Align Dual Partnership (HMO D-SNP) Costs & Coverage, Burleigh County, North Dakota
Align Dual Partnership (HMO D-SNP) Costs & Coverage, Burleigh County, North Dakota
Explore the benefits and costs of Align Dual Partnership (HMO D-SNP), a 2025 Medicare Special Needs Plan designed to meet your unique healthcare needs. Dive into this detail page to see how this Great Plains Medicare Advantage SNP can support your specific health conditions or financial circumstances.
Available in Burleigh County, ND, to qualified beneficiaries, Align Dual Partnership offers all of the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may include additional benefits that Medicare Part A and Part B do not cover.
According to CMS enrollment data (May, 2025), there are approximately 52 members enrolled in this plan, 25 in Burleigh County.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. The Great Plains Medicare Advantage logo is a registered trademark.[2]
Align Dual Partnership Overview
| Plan ID H8967-003-0 Overview | |
|---|---|
| Health Plan ID: | H8967-003-0 |
| Medicare Advantage Plan Type: | HMO D-SNP |
| Plan Year: | 2025 |
| Monthly Premium: | $46.90 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $9,350.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Basic, $590.00 deductible |
| Additional Benefits: | Vision, Hearing |
| Availability: | Burleigh County, ND |
| Insured By: | Great Plains Medicare Advantage |
We're Here to Help You Enroll
Health Plan Cost Sharing & Benefits
Align Dual Partnership is a Health Maintenance Organization (HMO) plan. As an HMO member, you typically receive healthcare services through the plan’s local network of providers, with referrals generally required to see specialists and other providers. However, Align Dual Partnership does cover out-of-network care for emergencies and out-of-area dialysis.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | 20% Coinsurance |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $90 Copay |
| Urgent care: | 20% Coinsurance |
| Ground ambulance: | 20% Coinsurance |
| Inpatient hospital care: | Coming Soon |
| Skilled Nursing Facility: | Unknown |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | 20% Coinsurance |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | 20% Coinsurance |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | 20% Coinsurance |
| Outpatient group therapy: | 20% Coinsurance |
| Inpatient psychiatric hospital care: | Coming Soon |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | 20% Coinsurance |
| Occupational therapy: | 20% Coinsurance |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 20% Coinsurance |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | 20% Coinsurance Prior Authorization Required |
| Lab services: | Not Covered |
| Outpatient x-rays: | 20% Coinsurance Prior Authorization Required |
| Diagnostic tests and procedures: | 20% Coinsurance Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | 20% Coinsurance |
| Oral exam | $0 |
| Dental x-rays | $0 |
| Cleaning | $0 |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Covered Limits may apply |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | 20% Coinsurance |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: No Eyeglass Frames: No Eyewear Upgrades: No |
Maximum eyewear benefit: | $100.00 Every year |
Do you have questions about the costs in this plan? Call 1-833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (Mon-Fri 5am-6pm, Sat 6am-5pm PST) and learn more about this Special Needs Plan (H8967-003-0) and other plans on this site.
Prescription Drug Plan Costs & Benefits
Prescription Drug Plan Premium
The following table outlines the prescription drug plan premium details of this plan.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $46.90 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $46.90 |
| Low Income Premium Subsidy: | $50.63 |
| Low Income Premium Subsidy CMS Pays: | $46.90 |
| Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $590.00. This is the amount you must pay at the pharmacy before Great Plains Medicare Advantage begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Align Dual Partnership has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Cost data not available. | ||
| *Deductible does not apply. | ||
CMS Rating Marks
The Centers for Medicare & Medicaid Services (CMS) annually rates Medicare Advantage HMO D-SNPs in nine key categories using a 5-star system. These ratings help you gauge the quality of care and service you might receive with this Great Plains Medicare Advantage plan.
CMS Star Ratings for Plan H8967-003-0 – 2025
| CMS Measure | Star Rating (out of 5) |
|---|---|
| 2025 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 |
How to Qualify for Enrollment in Align Dual Partnership
To enroll in Align Dual Partnership you must qualify for both Medicare and Medicaid and live in one of the plan's service areas. Eligibility for Medicare requires you to be either 65 years of age or older, or have received Social Security Disability Insurance for at least 24 months. For Medicaid eligibility, your income and assets must fall at or below your state's thresholds.
SNP Plan Enrollment Periods
After determining your eligibility for Align Dual Partnership , it’s important to be aware of the Medicare Enrollment Periods, which determine when you can enroll in or change your plan. Depending on your circumstances, one of the following periods will apply:
- Initial Enrollment Period (IEP): This is your first opportunity to enroll when you become Medicare-eligible.
- Annual Enrollment Period (AEP): The annual window when you can review and adjust your Medicare coverage.
- Special Enrollment Periods (SEPs): Special situations may allow you to enroll or change plans outside of the standard periods.
To get a deeper understanding of these enrollment periods, click here to learn more and stay informed about your Medicare choices.
Contact Great Plains Medicare Advantage
Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (Mon-Fri 5am-6pm, Sat 6am-5pm PST) and learn more about this plan and other plans on this site. You may also Enroll Online.
| Contact Type | Details |
|---|---|
| Website: | Great Plains Medicare Advantage Plan Page |
| Providers: | Great Plains Medicare Advantage Providers Page |
| Formulary: | Great Plains Medicare Advantage Formulary Page |
| Pharmacy: | Great Plains Medicare Advantage Pharmacy Page |
| New Member Health Plan Help: | (844)637-4760 |
| New Member Health Plan TTY: | (888)279-1549 |
| New Member Part D Help: | (844)637-4760 |
| New Member Part D TTY Users: | (888)279-1549 |
If you qualify for Medicare benefits but have not yet enrolled or verified your status, visit Social Security Administration website or Medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance — Last accessed October 15, 2024
- CMS.gov, Plan Benefits Package — Last accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed July 31, 2025
Learn more about how we use CMS data.
- Great Plains Medicare Advantage, http://www.greatplainsmedicareadvantage.com — Last accessed June 1, 2025
- CMS.gov, "Dual Eligible Special Needs Plans (D-SNPs)" — Last accessed January 20, 2023
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.