What Alignment Health Medicare Advantage offers
Alignment Health Plan is an HMO, HMO-POS, PPO, and SNP Medicare Advantage carrier operating in select markets, with a senior-first model emphasizing 24/7 support and integrated care. In 2025, its H5296 HMO contract in Nevada and North Carolina received a 5‑star CMS rating. Benefits and availability vary by county and plan.
Key member features
- $0-cost options: Many plans advertise $0 monthly premiums, $0 primary care and telehealth copays, and $0 cost on thousands of generic drugs, plus included vision and gym benefits (plan-specific).
- ACCESS On‑Demand Concierge: 24/7 live support that can schedule appointments, arrange transportation, answer questions, and coordinate in-home and virtual care. Select plans include a preloaded Concierge Card usable at 65k+ retailers for eligible OTC items.
- Network and care access: Expanding provider networks and care centers focused on seniors; special needs plans (C‑SNP, D‑SNP) are available where contracted.
- Plan breadth and updates: Annual enhancements and market expansions are announced for AEP/OEP, with benefits refined year to year.
Why this benefits insurance agents
- Competitive products: Differentiated benefits (concierge model, OTC card, $0 copays) create clear value props and talking points that resonate during AEP/OEP and SEP scenarios (especially SNPs), helping agents convert and retain members.
- Broker support and tools: Dedicated broker support, trainings, and an Agent Portal for certifications, plan materials, and sales enablement streamline selling and post-enrollment servicing.
- Commission operations: Alignment highlights competitive commissions paid accurately and on time, plus ongoing support that reduces administrative friction.
- Certification incentives: Broker site promotes discounted AHIP training and event RSVPs, lowering onboarding cost and accelerating readiness.
Why this benefits customers
- Lower out‑of‑pocket potential: $0 premiums and copays on common services can reduce total spend for many seniors versus Original Medicare + Medigap + Part D.
- Simplified access: The 24/7 concierge removes barriers—members get help scheduling, transportation, and quick clinical access (in‑home, telehealth), which supports adherence and chronic condition management.
- Comprehensive supplemental benefits: Built‑in vision, fitness, OTC allowances, and pharmacy coverage under one ID card can improve convenience and adherence.
- Quality signal: A 5‑star contract in certain states enables special enrollment opportunities and indicates high performance in measures CMS evaluates. Benefits still vary by plan and locale.
Important considerations
- Local availability: Plan type, premiums, copays, networks, and supplemental benefits vary by county and ZIP; always verify specifics in the plan finder before recommending.
- Provider fit and drugs: Confirm the member’s preferred doctors and pharmacies are in network and check drug tiering and prior auth requirements in the formulary.
- Special Needs Plans: SNP suitability depends on chronic conditions or Medicaid status; SNPs can offer richer, tailored benefits but have specific eligibility rules.
Explore and offer Alignment Health to customers
- For plan shopping and highlights: Medicare Advantage Plans that Put You First ↗.
- For agent resources and certification: Brokers | Alignment Health ↗ and Agents Overview ↗.
- For member education: Medicare Advantage FAQs ↗.