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Alignment Health Freedom (PPO)

H8832 - 003 - 0
Plan Not Rated

Alignment Health Freedom (PPO) is a Medicare Advantage Plan by Alignment Health Plan.

This page features plan details for 2025 Alignment Health Freedom (PPO) H8832 – 003 – 0 available in Stanislaus, San Joaquin and San Diego.

Locations

Alignment Health Freedom (PPO) is offered in the following locations.

California
San Diego County, California
San Joaquin County, California

Click to see more locations

Plan Overview

Alignment Health Freedom (PPO) offers the following coverage and cost-sharing.

Insurer:Alignment Health Plan
Health Plan Deductible:$0
MOOP:$11,950 In and Out-of-network
$7,800 In-network
Drugs Covered:Yes

Ready to sign up for Alignment Health Freedom (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Premium Breakdown

Alignment Health Freedom (PPO) has a monthly premium of $23.10. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $23.10 $ $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Alignment Health Freedom (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $590.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Defined Standard

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$23.10$0.00

Initial Coverage Phase

After you pay your $590.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs.

Additional Benefits

Alignment Health Freedom (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: Yes, contact plan for further details

Comprehensive Dental

  • Endodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Periodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Prosthodontics, fixed
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Prosthodontics, removable
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Restorative Services
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – No Copay
    • Out-of-Network: 20% Coins – No Copay
  • Fluoride Treatment
    • In-Network: No Coins – No Copay
    • Out-of-Network: 20% Coins – No Copay
  • Oral Exams
    • In-Network: No Coins – No Copay
    • Out-of-Network: 20% Coins – No Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – No Copay
    • Out-of-Network: 20% Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Lab services
    • In-Network: 20% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: 20% coinsurance (Authorization Required)
  • Outpatient x-rays
    • In-Network: 20% coinsurance (Authorization Required)
  • Lab services
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: 20% coinsurance (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: 20% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: 20% coinsurance per visit
  • Specialist
    • Out-of-Network: 20% coinsurance per visit
  • Primary
    • In-Network: 20% coinsurance per visit
  • Specialist
    • In-Network: 20% coinsurance per visit

Emergency care/Urgent care

  • Emergency
    • 20% coinsurance per visit (always covered)
  • Urgent care
    • $0 copay

Foot care (podiatry services)

  • Foot exams and treatment
    • Out-of-Network: 20% coinsurance
  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • In-Network: 20% coinsurance

Ground ambulance

    • In-Network: 20% coinsurance
    • Out-of-Network: 20% coinsurance

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Hearing aids
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Medicare-Covered Hearing Exam
    • Out-of-Network: 20% coinsurance
  • Hearing aids
    • In-Network: $0 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $0 copay
  • Hearing aids OTC
    • Not covered

Inpatient hospital coverage

    • In-Network: Coming soon (Authorization Required)
    • Out-of-Network: 20% per stay (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $11,950 In and Out-of-network
      $7,800 In-network

Medical equipment/supplies

  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • Out-of-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: 20% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • Out-of-Network: 20% per stay (Authorization Required)
  • Outpatient group therapy visit
    • Out-of-Network: 20% coinsurance
  • Outpatient individual therapy visit
    • In-Network: 20% coinsurance
    • Out-of-Network: 20% coinsurance
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: 20% coinsurance
    • Out-of-Network: 20% coinsurance
  • Inpatient hospital – psychiatric
    • In-Network: Coming soon (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: 20% coinsurance
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: 20% coinsurance
    • Out-of-Network: 20% coinsurance

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: 20% coinsurance per visit (Authorization Required)
    • Out-of-Network: 20% coinsurance per visit (Authorization Required)

Preventive care

    • Out-of-Network: 20% coinsurance
    • In-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: 20% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Occupational therapy visit
    • Out-of-Network: 20% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: 20% coinsurance (Authorization Required)

Skilled Nursing Facility

    • In-Network: Coming soon (Authorization Required)
    • Out-of-Network: 20% per stay (Authorization Required)

Transportation

    • In-Network: $0 copay (Limits Apply, Authorization Required)
    • Out-of-Network: 20% coinsurance (Limits Apply, Authorization Required)

Vision

  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
  • Other
    • Not covered
  • Eyeglasses (frames and lenses)
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Contact lenses
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)
  • Upgrades
    • Not covered
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • Out-of-Network: 20% coinsurance (Limits Apply)
  • Routine eye exam
    • Out-of-Network: 20% coinsurance (Limits Apply)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Ready to sign up for Alignment Health Freedom (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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