In-network
Inpatient hospital
inpatient coinsurance is selected but its percentage is missing; inpatient copayment is selected but its amount is missing
● CMS 2026 plan record
Alignment Health Plan Retiree Options (HMO)
Choose and order benefitsSelections are saved only on this device.
Emergency transport
Ambulance
Ground · in-network20% coinsurance
Air · in-network20% coinsurance
Emergency services
Emergency room
20% coinsurance
Medical maximum
Maximum out-of-pocket
In-network$6,751
Combined in + outNot reported
Skilled care at home
Home health
In-networkCost share not reported
Out-of-networkNot separately reported
Monthly cost
Premium & giveback
Part C premiumNot reported
Consolidated C + DNot reported
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Primary care physician
In: 20% coinsurance · Out: Not separately reported
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Specialist
In: 20% coinsurance · Out: Not separately reported
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Preventive care
In: 20% coinsurance · Out: Not separately reported
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Diagnostic procedures & tests
In: 20% coinsurance · Out: Not separately reported
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Laboratory services
In: 20% coinsurance · Out: Not separately reported
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X-rays & standard imaging
In: 20% coinsurance · Out: Not separately reported
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MRI, CT & PET imaging
In: 20% coinsurance · Out: Not separately reported
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Urgent care
In: Cost share not reported · Out: Not separately reported
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Emergency room
In: 20% coinsurance · Out: Not separately reported
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Ground ambulance
In: 20% coinsurance · Out: Not separately reported
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Air ambulance
In: 20% coinsurance · Out: Not separately reported
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Outpatient hospital
In: 20% coinsurance · Out: Not separately reported
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Outpatient surgery / ASC
In: 20% coinsurance · Out: Not separately reported
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Home health
In: Cost share not reported · Out: Not separately reported
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Skilled nursing facility
In: Cost share not reported · Out: Not separately reported
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Cardiac & pulmonary rehabilitation
In: 20% coinsurance · Out: Not separately reported
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Occupational therapy
In: 20% coinsurance · Out: Not separately reported
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Physical & speech therapy
In: 20% coinsurance · Out: Not separately reported
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Mental health services
In: 20% coinsurance · Out: Not separately reported
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Substance use treatment
In: 20% coinsurance · Out: Not separately reported
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Podiatry
In: 20% coinsurance · Out: Not separately reported
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Chiropractic
In: 20% coinsurance · Out: Not separately reported
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Dental
In: Cost share not reported · Out: Not separately reported
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Vision
In: 20% coinsurance · Out: Not separately reported
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Hearing
In: 20% coinsurance · Out: Not separately reported
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Transportation
Not reported in this CMS export
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Fitness & wellness
Not reported in this CMS export
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Over-the-counter allowance
Not reported in this CMS export
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Meals
Not reported in this CMS export
Plan details
All plan benefits
No benefits match that search.
Medical care3 benefits
Primary care physician
In-network20% coinsurance
Out-of-networkNot separately reported
Specialist
In-network20% coinsurance
Out-of-networkNot separately reported
Preventive care
In-network20% coinsurance
Out-of-networkNot separately reported
Diagnostics & imaging4 benefits
Diagnostic procedures & tests
In-network20% coinsurance
Out-of-networkNot separately reported
Laboratory services
In-network20% coinsurance
Out-of-networkNot separately reported
X-rays & standard imaging
In-network20% coinsurance
Out-of-networkNot separately reported
MRI, CT & PET imaging
In-network20% coinsurance
Out-of-networkNot separately reported
Urgent & hospital care6 benefits
Urgent care
In-networkCost share not reported
Out-of-networkNot separately reported
Emergency room
In-network20% coinsurance
Out-of-networkNot separately reported
Ground ambulance
In-network20% coinsurance
Out-of-networkNot separately reported
Air ambulance
In-network20% coinsurance
Out-of-networkNot separately reported
Outpatient hospital
In-network20% coinsurance
Out-of-networkNot separately reported
Outpatient surgery / ASC
In-network20% coinsurance
Out-of-networkNot separately reported
Recovery & therapy5 benefits
