In-Home Support Services
Cost not publishedMandatory
IncludedAdvantage Care (HMO)
Align Senior Care
HMOSanta Clara CountyIncludes Part DPlan year 2026
$0/momonthly premium
$1,900most you pay in-network per year
Not Enough Data Availableoverall CMS star rating
46members enrolled, January 2026
Plan-level limits
Premium, deductibles, and the most you can pay out of pocket in a year.
In-network out-of-pocket maximum$1,900
Plan premium, per month$0
What a year on this plan would likely cost
What you pay for care
In-network costs for every service in this plan's CMS benefit filing. A copay is a fixed dollar amount; coinsurance is a percentage of the bill.
Hospital stays
Inpatient psychiatric stay
Days 1–3$0 per day
Days 4–10$100 per day
Days 11–90$0 per day
Days 1–60Lifetime Reserve: $838 per day
Skilled nursing facility stay
Days 1–100$0 per day
Doctor visits
Telehealth visit
$0
You pay nothing
Other health care professional
20%
Coinsurance — your share of the bill
Chiropractic care (Medicare-covered)
20%
Coinsurance — your share of the bill
Routine chiropractic care
$30
Copay
Podiatry (Medicare-covered)
20%
Coinsurance — your share of the bill
Emergency and urgent care
Emergency room visit
$90
Copay
Urgent care visit
$40
Copay
Mental health and substance use
Partial hospitalization program
20%
Coinsurance — your share of the bill
Therapy and rehabilitation
Cardiac rehabilitation
20%
Coinsurance — your share of the bill
Intensive cardiac rehabilitation
20%
Coinsurance — your share of the bill
Pulmonary rehabilitation
20%
Coinsurance — your share of the bill
Supervised exercise therapy for peripheral artery disease
20%
Coinsurance — your share of the bill
Tests, labs and imaging
Diagnostic tests
20%
Coinsurance — your share of the bill
Diagnostic radiology (MRI, CT, PET)
20%
Coinsurance — your share of the bill
Therapeutic radiology
20%
Coinsurance — your share of the bill
Outpatient hospital and surgery
Outpatient hospital services
$0–$225
Copay, depends on the service
Ambulatory surgical center
20%
Coinsurance — your share of the bill
Observation services
$100
Copay
Blood services
20%
Coinsurance — your share of the bill
Ambulance
Ground ambulance
$125
Copay
Air ambulance
20%
Coinsurance — your share of the bill
Medical equipment and supplies
Durable medical equipment
20%
Coinsurance — your share of the bill
Medical supplies
20%
Coinsurance — your share of the bill
Prosthetic devices
20%
Coinsurance — your share of the bill
Dialysis
Dialysis
20%
Coinsurance — your share of the bill
Part B drugs
Part B drugs
0–20%
Coinsurance, depends on the service
Chemotherapy drugs
0–20%
Coinsurance, depends on the service
Part B insulin
0–20%
Coinsurance, depends on the service
Never more than $35 for a one-month supply
Vision
Eye exam (Medicare-covered)
20%
Coinsurance — your share of the bill
Eyewear after cataract surgery (Medicare-covered)
20%
Coinsurance — your share of the bill
Eyewear allowance
Up to $225 per year
Allowance
Hearing
Hearing exam (Medicare-covered)
20%
Coinsurance — your share of the bill
Extra benefits
Acupuncture
$30
Copay
Extra benefits beyond Original Medicare
Supplemental benefits this plan filed with CMS, with the cap and period exactly as filed.
