Alignment Health the ONE (HMO)
Alignment Health Plan · HMO · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $3,400
- Higher than most plans here
- Drug deductible
- $0
- Tied for lowest here
- Medicare star rating
- 4 of 5
In plain English
Compared with the 57 other plans in San Bernardino County that the same person could join.
What stands out
- No monthly premium
- $0 for the emergency room, lowest of 57 plans here
- No drug deductible, tied for lowest here
Watch out for
- Up to $3,400 a year for covered care, higher than most plans here
- No dental extra, though most plans here have one
- You need a referral to see a specialist
- Covers only the plan’s own doctors and hospitals, except in an emergency or for urgent care
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$0$0 in premiums + $0 for care2 checkups and 2 lab tests.
- A busier year$0$0 in premiums + $0 for careTied for lowest here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$175$0 in premiums + $175 for careLower than most plans here6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$0Referral neededPlan approval may be needed
- Urgent care$0
- Emergency room$0Lowest of 57 plans here
- Hospital stay$0 for days 1 to 4, then $100 a day for days 5 to 10, then $0 for days 11 to 90Referral neededPlan approval may be needed
- Lab tests$0Referral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$100Higher than most plans hereReferral neededPlan approval may be needed
- Outpatient hospital care$200Higher than most plans here
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0Referral neededPlan approval may be needed
- Ground ambulance$75Lower than most plans herePlan approval may be needed
- Skilled nursing facility$0Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2026. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 57 other plans in San Bernardino County that the same person could join. Read the plan’s 2026 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2Generic | $1 |
| 3Preferred Brand | $40 |
| 4Non-Preferred Drug | $100 |
| 5Specialty Tier | 33% of the price |
| 6Select Care Drugs | $5 |
For a 1-month supply. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2026, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental Not included
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $350 every two years.
- Hearing IncludedHearing test: $0. Hearing aids covered.
- Over-the-counter items IncludedUp to $60 a month for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness IncludedIncludes gym or fitness classes.
- Rides to care Included20 one-way rides to medical visits a year.
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Alignment Health the ONE (HMO), plan number H3815-034, for 2026?”