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Alignment Health Plan: Medicare Advantage Plans 2027 Costs & Ratings

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 9, 2026

Alignment Health Plan is doing something almost no other Medicare Advantage carrier is doing for 2027: growing. While much of the industry is cutting plans and pulling out of counties, Alignment is adding four new markets, ten new counties and expanding to 77 plans.

It is also one of the highest-rated carriers in the country by CMS star ratings. Here is what Alignment offers for 2027, where it operates, and whether it is worth considering in your county.

✔ Licensed across all 50 states✔ Built on CMS 2027 data✔ No-cost plan comparison
Alignment Health Plan expands from 45 to 55 counties with 77 Medicare Advantage plans for 2027 while most carriers contract

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2027 STAR RATINGS UPDATE — OCTOBER 9, 2026

Alignment Health’s largest contract, California HMO H3815, fell to 3.5 stars for 2027. Because that contract covers about three-quarters of Alignment’s members, only about 25% of its members are now in plans rated 4 stars or higher, down from 98% for 2026.

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Six of seven rated contracts still earned 4 stars or higher, including three at 4.5 stars, across Arizona, California, Nevada, North Carolina and Texas.

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Alignment is disputing the H3815 rating with CMS.

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Why it matters: contracts below 4 stars do not earn quality bonus payments, which plans generally use to fund extra benefits, so California members should read their Annual Notice of Change closely.

Ratings shown elsewhere on this page are from 2026. Check the 2027 rating on your specific plan in Medicare Plan Finder. See the full 2027 Medicare Advantage star ratings breakdown.

In North Carolina?

Alignment Health sells 8 plans in 20 North Carolina counties for 2027, out of 176 plans statewide. Compare every carrier in our guide to Medicare Advantage plans in North Carolina for 2027.

Alignment Health Medicare Advantage Plans 2027: What Is New

Alignment announced its 2027 lineup on October 1, 2026. The headline numbers: 77 plans across 55 counties in five states, up from 45 counties the year before. Its footprint now reaches roughly 9.5 million Medicare-eligible seniors.

Four new markets open for 2027.

New market for 2027 Counties added Medicare-eligible seniors
San Antonio, Texas Bexar, Comal 392,000+
Charlotte, North Carolina Cabarrus, Gaston, Mecklenburg, Rowan 295,000+
California Central Valley Kern, Kings, Tulare 228,000+
Nye County, Nevada Nye 18,000+

EXPANDING WHILE OTHERS RETREAT

This matters more than it would in a normal year. Carriers across the industry are reducing service areas and discontinuing plans for 2027, and members are receiving non-renewal notices. Alignment moving in the other direction means that in some counties it is arriving precisely as other options disappear. If your plan is ending, see our guide to Medicare Advantage plans going away in 2027 for what your options are.

Alignment Health Plan Star Ratings

This is Alignment’s strongest card. 100% of its Medicare Advantage members are enrolled in plans rated 4 stars or higher. Very few carriers at any size can say that.

Contract Rating Notes
Nevada HMO 5 stars Two HMO contracts at the top rating
Nevada & North Carolina HMO 5 stars Fourth consecutive year at 5 stars
Texas HMO 4.5 stars First year eligible for a rating
California HMO 4 stars Ninth consecutive year at 4+ stars; 81% of total membership

Those are 2026 plan-year ratings, which is the most recent finalized set. A 5-star contract carries a practical advantage most people do not know about: it comes with a Special Enrollment Period that lets you switch into it once during the year outside the normal window. See our top rated Medicare Advantage plans guide for how that works, and our 2027 Medicare Advantage star ratings page for how Alignment compares to the national carriers.

Where Alignment Health Plan Is Available

Alignment sells Medicare Advantage in five states: Arizona, California, Nevada, North Carolina and Texas. California remains the core of the business at 81% of membership, but Texas and North Carolina are where the growth is going.

It is not a national carrier. If you are outside those five states, Alignment is not an option, and service areas are defined county by county rather than state-wide — being in Texas does not mean being in an Alignment county. Our guides to Medicare Advantage plans in California and Medicare Advantage plans in Texas cover who else sells in those markets.

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What Types Of Plans Alignment Offers

Seventy-seven plans is a lot of choice, and they fall into a handful of structures.

HMO. The core product. In-network care with a primary care physician coordinating, which is where most of Alignment’s membership sits and where its star ratings are earned.

Smart HMO with Part B rebate. A giveback plan that returns part of your Medicare Part B premium, reducing the deduction from your Social Security payment.

HMO-POS. An HMO that permits some out-of-network care at higher cost sharing.

PPO. Out-of-network access without referrals, at higher cost.

C-SNP and D-SNP. Special Needs Plans for people with qualifying chronic conditions, and for people who have both Medicare and Medicaid.

Alignment has highlighted a $0 premium Platinum Preferred (HMO) plan in Orange County, California for 2027. Whether a $0 premium plan exists in your county depends entirely on where you live. Our guides to Medicare Advantage HMO plans, PPO plans and Special Needs Plans explain how each structure works in practice.