Not offered by this plan
Health EducationIn-Home Safety AssessmentPersonal Emergency Response System (PERS)Medical Nutrition Therapy (MNT)Post discharge In-Home Medication ReconciliationRe-admission PreventionWigs for Hair Loss Related to ChemotherapyWeight Management ProgramsAlternative TherapiesTherapeutic MassageAdult Day Health ServicesNutritional/Dietary BenefitHome-Based Palliative CareSupport for Caregivers of EnrolleesAdditional Sessions of Smoking and Tobacco Cessation CounselingFitness BenefitEnhanced Disease ManagementTelemonitoring ServicesRemote Access Technologies (including Web/Phone-based technologies and Nursing Hotline)Home and Bathroom Safety Devices and ModificationsCounseling Services
Dental
No dental deductible.
Preventive
Oral examsMandatory
CleaningsMandatory
X-raysMandatory
Fluoride treatmentMandatory
Other diagnostic servicesMandatory
Comprehensive
Restorative (fillings)Mandatory
Endodontics (root canals)Mandatory
Periodontics (gum treatment)Mandatory
Oral surgeryMandatory
Fixed prosthodontics (crowns, bridges)Mandatory
Removable prosthodontics (dentures)Mandatory
Adjunctive general servicesMandatory
Prescription drugs (Part D)
$0 annual drug deductible · 5 formulary tiers · mail order available. Costs shown for a 30-day supply.
Initial coverage
| Tier | Preferred retail | Standard retail | Mail order | Insulin | Deductible |
|---|---|---|---|---|---|
| 1. Preferred Generic | — | No copay | — | — | Waived |
| 2. Generic | — | $10 copay | — | — | Waived |
| 3. Preferred Brand | — | $45 copay | — | — | Waived |
| 4. Non-Preferred Drug | — | $95 copay | — | — | Waived |
| 5. Specialty Tier specialty | — | 33% coinsurance | — | — | Waived |
Catastrophic (after the out-of-pocket threshold)
| Tier | Preferred retail | Standard retail | Mail order | Insulin | Deductible |
|---|---|---|---|---|---|
| 1. Preferred Generic | No copay | No copay | No copay | — | Waived |
| 2. Generic | No copay | No copay | No copay | — | Waived |
| 3. Preferred Brand | No copay | No copay | No copay | — | Waived |
| 4. Non-Preferred Drug | No copay | No copay | No copay | — | Waived |
| 5. Specialty Tier specialty | No copay | No copay | No copay | — | Waived |
Out-of-pocket threshold for the catastrophic phase: $2,100.
Is my medicine on this plan’s list?
Pharmacies near you in this plan's network
From the plan's filed Part D pharmacy network, matched to geocoded pharmacy locations. Preferred pharmacies come first: they carry the lower copay column in the tier table above. The ZIP you enter stays in this browser.
CMS star ratings
Star ratings are set by CMS for the whole contract, so every plan under this contract shares them.
Not yet ratedNot yet ratedOverall rating
Not yet ratedNot yet ratedHealth services (Part C)
Not yet ratedNot yet ratedDrug plan (Part D)
Managing chronic (long-term) conditions
- Special needs plan SNP care management4
Health plan customer service
- Call center3
Drug plan customer service
5- Call center foreign language interpreter and TTY availability5
Drug safety and accuracy of drug pricing
4- Price accuracy5
- Medication therapy management comprehensive medication review completion4
- Medication adherence for hypertension RAS antagonists s3
- Medication adherence for cholesterol statins5
Service area and network
Sold in 8 California counties.
AlamedaLos AngelesMarinOrangeRiversideSan FranciscoSan MateoSanta Clara
Doctor directory
1,110 providers are named in Align Senior Care’s directory for this plan, dated Jul 31, 2026.
A doctor named there is listed. A doctor missing from it is unknown, never out of network: carrier directories are partial and change monthly. Open the carrier directory
Contract with Medicare sinceJan 1, 2022
Medicare Advantage regionCalifornia
Ask about this plan
A question box grounded in this plan's filed benefits, drug list, and pharmacy network. It reads the same records shown on this page and says so when something is not filed.
Answers come from this plan’s filed benefits, drug list, and pharmacy network. They are not enrollment advice; the Evidence of Coverage is the final word.