Private Payers News

Alignment Health Expands Medicare Advantage Offerings for 2023

The payer is expanding its Medicare Advantage offerings to reach members in 14 additional counties and two new states: Florida and Texas.

Medicare Advantage offerings, Alignment Health, health plan benefits

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By Victoria Bailey

- Alignment Health has expanded its Medicare Advantage offerings for 2023, increasing access to care for seniors through new zero-dollar premium plans, special needs plans, and tailored benefits.

The Alignment Health Plan options will be available to 8.3 million Medicare-eligible adults during Medicare’s open enrollment season, which starts October 15 and runs until December 7.

“Our model puts our members at the heart of everything we do: our plans deliver a breadth of choice and value; our care teams proactively engage members to ensure the best care experience; and our proprietary technology empowers us to deliver customized, coordinated care that drives better health outcomes,” John Kao, founder and chief executive officer of Alignment Health, said in the press release.

“As we grow, we continue to show that it is possible to deliver high-quality care at a lower cost and to do it at scale. Our 2023 plan offerings and benefits are designed to empower seniors nationwide to age well, where and how they choose.”

Alignment is expanding its footprint in 2023 to reach 1.1 million additional people in 14 new counties. Its health plans will be available in 52 markets across Arizona, California, Nevada, North Carolina, Florida, and Texas.

In addition, Alignment will offer zero-dollar premium preferred provider organization (PPO) plans to more markets, including Santa Cruz County in Arizona, Venture and Santa Clara counties in California, Orange County in North Carolina, and El Paso and Hudspeth counties in Texas.

The payer is also increasing offerings for beneficiaries who are dually eligible for Medicare and Medicaid. Alignment’s dual-eligible special needs plans (D-SNPs) will be available to individuals in 8 new counties in Florida, Nevada, and North Carolina.

A PPO D-SNP plan will be available in all six of Alignment’s markets in Nevada, including Carson City, Clark, Douglas, Nye, Storey, and Washoe counties, the press release noted.

Dual eligibles and beneficiaries who qualify for Medicare’s low-income subsidy (LIS) program in select Arizona, California, and Texas counties will have access to new benefits through the federal government’s Medicare Advantage Value-Based Insurance Design (VBID) model, such as financial assistance for gas and utilities.

In addition, the payer is expanding its chronic condition special needs plans (C-SNPs) to additional markets in all six states.

Alignment’s 2023 offerings will also aim to meet members’ cultural needs by expanding two existing plans.

The Harmony health maintenance organization (HMO) plan, tailored toward Asian members, offers traditional Eastern wellness services, including acupuncture, cupping, and gua sha, for no additional costs. The plan includes a $50 monthly grocery allowance that can be used at in-network Asian grocery stores.

The Harmony plan features resources in Chinese, Korean, and Vietnamese and offers network providers and service agents fluent in those languages. The payer will expand this plan to four additional California counties in 2023: Alameda, Los Angeles, Orange, and San Francisco.

Alignment is expanding the ONE or “el ÚNICO” plan to Medicare-eligible individuals in Clay, Duval, Manatee, and Sarasota counties in Florida and El Paso and Hudspeth counties in Texas. The zero-dollar HMO plan is tailored toward Hispanic members and includes a Spanish-speaking provider network, Spanish-speaking service agents, and member materials in Spanish.

The payer is building on its ACCESS On-Demand Concierge black card, which operates like a debit card for certain grocery and over-the-counter items. In 2023, the card will have a separate benefit for members to purchase items and services related to vision, hearing, dental, and chiropractic care.

Finally, Alignment is also offering more benefits to address social determinants of health, such as economic instability and food insecurity. Next year, members will have access to a one-month supply of insulin for $35 or less, discounted pet medication, and caregiver support.

Caregivers on certain plans will be eligible for $300 to $600 of annual reimbursement after submitting forms that detail their hours and tasks associated with caregiver support.