Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Alignment Health Smart 013, 2027
H3815Contract013Plan
HMO · 5 counties in California
Run by Alignment Health Plan (contract H3815), sold as Alignment Health Plan, owned by Alignment Healthcare USA, LLC
Alignment Health Smart 013 (H3815-013) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $2,499. In 2026 it was called Alignment Health smartHMO.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Plan name | Alignment Health smartHMO | Alignment Health Smart 013 | renamed |
| Part B premium reduction, monthly | $164.90 | $150 | ▼down $14.90 |
| Emergency room | $70 copay | $150 copay | ▲up $80 |
| Hospital stay, in network | $0 a stay | $120 a day for days 1–5, then $0 a day for days 6–90 | ▲up $600for a 5-day stay |
| 19 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $2,499 | $2,499 | no change |
| Drug deductible | $0 | $0 | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $5 copay | $5 copay | no change |
| Medical deductible, in network | none | none | no change |
| Skilled nursing facility, in network | $20 a day for days 1–20, then $100 a day for days 21–100 | $20 a day for days 1–20, then $100 a day for days 21–100 | no change |
| Ground ambulance, in network | $100 copay | $100 copay | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Over-the-counter items, yearly | not offered | not offered | no change |
| Counties served | 5 | 5 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, generic | $0 | $0 | no change |
| Drug tier 3, preferred brand | $30 | $30 | no change |
| Drug tier 4, non-preferred drug | $100 | $100 | no change |
| Drug tier 5, specialty tier | 33% of the cost | 33% of the cost | no change |
| Drug tier 6, select care drugs | $5 | $5 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $0 | $0 |
| Tier 3 | Preferred Brand | $30 | $30 |
| Tier 4 | Non-Preferred Drug | $100 | $100 |
| Tier 5 | Specialty Tier | 33% of the cost | 33% of the cost |
| Tier 6 | Select Care Drugs | $5 | $5 |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 137 plans open to everyone are sold for 2027, this one included. Against the others, 82 plans have a lower out-of-pocket limit, 2 the same, 52 a higher one. On the premium, 118 the same, 18 a higher one.
Out-of-pocket limits of the 137 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 5 counties: $0 a month and $2,499.
California
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H3815-013
- Legal name of the contract
- Alignment Health Plan
- Sold as
- Alignment Health Plan
- Parent company
- Alignment Healthcare USA, LLC
- Plan type
- HMO
- 2026 star rating of the contract
- 4 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
- Members, September 2026
- 21,100
- Plan website, as filed with CMS
- www.alignmenthealthplan.com
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Los Angeles, CAWhere most of its members live; premiums and limits side by side
- Every Alignment Health Plan plan for 2027Its contracts, counties and plans that end
- The other 34 plans of contract H3815Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.