Alignment Health Clarity Plus 042 (HMO C-SNP) (2027)

Chronic Condition Special Needs Plan (Medicare Advantage) from Alignment Health Plan, plan ID H3815-042-000. Sold in 18 counties in California.

★★★★★3.5

Who can join

Only for people with certain chronic conditions; the plan checks your diagnosis.

2027 costs

Monthly premium$7.30
Drug deductible$700
Medical deductible$0
Out-of-pocket maximum (in network)$9,850
Plan typeChronic Condition Special Needs Plan (Medicare Advantage), HMO
Referral needed to see a specialistYes
Plan IDH3815-042-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit$0
Specialist visit$0
Preventive care$0
Urgent care$0
Emergency room20%
Hospital stay$0
Outpatient surgery20%
Lab tests20%
Mental health visit20%
Physical therapy20%
Medical equipment20%
TelehealthCovered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $500/quarter allowance
VisionCovered — up to $500 every 2 yrs allowance
HearingCovered
Over-the-counter itemsCovered — up to $103/mo allowance
FitnessCovered
Rides to appointmentsCovered — 50 one-way trips/yr

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic$0$0$0
2 Generic25%25%25%
3 Preferred Brand25%25%25%
4 Non-Preferred Drug29%29%29%
5 Specialty Tier25%25%N/A
6 Select Care Drugs$5$5$0

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.