A Dual Eligible Special Needs Plan, or D-SNP, is a type of health insurance plan that coordinates coverage for people who qualify for both Medicare and Medicaid. These plans, like the Align DUALPartnership Plan (HMO D-SNP) from Align powered by Sanford Health Plan, can offer members comprehensive and affordable coverage with additional benefits, making them a great option for people who are eligible for both programs.

Use our guide below to find out if you may be eligible for D-SNP coverage so you can take advantage of this excellent health insurance option.

Qualifying for Medicare

To qualify for Medicare Parts A and B, you must:

• Be at least 65 years old, or under 65 and qualified based on disability or other special situations
• Be a U.S. citizen, or a legal resident who has lived in the U.S. for at least five consecutive years before applying

Qualifying for Medicaid

Medicaid eligibility varies depending on the state you live in. In North Dakota, you must be a resident of the state of North Dakota, a U.S. national, citizen, permanent resident, or legal alien in need of health care or insurance assistance. Additionally, your financial situation needs to be characterized as low income or very low income. Per the North Dakota Health and Human Services department, you must also be in one of the following groups:

• Individuals with income within limits
• Children in foster care or subsidized adoption
• Former foster care children up to age 26, under certain circumstances
• Children with disabilities (birth to 19)
• Pregnant women
• Individuals with breast or cervical cancer
• Workers with disabilities
• Other blind and disabled individuals
• Low-income Medicare beneficiaries (Medicare Savings Programs)

To qualify financially, you must have an annual income (before taxes) that is below the following amounts based on household size¹:

¹Income levels table from https://www.hhs.nd.gov/healthcare/medicaid/eligibility

Living in a service area

Align DUALPartnership Plans (HMO D-SNP) are currently offered to people who reside in one of these three North Dakota counties:

• Burleigh County
• Cass County
• Morton County

Applying for a D-SNP

Anyone who’s eligible for Medicare can enroll or change their plan during the Medicare Annual Enrollment Period (AEP) in the fall. But if you qualify for a D-SNP, you may not have to wait.

You may be able to enroll in a D-SNP today if you:

• Are 65 years old and newly eligible for Medicare or have a qualifying disability
• Are retiring and losing your current coverage
• Have moved out of your current Medicare plan’s coverage area
• Receive Medicaid benefits

If you already have both Medicare and Medicaid, you can enroll in or switch to a D-SNP once per Special Enrollment Period (SEP) or during the AEP. As long as you maintain Medicaid eligibility, you’ll stay qualified for a D-SNP.

Annual Enrollment Periods

If you are interested in applying for an Align DUALPartnership Plan (HMO D-SNP), you can visit our website and click “Apply Now.”

Where to find more information

If you need help choosing a plan, we have an easy-to-use buyer’s guide for Dual Eligible Special Needs Plans you can download.

To get additional information or to ask questions about your coverage, reach out to one of our local, licensed agents who provide free assistance (with no obligation to purchase). Call (866) 404-6597 (TTY: 711) Monday–Friday, 8 a.m.–8 p.m. local time or visit align.sanfordhealthplan.com/dual.

Sanford Health Plan and Sanford Health Plan of Minnesota have HMO and PPO plans with a Medicare contract. Sanford Health Plan D-SNPs have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Sanford Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, or any other classification protected under the law. This information is not a complete list of benefits. Call (888) 605-9277 ( TTY: 711) for more information. If you need language services or information given in a different format please call (888) 278-6485 (TTY: (888) 279-1549). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (888) 278-6485 (TTY: (888) 279-1549). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電(888) 278-6485 (TTY: (888) 279-1549). Our customer service lines are available 8 a.m. to 8 p.m. CST, 7 days a week, October 1-March 31 except on Christmas and Thanksgiving, and Monday through Friday all other dates except on federal holidays.