Alignment Health Plan
Alignment Health Plan is a Medicare Advantage insurer offering HMO, PPO, and Special Needs Plans across five states (AZ, CA, NV, NC, TX) for 8.1 million Medicare-eligible seniors, supported by a 24/7 ACCESS concierge service and a 66,000-retailer debit-card benefits network.
- Company typePublic
- Founded2013
- HeadquartersOrange, United States
- Headcount51–100
- GTM typeB2C
- OfferingServices
What Alignment Health Plan does
Alignment Health Plan is a Medicare Advantage health plan brand operated by Alignment Healthcare USA, LLC, a wholly owned subsidiary of the publicly traded Alignment Healthcare, Inc. (NASDAQ: ALHC), headquartered in Orange, California. The plan offers HMO, HMO POS, HMO C-SNP, HMO D-SNP, and PPO Medicare Advantage products across five states — Arizona, California, Nevada, North Carolina, and Texas — serving 53 counties and an addressable population of 8.1 million Medicare-eligible adults. The portfolio includes more than 55 plan benefit options for 2025 and 18 Special Needs Plans (SNPs), comprising chronic-condition C-SNPs such as BreathEasy (lung) and Clarity (mental health), dual-eligible D-SNPs including Dual Select+ in Texas, and a culturally tailored el ÚNICO plan for Hispanic seniors.
The technology stack centers on the ACCESS On-Demand Concierge — a 24/7 member service layer providing telehealth routing, appointment and transportation scheduling, benefit navigation, and a preloaded debit card accepted at 66,000+ retailers and pharmacies. The AVA Provider Portal handles eligibility verification, claims status, and prior authorization for in-network providers, while a member-facing mobile app and web portal support self-service. Quality credentials are a defining feature: 100% of members are in plans rated 4 stars or higher by CMS, with 5-star ratings on H5296 (Nevada and North Carolina) and H9686 (Nevada) contracts, and seven PQA Excellence in Quality Awards since 2018.
Revenue is generated primarily through Medicare Advantage capitation premiums paid by CMS, supplemented by integrated Medicare Part D prescription drug coverage and bundled supplemental benefits (transportation, grocery allowances, OTC items, vision, dental, hearing, fitness). Go-to-market combines direct-to-consumer enrollment (website, phone sales at 1-888-293-8272, in-person and virtual seminars), broker and agent partnerships via a dedicated portal, provider referrals through the AVA network, and Medicare.gov marketplace listing. The customer base is Medicare-eligible seniors, with targeted sub-segments including Hispanic seniors, chronic-condition beneficiaries, dual-eligible individuals, and seniors in underserved rural geographies.
Alignment Health Plan firmographics
Firmographics- Name
- Alignment Health Plan
- Legal name
- Alignment Healthcare USA, LLC
- Website
- https://alignmenthealthplan.com
- Company type
- Public
- Founded year
- 2013
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Alignment Health Plan is a Medicare Advantage insurer offering HMO, PPO, and Special Needs Plans across five states (AZ, CA, NV, NC, TX) for 8.1 million Medicare-eligible seniors, supported by a 24/7 ACCESS concierge service and a 66,000-retailer debit-card benefits network.
- Ownership category
- akta.pro rank
Alignment Health Plan industry classification
Industry- Product category
- Medicare Advantage Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- Medicare Advantage HMOs (HMO/HMO-POS) (HLAEAMAH)
- akta.pro secondary industries
- D-SNP Medicare–Medicaid Integration & State Contracting (HLAEAFAH), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG), MA Prescription Drug Plans (MA-PD) (HLAEACAF)
Keywords
Where Alignment Health Plan is headquartered
LocationHeadquarters
- HQ city
- Orange
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Alignment Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medicare Advantage Premiums: Alignment Health Plan generates revenue primarily through Medicare Advantage plan premiums paid by CMS (capitation payments) based on enrollment. The company operates HMO, PPO, C-SNP, and D-SNP plans with varying benefit structures.
