Alignment Health smartHMO (HMO)
H5296 - 008 - 0
(5 / 5)
Alignment Health smartHMO (HMO) is a Medicare Advantage Plan by Alignment Health Plan.
This page features plan details for 2025 Alignment Health smartHMO (HMO) H5296 – 008 – 0 available in Clark, Washoe.
Locations
Alignment Health smartHMO (HMO) is offered in the following locations.
Plan Overview
Alignment Health smartHMO (HMO) offers the following coverage and cost-sharing.
| Insurer: | Alignment Health Plan |
| Health Plan Deductible: | $0 |
| MOOP: | $2,499 In-network |
| Drugs Covered: | Yes |
Ready to sign up for Alignment Health smartHMO (HMO) ?
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
Medicare Part B Give Back Benefit
The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans.
Alignment Health smartHMO (HMO) qualifies for a monthly Medicare Give Back Benefit of $150.00.
| Premium Reduction: | $150.00 |
Premium Breakdown
Alignment Health smartHMO (HMO) has a monthly premium of $0.00. 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 | $0.00 | $150.00 | $ |
- 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 smartHMO (HMO) 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: | Enhanced Alternative |
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 D | LIS Full |
|---|---|
| $0.00 | $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.
30 Day
60 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | ||||
| 3) Preferred Brand | $45.00 Copay | $45.00 Copay | ||
| 4) Non-Preferred Drug | $100.00 Copay | $100.00 Copay | ||
| 6) Select Care Drugs | $5.00 Copay | $5.00 Copay |
60 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | ||||
| 3) Preferred Brand | $90.00 Copay | $90.00 Copay | ||
| 4) Non-Preferred Drug | $200.00 Copay | $200.00 Copay | ||
| 6) Select Care Drugs | $10.00 Copay | $10.00 Copay |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1) Preferred Generic | ||||
| 3) Preferred Brand | $135.00 Copay | $135.00 Copay | ||
| 4) Non-Preferred Drug | $300.00 Copay | $300.00 Copay | ||
| 6) Select Care Drugs |
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. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.
Additional Benefits
Alignment Health smartHMO (HMO) also provides the following benefits.
Ready to sign up for Alignment Health smartHMO (HMO) ?
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