Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Alignment Health Heart & Diabetes Plus 039, 2027

H3815Contract039Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 20 counties in California

Run by Alignment Health Plan (contract H3815), sold as Alignment Health Plan, owned by Alignment Healthcare USA, LLC

Renews for 2027

2026 star rating, contract H3815: 4 of 5

Alignment Health Heart & Diabetes Plus 039 (H3815-039) costs $7.30 a month in 2027, down $4.70 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026). In 2026 it was called Alignment Health Heart & Diabetes CalPlus.

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
Plan name	Alignment Health Heart & Diabetes CalPlus	Alignment Health Heart & Diabetes Plus 039	renamed
Monthly premium	$12	$7.30	down $4.70
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$615	$700	up $85
Over-the-counter items, yearly	$1,548 a year	$1,524 a year	down $24
Counties served	19	20	up 1
Drug tier 4, non-preferred drug	31% of the cost	29% of the cost	down 2 points
Drug tier 6, select care drugs	$0	$5	up $5
15 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$0 copay	$0 copay	no change
Emergency room	20% of the cost	20% of the cost	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$275 a day for days 1–6, then $0 a day for days 7–90	$275 a day for days 1–6, then $0 a day for days 7–90	no change
Skilled nursing facility, in network	not filed	not filed	no change
Ground ambulance, in network	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit	$2,000 a year	$2,000 a year	no change
Eyewear, yearly limit	$250 a year	$250 a year	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 2, generic	25% of the cost	25% of the cost	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 5, specialty tier	25% of the cost	25% of the cost	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?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	25% of the cost	25% of the cost
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	31% of the cost	29% of the cost
Tier 5	Specialty Tier	25% of the cost	25% of the cost
Tier 6	Select Care Drugs	$0	$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, 75 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 49 plans have a lower out-of-pocket limit, 25 the same. On the premium, 69 plans have a lower premium, 5 the same.

Out-of-pocket limits of the 75 chronic or disabling condition special needs plans

$0 to under $2,00036 plans

$2,000 to under $4,0008 plans

$4,000 to under $6,0002 plans

$6,000 to under $8,0000 plans

$8,000 to $10,000 (this plan)29 plans

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 20 counties: $7.30 a month and $9,850.

California

Alameda Fresno Kern Los Angeles Madera Marin Merced Orange Placer Riverside Sacramento San Bernardino San Diego San Francisco San Joaquin San Luis Obispo Santa Clara Stanislaus Ventura Yolo

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: H3815-039
Legal name of the contract: Alignment Health Plan
Sold as: Alignment Health Plan
Parent company: Alignment Healthcare USA, LLC
Plan type: HMO C-SNP
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: 28,735
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 Santa Clara, 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.