- Medicare Part D Prescription Drug Coverage: Integrated prescription drug coverage (Part D) included in Medicare Advantage plans, providing outpatient prescription drug coverage, vaccines, and related supplies.
- Supplemental Benefit Programs: Additional supplemental benefits including transportation, grocery allowances, OTC items, vision, dental, hearing, and fitness memberships bundled into plan offerings.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | As low as $0 monthly plan premium |
Go-to-market motion3 records
Distribution channels6 records
Marketing channels8 records
Alignment Health Plan product offering
Product offeringCore offering
Alignment Health Plan is a Medicare Advantage insurance provider offering HMO, HMO POS, HMO C-SNP, HMO D-SNP, and PPO plans to Medicare-eligible seniors across five U.S. states (Arizona, California, Nevada, North Carolina, Texas). Plans bundle medical coverage, integrated Medicare Part D prescription drug coverage, and supplemental benefits (vision, dental, hearing, transportation, gym, caregiver support), supported by a 24/7 ACCESS On-Demand Concierge service and preloaded Concierge debit card.
Product overview
Alignment Health Plan is a Medicare Advantage insurance provider offering HMO, HMO POS, HMO C-SNP, HMO D-SNP, and PPO plans across five states (Arizona, California, Nevada, North Carolina, Texas). The product portfolio centers on the ACCESS On-Demand Concierge as the primary member service layer, supported by the AVA Provider Portal for network providers, and a Member Portal/Mobile App for self-service access. Core benefits include integrated Medicare Part D prescription drug coverage with $0 copays on 10,000+ generics, transportation scheduling, virtual care/telehealth, and specialized Special Needs Plans (SNPs) including Dual-eligible (D-SNP) and Chronic condition (C-SNP) plans such as Dual Select+, BreathEasy, Clarity, and the culturally tailored el ÚNICO plan for Hispanic seniors.
Differentiator
Problem solved
Functional benefit
Brands
- el ÚNICO: Culturally tailored Medicare Advantage plan specifically designed for Hispanic seniors, offering bilingual care.
Products and services
- Medicare Advantage Health Plans (HMO, HMO POS, HMO C-SNP, HMO D-SNP, PPO)
- ACCESS On-Demand Concierge
- Medicare Part D Prescription Drug Coverage
- Dual Select+ D-SNP
- BreathEasy C-SNP
- Clarity C-SNP
- el ÚNICO Plan
- Transportation Benefit Service
- Medication Therapy Management Program
- Intermountain Health $0-Premium 5-Star Medicare Advantage Plan (Clark County, NV)
Quantifiable outcome
- Sustained excellence in medication safety and adherence for seniors since 2018
- +2 more outcomes
Companies that use Alignment Health Plan
Customer profileNamed customers2 records
Segments5 records
Ideal customer profiles4 records
Alignment Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature5 records
Alignment Health Plan partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- Intermountain HealthcoreLaunched $0-premium, 5-star Medicare Advantage plan in Clark County, Nevada. Partnership provides seniors access to comprehensive benefits including transportation and grocery allowances through Alignment Health Plan's network combined with Intermountain Health's healthcare delivery system.
- Suvida HealthcarecorePartnership to expand bilingual primary care access for Spanish-speaking seniors in Arizona's Pima and Maricopa counties. Collaboration targets approximately 2.3 million Hispanic residents in Arizona and includes Alignment's culturally tailored el ÚNICO plan specifically designed for Hispanic seniors. Effective October 1, 2025.
Scale indicators10 records
Recent moves6 records
Expansion highlights5 records
Alignment Health Plan competitors and assessment
Company assessmentBroad incumbents
- Centene Corporation: Largest Medicaid managed-care operator with growing MA book (Wellcare); direct competitor in dual-eligible D-SNP markets and in several of Alignment's Sun Belt expansion states.
- UnitedHealthcare (UnitedHealth Group): Largest U.S. health insurer and dominant MA player (AARP-branded plans) with nationwide footprint; competes directly with Alignment across all five operating states and sets the de facto benchmark for provider contracting leverage and Stars performance.
