Medicare Open Enrollment

Open Enrollment starts October 15

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1-on-1 Medicare for Californians

San Fernando Valley, California

MAPD 2027 plan HMOPOS

Alignment Health Platinum + Instacart 016 (HMO-POS)

Plan information effective January 1, 2027.

Alignment Health Plan Plan ID H3815-016-000 Plan #16 MAPD

Plan costs & ratings

Monthly premium$0.00
Annual premium$0.00
Medical premium$0.00
Medical deductible$0
Drug premium$0.00
Drug deductible$0
Medical out-of-pocket limit (in network)$1,100
Part D annual out-of-pocket threshold$2,400

Availability

Available in 3 California counties

Marin County, CA, San Diego County, CA, San Francisco County, CA

Available Cities

This plan is available in 39+ cities in California.

Benefits

Primary care In Network

In-Network: $0 copay per visit

Inpatient hospital In Network

In-Network-Out-of-Network: $0 copay per day for days 1-3, $50 copay per day for days 4-7, $0 copay per day for days 8-90 (Unlimited days per admission).

Skilled nursing In Network

In-Network: $0 copay per day for days 1-20, $50 copay per day for days 21-100 (no prior hospital stay required).

Emergency care In Network

In-Network: $150 copay per visit (waived if admitted within 48 hours)

Urgently needed care In Network

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

Ambulance In Network

In-Network: $75 copay per trip (waived if admitted)

Dental In Network

In-Network: $0 copay for Medicare-covered Dental Services

Vision In Network

This plan includes: Eye Exams, Eyewear.

Hearing In Network

In-Network: $0 copay for Medicare-covered Hearing Services

Over-the-counter In Network

In-Network: $0 copay; Maximum plan benefit coverage of $25.00 every month (no rollover).

Transportation In Network

$0 copay; Limit of 24 one-way trips every year to plan approved locations (within a 25-mile radius).

Fitness In Network

In-Network: $0 copay for Fitness Benefit.

Highlights

  • $0 premium plan with a low MOOP and platinum-level benefits, $25/month OTC, and $100/quarter Groceries allowance through Instacart, including a complimentary membership to Instacart+.

Plan Overview

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

Plan identifiers

Plan IDH3815-016-000
Plan number16
ContractH3815
Segment0
DRX ID0K6ZVNPBR2
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

$0 premium plan with a low MOOP and platinum-level benefits, $25/month OTC, and $100/quarter Groceries allowance through Instacart, including a complimentary membership to Instacart+.