Insurance Carrier
Alignment Health
Alignment Health was founded in 2013 with a premise that most Medicare plans have never seriously tested: what if a plan was engineered from the ground up to track your health proactively - not just process claims after you’re already sick? Built around an accountable care model with owned clinics, dedicated care teams, and a proprietary technology platform called AVA, Alignment Health is less a traditional insurer and more a healthcare delivery system that happens to offer a Medicare Advantage plan. If you’ve ever felt like just a member number in a large insurance system with no one actually watching out for you between appointments, the way this carrier is structured is worth understanding.
Most people assume all Medicare Advantage plans work the same way - you pick a network, you get a card, and you call the 800 number when something goes wrong. Alignment Health was built on a fundamentally different premise: that the plan itself should be accountable for your health outcomes, not just your claims. They operate through an accountable care organization (ACO) structure with owned clinics, embedded care navigators, and a proprietary data platform (AVA) that flags health risks before they become emergencies - a model typically only seen inside large integrated health systems, not a Medicare plan. That is a structurally different value proposition than what most national carriers offer, and it is why Alignment has attracted significant institutional investment and rapid market expansion since its public listing in 2021.
What Alignment Health Is Known For
Alignment Health Plan has received 4-Star CMS ratings on Medicare Advantage contracts in California, reflecting quality performance in chronic disease management, preventive care compliance, and member experience measures
Alignment operates on a fully integrated accountable care organization (ACO) model - meaning their clinics, care teams, and insurance plan are aligned under a single financial structure designed to reward keeping members healthy, not simply billing for services rendered
Select Alignment Health Medicare Advantage plans may include $0-premium options, dental and vision benefits, over-the-counter (OTC) allowances, and transportation support - specific benefit amounts and availability vary by plan and county
Alignment deploys a proprietary AI-driven care platform called AVA that monitors member health data across the care continuum, enabling care teams to conduct proactive outreach, home visits, and same-day telehealth appointments - where available depending on your service area and plan
Founded in Orange County, California in 2013, Alignment Health has expanded from its California roots into Arizona, Nevada, North Carolina, Texas, and Florida, serving hundreds of thousands of Medicare Advantage members with continued growth as of 2025
Member Perks & How to Use Them
Alignment Health built a suite of benefits that only deliver real value if you actually use them - and most members who leave money on the table do so simply because no one showed them the on-ramp. If your plan includes care navigator support, an OTC card, or telehealth access, those are active tools waiting for you to engage with them. Here is how to put each one to work before the year closes out.
AVA-powered care navigation: Your plan may include proactive outreach from a dedicated care team using Alignment’s AVA health platform - respond to care gap alerts, telehealth scheduling requests, and post-visit follow-ups to get the most out of this built-in concierge layer
OTC allowance: On qualifying plans, your OTC benefit loads to a card you can use for approved health and wellness products at participating retailers. Call Member Services or log into your Alignment member portal to check your balance and view eligible items
Annual wellness visit coordination: Your care team may proactively reach out to schedule your annual wellness visit - take advantage of this coordination service to stay current on preventive screenings that keep you out of urgent care
Telehealth and same-day access: Qualifying plans may include telehealth visit access and same-day appointment options at Alignment-affiliated clinics. Ask Member Services how to connect with a provider virtually or access a same-day clinic in your area
Dental and vision: Use your included annual allowances before year-end. Find in-network providers through your plan materials or at alignmenthealthcare.com
Availability
Alignment Health Medicare Advantage plans are available in select counties across California, Arizona, Nevada, North Carolina, Texas, and Florida. Coverage footprint continues to expand, but availability is highly county-specific - confirm your ZIP code with a licensed agent before comparing plans.
What to Verify Before Enrolling
Alignment Health’s model is genuinely different from a traditional Medicare Advantage plan - which means there are a few things that matter more here than they would with a conventional carrier. Before you enroll, work through each of these checkpoints so you know exactly what you are getting into and how to use it once your coverage begins.
- ✓
Confirm which specific counties in California, Arizona, Nevada, North Carolina, Texas, or Florida have Alignment Health plan options available for your ZIP code, as coverage footprint varies significantly by county even within states they serve
- ✓
Ask whether your primary care physician participates in Alignment’s value-based care network or an affiliated accountable care organization - their model works differently from a traditional open-panel HMO, and network fit is especially important with this carrier
- ✓
Review the full prescription drug formulary for the specific Alignment plan available in your county, including drug tiers, prior authorization requirements, and which retail and mail-order pharmacies are in their preferred network
- ✓
Understand exactly what proactive care services - including care navigator support, home visit eligibility, and telehealth access - are included in your specific plan and how to access them, since these features are central to Alignment’s model but may vary by plan design
- ✓
Verify copay and cost-sharing amounts for specialist visits, urgent care, emergency room use, and inpatient hospital stays on the specific plan you are considering, along with the plan’s maximum out-of-pocket limit for in-network services
Contact Alignment Health Directly
Whether you want to verify that your doctor is in Alignment’s value-based network, confirm what care navigator services are available on your plan, or simply ask about your OTC balance, their Member Services team is the authoritative source. Have your member ID ready when you call, and use the contact details below to reach Alignment directly.
Member Services
1-855-634-3198Website
www.alignmenthealthcare.comMailing Address
Alignment Health Plan 1100 W. Town & Country Rd. Orange, CA 92868
Contact information is provided for reference and may change. Always verify current contact details on Alignment Health’s official website or your plan materials.
Benefits Vary by Plan, County, and Eligibility
Plan availability varies by county and ZIP code. Benefits, premiums, copayments, provider networks, formularies, and rules vary by plan and may change. Always review official plan materials before enrolling.
Check Alignment Health Availability in Your Area
If a plan built around proactive health management - with a care team that is actually watching your data between appointments - sounds like something worth exploring, the first step is finding out whether Alignment Health is even available in your county. Enter your ZIP code below and a licensed agent will pull every option available where you live, walk you through the network fit, and help you decide if this model is the right match for the way you actually use healthcare.
Quick Medicare Review
Enter your details and a licensed agent will reach out to you.