- Cigna: National carrier with growing MA franchise (post-HealthSpring legacy) operating in several of Alignment's footprint states; competes on supplemental benefits and global commercial scale, though smaller MA share than Humana/United.
- CVS Health (Aetna): Diversified payer-retail-PBM owner of Aetna, a top-3 MA carrier; competes in Alignment's states with HMO/PPO/SNP products and uses vertical integration (Oak Street, Caremark) to differentiate on care delivery and drug economics.
- Elevance Health (Anthem Blue Cross Blue Shield): Major Blue Cross Blue Shield licensee operating MA plans across many of Alignment's states; competes on network strength and brand, particularly in California (Anthem Blue Cross) where Alignment is a direct competitor.
Direct peers
- Devoted Health: Tech-enabled MA-focused startup with overlapping $0-premium, supplemental-benefit-led product strategy and HMO-heavy footprint in select Sun Belt states; closest comparable in scale, age, and tech-forward concierge model.
- Kaiser Permanente: Vertically integrated HMO with deep California penetration offering $0-premium MA plans; competes head-to-head with Alignment in California via integrated care delivery model and high Star ratings.
- Molina Healthcare: Government-program-focused payer with heavy dual-eligible and MA concentration; similar scale profile to Alignment and a comparable go-to-market emphasizing $0-premium, SNP-rich product sets in overlapping states.
- Clover Health: Tech-driven MA insurer (NASDAQ: CLOV) focused on $0-premium PPO/HMO plans for dual-eligible and chronic-condition seniors; competes in similar member demographics and uses proprietary care-coordination software to drive Stars performance.
- Humana: Largest pure-play Medicare Advantage insurer with a HMO-heavy portfolio across many of the same Sun Belt states Alignment operates in (AZ, NV, TX, NC); competes head-to-head for senior enrollment with similar $0-premium, supplemental-benefit-led product design.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Alignment Health Plan compliance and trust
Trust signalCompliance7 records
Alignment Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Alignment Health Plan leadership team
Management profileNumber of profiles
Profiles1 record
Alignment Health Plan subsidiaries and ownership
Company hierarchySubsidiaries1 record
Alignment Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Alignment Health Plan M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Alignment Health Plan
What does Alignment Health Plan do?
Alignment Health Plan is a Medicare Advantage insurance provider offering HMO, HMO POS, HMO C-SNP, HMO D-SNP, and PPO plans to Medicare-eligible seniors across five U.S. states (Arizona, California, Nevada, North Carolina, Texas). Plans bundle medical coverage, integrated Medicare Part D prescription drug coverage, and supplemental benefits (vision, dental, hearing, transportation, gym, caregiver support), supported by a 24/7 ACCESS On-Demand Concierge service and preloaded Concierge debit card.
Is Alignment Health Plan a public or private company?
Alignment Health Plan is a public company. It is classified as public and is currently operating.
When was Alignment Health Plan founded?
Alignment Health Plan was founded in 2013. It employs 51 to 100 people.
Where is Alignment Health Plan based?
Alignment Health Plan is headquartered in Orange, United States, in the North America region.
How does Alignment Health Plan make money?
Three revenue lines are on record. Medicare Advantage Premiums are the primary driver. The others are medicare Part D Prescription Drug Coverage and supplemental Benefit Programs.
Who are Alignment Health Plan's main competitors?
Broad incumbents on record are Centene Corporation, UnitedHealthcare (UnitedHealth Group), Cigna, CVS Health (Aetna) and Elevance Health (Anthem Blue Cross Blue Shield). Direct peers are Devoted Health, Kaiser Permanente, Molina Healthcare, Clover Health and Humana.
Does Alignment Health Plan have an API?
No public API is recorded for Alignment Health Plan.
What industry is Alignment Health Plan in?
Alignment Health Plan's product category is Medicare Advantage Insurance. Its primary akta.pro industry code is HLAEAMAH, Medicare Advantage HMOs (HMO/HMO-POS), with a secondary code of HLAEAFAH, D-SNP Medicare–Medicaid Integration & State Contracting. Its NAICS code is 524114 and its SIC code is 6321.