Senior Care (HMO I-SNP) H3274-001 • 2027 • Los Angeles County, CA
- Monthly Premium
- $7.30Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Los Angeles County, CA
- Local Enrollment
- 51 beneficiaries in Los Angeles County
Introduction
CMS Plan ID H3274-001 identifies Senior Care, a Medicare Advantage Institutional Special Needs Plan (I-SNP) offered by Align Senior Care. Its provider network is a Health Maintenance Organization (HMO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $7.30 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.
Qualifying residents of Los Angeles County, California may enroll in this plan. CMS reports 51 beneficiaries enrolled in this plan in Los Angeles County. New members can call the plan directly at (844)305-3879 (TTY 711) for assistance.
Eligibility
Senior Care is a Hybrid Institutional (HI-SNP) plan for individuals that require nursing care.
- Special Needs Plan Type
- Institutional Special Needs Plan (I-SNP)
- Medicare Requirement
- Must have Medicare Part A and Part B
- Special Needs Requirement
- This plan accommodates individuals in a long-term care facility. It is also available to people who need the level of care given in a long-term care facility who can remain at home or live in an assisted living facility.
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Los Angeles County
Compare this plan with the two most-enrolled HMO I-SNP plans available in Los Angeles County, California. Enrollment is based on CMS local enrollment data.
| Plan Detail | Senior Care | SCAN Embrace | Anthem I CareMore Home Care |
|---|---|---|---|
| CMS Plan ID | H3274-001-0 |
H5425-086-0 |
H0544-005-0 |
| Local Enrollment | 51 | 1,440 | 915 |
| Monthly Premium | $7.30 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $799.00 | $700.00 |
| Part B Giveback | Not offered | −$62.00 reduction | −$22.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | 0%-20% coinsurance | $0 copay | $0 copay |
| Part D Deductible | $700.00 | $0.00 | $100.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Plan Benefits
Senior Care has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H3274-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H3274-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: 0%-20% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- Not covered
- Telehealth benefit
- In-network: 0%-20% coinsurance
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: 20% coinsurance
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: 20% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- Tier 1
$235 per day for days 1-10
$0 per day for days 11-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-100 - Ground ambulance
- In-network: 20% coinsurance
Mental Health Services
- Outpatient individual therapy
- In-network: 20% coinsurance
- Outpatient group therapy
- In-network: 20% coinsurance
- Inpatient psychiatric hospital care
- Tier 1
$235 per day for days 1-10
$0 per day for days 11-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: 20% coinsurance
- Occupational therapy
- In-network: 20% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: $0 copay
- Endodontics
- In-network: $0 copay
- Restorative services
- In-network: $0 copay
- Implant services
- In-network: $0 copay
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- In-network: $0 copay
- Eyeglass lenses only
- In-network: $0 copay
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- In-network: $0 copay
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $0 copay
- OTC hearing aids
- In-network: $0 copay
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Senior Care as a Part B benefit.
Prescription Drug Coverage
Senior Care includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $7.30 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $7.30 |
| Low-Income Premium Subsidy: | $7.28 |
| Low-Income Premium Subsidy Paid by CMS: | $7.30 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Align Senior Care starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Senior Care may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | 25% coinsurance |
| Generic drugs | 25% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H3274)
Medicare evaluates plan quality using a star rating system developed by the Centers for Medicare & Medicaid Services (CMS). Ratings are based on measures such as health outcomes, member experience, and customer service, and are reported on a 1 to 5 star scale, with higher ratings indicating stronger overall performance.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Not enough data available |
| Managing Chronic (Long Term) Conditions | Not enough data available |
| Member Experience with Health Plan | Not enough data available |
| Complaints and Changes in Plans Performance | Not enough data available |
| Health Plan Customer Service | Not enough data available |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | Not enough data available |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Align Senior Care
- Website
- Align Senior Care Plan Page
- Providers
- Align Senior Care Providers Page
- Formulary
- Align Senior Care Formulary Page
- Pharmacy
- Align Senior Care Pharmacy Page
- New Member Health Plan Help
- (844)305-3879
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (844)305-3879
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Align Senior Care (official source) | http://www.alignseniorcare.com | October 4, 2026 |
| CMS.gov | Institutional Special Needs Plans (I-SNPs) | April 28, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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