Alignment Health Plan adds Hoag with 1,800 physicians and Astrana Health with 2,000 primary care and 5,000 specialty providers for 2027

New Provider Partnerships For 2027

Network is where regional carriers win or lose, and Alignment added two notable partners for 2027.

Hoag, the Orange County health system, brings roughly 1,800 physicians into the network. Astrana Health adds around 2,000 primary care providers and 5,000 specialists.

That matters because the single most common Medicare Advantage regret is discovering after enrollment that a long-standing doctor is out of network. A carrier adding major systems is expanding the odds your physician is covered — but it is still worth checking your own doctors by name rather than assuming a health system being in network covers every practice under its banner.

Is Alignment Health Plan Worth Considering?

The honest read, strengths and limits both.

WHAT IT HAS GOING FOR IT

Every member in a 4-star-or-better plan. Multiple 5-star contracts, one of them for four years running. Expanding rather than contracting, which signals a carrier that intends to stay in these markets. And a growing provider network rather than a shrinking one.

WHAT TO WEIGH AGAINST IT

Five states only, so it moves with you nowhere else. Mostly HMO, which means referrals and a tighter network than a national PPO. And in brand-new markets like San Antonio and Charlotte the carrier has no local track record yet — a strong rating earned in Nevada does not automatically transfer to a network built from scratch in Texas.

How To Choose An Alignment Plan For 2027

1

Check your county, not your state. Alignment covers 55 counties across five states, not the whole of any of them.

2

Check whether you qualify for a Special Needs Plan. If you have a qualifying chronic condition or both Medicare and Medicaid, a C-SNP or D-SNP generally beats the standard plans on value.

3

Decide HMO or PPO before comparing premiums. Most of Alignment’s membership and most of its star ratings sit on the HMO side.

4

Look at the Part B giveback plans if cash flow matters. A Smart HMO with a rebate reduces what comes out of your Social Security payment each month.

5

Verify your doctors by name. Especially in the new 2027 markets, where networks are being assembled now.

6

Compare against the other carriers in your county. See our 2027 Medicare Advantage plans by carrier comparison.

The Annual Enrollment Period runs October 15 through December 7, with coverage starting January 1, 2027.

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Alignment Health Plan 2027 FAQ

➤ What is Alignment Health Plan?

Alignment Health Plan is a Medicare Advantage carrier operating in Arizona, California, Nevada, North Carolina and Texas. For 2027 it offers 77 plans across 55 counties, including HMO, PPO, HMO-POS, Part B giveback and Special Needs Plans. It is not a national carrier and does not sell outside those five states.

➤ Is Alignment Health Plan expanding in 2027?

Yes. Alignment is adding ten counties and four new markets for 2027, growing from 45 counties to 55. The new markets are San Antonio, Texas (Bexar and Comal counties), Charlotte, North Carolina (Cabarrus, Gaston, Mecklenburg and Rowan), California’s Central Valley (Kern, Kings and Tulare) and Nye County, Nevada. That makes it one of the few carriers expanding rather than contracting for the 2027 plan year.

➤ What star ratings does Alignment Health Plan have?

All of Alignment’s Medicare Advantage members are enrolled in plans rated 4 stars or higher. Its Nevada HMO contracts hold 5 stars, a Nevada and North Carolina contract has held 5 stars for four consecutive years, its Texas HMO rated 4.5 stars in its first eligible year, and its California HMO has held 4 stars or better for nine consecutive years while carrying 81% of total membership.

➤ What states does Alignment Health Plan cover?

Arizona, California, Nevada, North Carolina and Texas — 55 counties in total for 2027. California accounts for about 81% of membership. Because Medicare Advantage service areas are set county by county, living in one of those five states does not guarantee Alignment is sold at your address. Check by ZIP code.

➤ Does Alignment Health Plan offer $0 premium plans?

Alignment has highlighted a $0 premium Platinum Preferred (HMO) plan in Orange County, California for 2027. Whether a $0 premium plan is available to you depends on your county, and you still pay your Medicare Part B premium separately on any Medicare Advantage plan. Some Alignment plans go further with a Part B giveback that rebates part of that premium back to you.

➤ What is a Smart HMO with Part B rebate?

It is a giveback plan. The plan pays part of your Medicare Part B premium on your behalf, which shows up as a smaller deduction from your Social Security payment each month. The trade is usually a tighter network or higher cost sharing elsewhere in the plan, so weigh the monthly cash benefit against what you would pay when you actually use care.

➤ Is Alignment Health Plan good?

On the measures CMS tracks, it rates better than most carriers of any size — every member is in a 4-star-or-higher plan and several contracts hold 5 stars. It is also expanding rather than retreating, which is a reasonable signal of commitment to its markets. The limits are that it covers only five states, most of its plans are HMOs, and its largest California contract fell to 3.5 stars for 2027, so check the rating on the specific plan in your county.

New to Medicare?

If you are new to Medicare, then you can enroll in a 2027 Medicare Advantage plan up to three months prior to your Medicare Part B effective date.

Call one of our licensed insurance agents to see what the best time frame is for you to enroll, based on your current situation. You can contact them at 1-855-409-6195 (TTY 711), Mon–Fri 8am–9pm EST.

Have Questions?

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