Home health
In-networkCost share not reported
Out-of-networkNot separately reported
Skilled nursing facility
In-networkCost share not reported
Out-of-networkNot separately reported
Cardiac & pulmonary rehabilitation
In-network20% coinsurance
Out-of-networkNot separately reported
Occupational therapy
In-network20% coinsurance
Out-of-networkNot separately reported
Physical & speech therapy
In-network20% coinsurance
Out-of-networkNot separately reported
Behavioral health2 benefits
Mental health services
In-network20% coinsurance
Out-of-networkNot separately reported
Substance use treatment
In-network20% coinsurance
Out-of-networkNot separately reported
Specialty care2 benefits
Podiatry
In-network20% coinsurance
Out-of-networkNot separately reported
Chiropractic
In-network20% coinsurance
Out-of-networkNot separately reported
Supplemental benefits7 benefits
Dental
In-networkCost share not reported
Out-of-networkNot separately reported
Vision
In-network20% coinsurance
Out-of-networkNot separately reported
Hearing
In-network20% coinsurance
Out-of-networkNot separately reported
Transportation
Not reported in this CMS exportNot reported in this CMS export
Fitness & wellness
Not reported in this CMS exportNot reported in this CMS export
Over-the-counter allowance
Not reported in this CMS exportNot reported in this CMS export
Meals
Not reported in this CMS exportNot reported in this CMS export
Plan costs & rulesCoverage overview
Premium & Part B giveback
Part C premium not reported · Part B giveback not separately reported
Maximum out-of-pocket (MOOP)
In-network$6,751
Combined in + outNot reported
Medical deductibles
In-networkNot reported
Out-of-networkNot reported
Network & referrals
HMO · Referrals: Required for some services · Out-of-network coverage: No
Prescription drugs0 tiers
Part D deductible
This plan is not present in the public CMS Landscape release
Using this plan
Understand H5472-801-000
Plain-language context built from this plan’s 2026 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.
Plan at a glance
A quick read on this plan
Alignment Health Plan Retiree Options (HMO) is a 2026 HMO offered by Alignment Health Plan in El Paso & Hudspeth. The CMS record does not indicate routine out-of-network coverage. Referrals are required for some services.
Common benefit costs
What you may pay
These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.
Routine care
- Primary care physician
- 20% coinsurance
- Specialist
- 20% coinsurance
- Laboratory services
- 20% coinsurance
Separate visits or services; costs are not added together.
Tests & outpatient care
- Diagnostic procedures & tests
- 20% coinsurance
- MRI, CT & PET imaging
- 20% coinsurance
- Outpatient hospital
- 20% coinsurance
The service setting and billing details can change what you pay.
Emergency & hospital care
- Emergency room
- 20% coinsurance
Actual costs depend on the care received and plan rules.
Helpful context
Terms worth knowing
Maximum out-of-pocket (MOOP)
This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.
Availability
Who can enroll
- Service area
- El Paso & Hudspeth (TX)
- Plan type
- HMO
- Contract / plan
- H5472-801
- Coverage year
- 2026
Enrollment is limited to people eligible through the sponsoring employer or group. Confirm eligibility and the exact service area with the plan before enrolling.
Supplemental coverage
Extra benefits reported
Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.
DentalCost share not reported
Vision20% coinsurance
Hearing20% coinsurance
Plan-specific answers
Frequently asked questions
Where is H5472-801-000 available?
Alignment Health Plan Retiree Options (HMO) is listed for El Paso & Hudspeth (TX). Enrollment is limited to people eligible through the sponsoring employer or group.
What is the in-network maximum out-of-pocket limit for H5472-801-000?
The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $6,751. Prescription drug spending generally does not count toward this medical limit.
What does an emergency room visit cost on H5472-801-000?
The plan record lists 20% coinsurance.
Does H5472-801-000 report extra benefits?
Yes. CMS reports dental, vision, hearing. See the detailed benefit rows and official plan documents for limits and conditions.
Source trail
Official CMS, Contract Year 2026
Plan identity and benefits come from CMS PBP data. Premium and MOOP figures are cross-checked against the August 2026 Landscape release; county identity is sourced from segment-level Landscape rows and stable codes are enriched from the aligned MA contract service-area release where matched. Quick-reference values should be confirmed in 2026 official plan documents.
Plan context
Where H5472-801-000 fits
- Full CMS plan ID
H5472-801-000- Contract
H5472- Base plan code
H5472-801- Segment
000- Carrier
- Alignment Health Plan
- Plan type
- HMO
- Service area
- El Paso & Hudspeth (TX)
County/service-area foundation
CMS service-area entries
These named entries come from a CMS contract-level service-area file. They describe the contract's published geography and must not be treated as proof that every segment has identical county-level rules.
- El Paso, TX
- Hudspeth, TX
About this code
What H5472-801-000 identifies
H5472-801-000 is a Contract Year 2026 Medicare plan segment code. Searches written as H5472-801, H5472 801, or the compact full CMS ID H5472801000 refer to this plan or its base plan code.
Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.