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Medicare Open Enrollment

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1-on-1 Medicare for Californians

San Fernando Valley, California

MAPD 2027 plan LPPO

Alignment Health Balance Plus 004 (PPO)

Plan information effective January 1, 2027.

Alignment Health Plan Plan ID H8832-004-000 Plan #4 MAPD

Plan costs & ratings

Monthly premium$7.30
Medical premium$0.00
Drug premium$7.30
Annual premium$87.60
Medical deductible$0
Drug deductible$700
Max OOP in network$9,850
Max OOP out of network$11,950
Initial coverage limit$2,400
Catastrophic limit$2,400

Availability

Available in 3 California counties

San Diego County, CA, San Joaquin County, CA, Stanislaus County, CA

Available Cities

This plan is available in 47+ cities in California.

Benefits

Primary care In Network

In-Network: 20% coinsurance per visit

Inpatient hospital Out of Network

Out-of-Network: 20% coinsurance per admission (Unlimited days per admission).

Skilled nursing Out of Network

Out-of-Network: 20% coinsurance per admission

Emergency care In Network

In-Network: 20% coinsurance per visit (waived if admitted within 3 days)

Urgently needed care In Network

In-Network: $0 copay for Medicare-covered urgently-needed-care visits

Ambulance In Network

In-Network: 20% coinsurance per trip (NOT waived if admitted)

Highlights

  • PPO plan for full duals with CKD with the flexibility to see providers in-network and out-of-network plus a $200/month Essentials Allowance*.

Notes

In-Network: Copay and coinsurance based on 2027 Medicare defined cost shares.

Plan Overview

CarrierAlignment Health Plan
Plan typeMAPD
PlanLPPO
Marketing nameAlignment Health Plan
Drug coverageIncluded
Enrollment hours8:00 a.m. to 8:00 p.m.
Carrier websiteOpen website

Plan identifiers

Plan IDH8832-004-000
Plan number4
ContractH8832
Segment0
DRX ID1M5SRQ226K
Carrier ID587
Formulary ID27146
Formulary version9042026

Carrier contact

Carrier phone1-866-634-2247
Enrollment phone1-866-634-2247
Enrollment TTY711
Carrier hours8:00 a.m. to 8:00 p.m.

Network & documents

Preferred pharmacy networkNo
Preferred retail pharmacyNo
Preferred mail pharmacyNo
Mail drug benefitsNo
Provider searchYes

PPO plan for full duals with CKD with the flexibility to see providers in-network and out-of-network plus a $200/month Essentials Allowance*.