Alignment Health Freedom (PPO) 2026 Plan Details for San Diego County, California Residents
Alignment Health Freedom (PPO) 2026 Plan Details for San Diego County, California Residents
Navigating your Medicare Advantage options in San Diego County for 2026 can be overwhelming, but we're here to help. With Alignment Health Freedom (PPO) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
The latest CMS enrollment data shows an estimated 84 Medicare beneficiaries are enrolled in this plan, with 42 members in San Diego County, CA.
Alignment Health Freedom Overview
| Plan ID H8832-003-0 Overview | |
|---|---|
| Health Plan ID: | H8832-003-0 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $12.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $8500.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | San Diego County, CA |
| Insured By: | Alignment Health Plan |
Explore the Benefits of Alignment Health Freedom
This MAPD PPO Medicare Advantage plan offers broad coverage with the freedom to choose your providers. With a monthly premium of $12.00, it includes all core benefits under Medicare Part A and Part B, plus prescription drug coverage to manage ongoing medications. The annual Part D deductible is $615.00. You can see any Medicare-approved provider — in or out of network — though in-network care typically costs less.
Primary care visits have a 20% coinsurance | Out-of-network: 20% coinsurance, and specialist visits come with a 20% coinsurance | Out-of-network: 20% coinsurance. Urgent care services carry a $0 copay, and ground ambulance transportation is 20% coinsurance | Out-of-network: 20% coinsurance. These costs all count toward your annual maximum out-of-pocket (MOOP) limit of $8500.00. After that limit is reached, all in-network care is fully covered through the end of the year.
CMS recognizes this plan as H8832-003-0. A detailed breakdown of cost sharing is available below. Still have questions? Check the FAQ section for more insights.
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Out-of-Pocket Costs
Alignment Health Freedom includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H8832-003-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Specialist: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | Not covered |
| Health transportation (non-emergency): | In-network: $0 copay | Out-of-network: 20% coinsurance |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | 20% coinsurance |
| Wordwide emergency care: | $0 copay |
| Urgent care: | $0 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 | Out-of-network: | 20% per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $209.5 per day for days 21-100 | Out-of-network: | 20% per stay |
| Ground ambulance: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Outpatient group therapy: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 | Out-of-network: | 20% per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Occupational therapy: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Lab services: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Outpatient x-rays: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
| Diagnostic tests and procedures: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: 20% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Prescription hearing aids: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | In-network: $0 copay | Out-of-network: 20% coinsurance |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Alignment Health Freedom as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Alignment Health Freedom includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $12.00 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $12.00 |
| Low-Income Premium Subsidy: | $12.00 |
| Low-Income Premium Subsidy Paid by CMS: | $12.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Alignment Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Alignment Health Freedom may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | 25% coinsurance | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 30% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Alignment Health Freedom?
You are eligible to enroll in Alignment Health Freedom if you meet the following conditions:
- You qualify for Medicare Part A and Part B.
- You live in the plan’s service area.
If these criteria describe your situation, you’re eligible to sign up for Alignment Health Freedom and take advantage of its full range of benefits.
When Can I Enroll in Alignment Health Freedom?
To ensure you don’t miss your chance to enroll in Alignment Health Freedom, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Enroll in Alignment Health Freedom
Enrolling in Alignment Health Freedom is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Alignment Health Freedom through the official Medicare website.
- Directly with Alignment Health Freedom: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID H8832-003-0:
How much does H8832-003-0 cost per month?
The 2026 premium is $12.00 each month, and you must continue to pay your Part B premium.
What is the annual out-of-pocket maximum on this plan?
For 2026, the maximum you’d spend out-of-pocket in-network is $8500.00.
Is there a Part D deductible with this plan?
The 2026 drug deductible is $615.00.
What’s the CMS star score for Alignment Health Freedom?
The latest CMS score is ★0.0 out of 5 stars; anything 4 or higher earns quality bonuses.
How many people are enrolled in this plan?
CMS reports 84 members in the latest file.
Contact Alignment Health Plan
| Contact Type | Details |
|---|---|
| Website: | Alignment Health Plan Plan Page |
| New Members: | 1-888-979-2247 |
| Existing Members: | 1-866-634-2247 |
| Plan Address: | 1100 W Town and Country Rd Suite 1300 | Orange, CA 92868 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Alignment Health Plan, http://www.alignmenthealthplan.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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