California Medicare Options - Alignment health and Sutter
Is Alignment Good Way to Get Access to Sutter Health?
The Advantage plan market has really changed over the last few years.
It used to be about copays and deductibles. In a given region, these all start to look the same across different carriers with very similar benefits according to our Triple Threat selection:
As the market has matured, it's now more and more about
networks. Giant, powerful medical groups and/or hospitals contracting
with specific Advantage plans.
In fact, 80% of our customers start the conversation with... "I want so and so medical group".
Whether it's Optum down in Los Angeles (a big one) or Sutter up North (another giant one), this now leads the dance and selection of Advantage plans.
So...Sutter health. Outside of Kaiser and the UC's, a monster presence in Sacramento and the Bay Area.
How do we combine the best of Advantage plans with access to our doctors and hospitals in Sutter health?
Hello Alignment.
First, our credentials (and there's no cost for our assistance):
Many seniors may not have heard of Alignment. They will!
Let's get into all the questions aside from our Alignment Advantage comparison and review.
- Quick intro to Alignment
- Alignment and Sutter Health
- The
Alignment Health Plan Sutter Advantage (Medicare Advantage HMO) plan
- Alignment and PAMF
- Alignment and different Sutter Locations
- How to quote and enroll in Alignment for Sutter health
Let's get started.
Quick intro to Alignment
Again, we have a big review on Alignment health but let's hit the relevant highlights.
First, we don't have to guess these days...we can turn right the Star Rating to see how actual members feel about a given plan.
Alignment's Star Ratings average 4 out of 5 for 2024 which is generally one of the highest in a given area.
For this reason, they keep gobbling up the market out of no where (compared to giant carriers who have been around for decades).
So we have high ratings.
We have significant and growing
member base (really important for HMOs).
We have a range of
different plan offerings with all the popular bells and whistles.
That just leaves networks and Sutter specifically.
Good news there.
Alignment and Sutter Health
First, Alignment has a set of plans that can work with Sutter health (make sure to run your updated quote here in case of changes):
The plans currently as of this writing:
- Alignment Health Plan MyChoice PPO
- Alignment Health Plan Sutter
Advantage (HMO)
- Retiree Options (HMO or PPO)
The first two are available to all eligible seniors in their respective areas.
The major difference between MyChoice and the Sutter Advantage plan is HMO versus PPO.
That's a difference in kind, not degree.
Generally, HMOs work best for Advantage plans and people who really want the flexibility and control of a PPO go with Medicare supplements.
See Medicare supplement versus Advantage plans.
More importantly, let's look at a sample quote for age 65 in Palo Alto:
- First, the Star Rating is much better with the HMO. 4 out of 5 stars
- The PPO has 3 out of 5 which is not great relative to the rest of the market.
- The deductibles are both zero and the out of pocket max is pretty comparable
- The premium is roughly half with the HMO which is to be expected. That's roughly $600/year savings.
- The other core benefits are pretty comparable unless you go out of network with the PPO.
So...roughly $600/year savings if you're really planning on
staying in the Sutter network.
You can change at the end of each year if you find one way or the other is not working for you.
Let's zero in on the more popular option (by far).
The Alignment Health Plan Sutter Advantage (Medicare Advantage HMO) plan
It's literally in the plan name. "Sutter Advantage".
This is an example of what we described in the beginning...giant mental networks making deals with health insurance carriers to offer richer benefits or less cost.
In this case, Alignment was savvy enough to see how strong Sutter's "branding" is in Northern California and outside of AARP or Humana, etc, the deal was signed with Alignment.
It also speaks to Alignment's rise in the California marketplace as Sutter is a huge brand. Right up there with the UC's and Dignity health (the old Catholic Healthcare West).
Sutter would not put its name and brand on the line unless the partner was solid and capable of delivering to its members.
Trust us...this reflects 100's of 1000s of members and speaks to Alignment's rise.
Again, we only need to look at the 4 out of 5 star rating to see that they're highly regarded by their existing members.
We did a full review of Alignment and you can quote them against other carriers here:
Let's turn to the question that always come up.
What about the Palo Alto Medical Foundation
Alignment and PAMF
If Sutter is a powerful health brand, PAMF is their crown jewel.
Right in the heart of silicon valley, it rivals Stanford and UCSF in popularity across the Bay Area.
For good reason and it's been tough to get on the pre-65 (Covered California) market for years now.
So...can we use the Sutter Advantage HMO or MyChoice PPO plan with PAMF?
Yes!
So we have PAMF, SF, West Bay, and more. PAMF is really the big draw for Alignment Sutter plans.
What about other areas?
Alignment and different Sutter Locations
First, the hospitals:
Roseville, Alta Bates, Davis, Sacramento are all there.
When you run your quote, make sure to enter your doctors just to be certain. Let's go there now.
How to quote and enroll in Alignment for Sutter health
It's easy.
You can run your Alignment Advantage plans for Sutter (HMO or PPO) here:
A few notes to get the most accurate quote.
Make sure to enter your:
- Doctors
- Medications and dosages
- Preferred Pharmacy
- Sort by "Total Estimated Cost"
The last one is important as it will show both monthly cost AND expected copays (RX).
There's no cost for this quoting option and you can even enroll right through the quote system securely.
Of course, we're happy to help with any questions and there's zero cost for our assistance.
We're just happy to have a solid Advantage plan option that includes Sutter!