacart (HMO) H5296 — 007— 0 is a Medicare Advantage plan with drug coverage. It has received a 4.5-out-of-5 star rating from CMS for 2024.
Learn more about Alignment Health Platinum + Instacart (HMO) H5296 - 007 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.
4.5 / 5 stars for 2024
$0 /mo
Monthly premium
$0
Health deductible
$0
Drug deductible
$698.00
Out-of-pocket maximum
Enroll online
Call to enroll
OR
Get personalized help from a licensed insurance agent
1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week!
Plan Overview
2024 Alignment Health Platinum + Instacart (HMO) H5296 — 007— 0 is a Local HMO offered in Clark, Washoe, Nye, Carson City, Douglas, Storey by Alignment Health Plan. It has a monthly premium of $0.00.
Premium Breakdown
Standard Part B Premium
$174.80
Part B premium reduction
$0
Part C Premium
$0
Part D Basic Premium
$0
Part D Supplemental Premium
$0
Part D Total
$0.00
Monthly Premium (Parts C & D)
$0.00
Total Premium (Parts B, C, & D)
$164.90
Special needs plan type
No
Out-of-pocket maximum
$698.00
Plan Organization:
Alignment Health Plan
Plan Type:
Local HMO
Location:
Clark, Washoe, Nye, Carson City, Douglas, Storey
Drugs Covered:
Yes
Drug Formulary:
Pharmacies:
Doctor Choice:
Plan Doctors for Most Services
Doctors Link:
Deductibles
The amount you must pay each year before your plan starts to pay for covered services or drugs.
Health deductible
$0
Drug deductible
$0
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
Alignment Health Platinum + Instacart (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
Drug Benefit Type
Enhanced
Prescription drug deductible
$0
Increased initial coverage limit
No
Additional gap coverage
Yes
Part D Premium Reduction
This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.
Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
$0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Initial Coverage Phase
After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.
Tier | Preferred Pharmacy | Standard Pharmacy | Preferred Mail | Standard Mail |
|---|---|---|---|---|
1. Preferred Generic | - | $0.00 copay | - | $0.00 copay |
2. Standard Generic | - | $0.00 copay | - | $0.00 copay |
3. Preferred Brand | - | $40.00 copay | - | $40.00 copay |
4. Non-Preferred Drug | - | $100.00 copay | - | $100.00 copay |
5. Specialty Tier | - | 33% | - | 33% |
Gap Coverage Phase
After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.
Tier | Preffered Pharmacy | Standard Pharmacy | Preffered Mail | Standard Mail |
|---|---|---|---|---|
Preferred Generic | - | $0.00 copay | - | $0.00 copay |
Select Care Drugs | - | $5.00 copay | - | $5.00 copay |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
Generic Drugs
$4.15 copay or 5% (whichever costs more)
Brand-name
$10.35 copay or 5% (whichever costs more)
Additional Benefits
Alignment Health Platinum + Instacart (HMO) also provides the following benefits.
Comprehensive dental
Preventive dental
Diagnostic procedures/lab services/imaging
Doctor visits
Emergency care/Urgent care
Foot care (podiatry services)
Ground ambulance
Hearing
Inpatient hospital coverage
Outpatient hospital coverage
Outpatient prescription drugs
Alignment Health Platinum + Instacart (HMO) does not provide this type of benefit.
Optional benefits
Alignment Health Platinum + Instacart (HMO) does not provide this type of benefit.
Medical equipment/supplies
Medicare Part B drugs
Mental health services
Preventive care
Rehabilitation services
Skilled Nursing Facility
Transportation
Vision
Wellness programs (eg, fitness, nursing hotline)
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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