Alignment Health Balance (PPO) in Stanislaus County, California — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Alignment Health Balance (PPO) (H4961-006) is a $41-premium Medicare Advantage PPO from Alignment Healthcare USA, LLC available in Stanislaus County, California in 2026, with a 4.0-star overall rating, a $2,850 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Alignment Healthcare USA, LLC |
|---|---|
| Plan name | Alignment Health Balance (PPO) |
| Contract ID | H4961 |
| Plan ID | 006 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | PPO |
| SNP | No |
| Monthly consolidated premium | $41.00 |
| Part C premium | $0.00 |
| Part D basic premium | $0.00 |
| Part D total premium | $41.00 |
| Annual Part D deductible | $0.00 |
| Maximum out-of-pocket (in-network) | $2850.00 |
| Overall star rating | 4.0 |
How this plan is structured
- $41 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PPO plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $2,850 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Stanislaus County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Stanislaus County
The CMS CY2026 Landscape file lists 38 Medicare Advantage plans in Stanislaus County, California, of which 0 carry a 5.0-star overall rating and 24 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $85.00 per month, and in-network out-of-pocket maximums range from $296.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Stanislaus County, California.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4961-006.
- Call the plan (Alignment Healthcare USA, LLC) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H4961-006 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4961-006, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4961 are the contract number issued to the organization, and the three-digit 006 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is Alignment Health Balance (PPO) an HMO or PPO?
Alignment Health Balance (PPO) is a PPO Medicare Advantage plan.
Does Alignment Health Balance (PPO) include prescription drug coverage?
Yes — Alignment Health Balance (PPO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $0.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Alignment Health Balance (PPO)?
The 2026 in-network maximum out-of-pocket limit for Alignment Health Balance (PPO) is $2850.00, per the CMS CY2026 Landscape file.
What counties offer Alignment Health Balance (PPO) (H4961-006)?
Alignment Health Balance (PPO) (H4961-006) is offered in two California counties: San Joaquin County and Stanislaus County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.