Align ChoiceElite (PPO)

Align ChoiceElite (PPO) is a PPO plan offered by Sanford Health available for enrollment in 2025 to people living in North Dakota. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Align ChoiceElite (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Align ChoiceElite (PPO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Align ChoiceElite (PPO) Medicare plan features a $300 prescription drug deductible. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when filled through preferred pharmacies or preferred mail order. For Tier 2 generic medications, copays start as low as $4 at preferred pharmacies and preferred mail order, while standard pharmacies charge a $10 copay for a one-month supply. Tier 3 preferred brand drugs require a $42 copay at preferred pharmacies or preferred mail order, compared to a $47 copay at standard pharmacies for a one-month fill. Higher-tier prescriptions utilize coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 29% coinsurance across all pharmacy options. This tiered structure provides distinct cost differences depending on whether you choose preferred, standard, or mail-order pharmacies.

Additional Benefits

The Align ChoiceElite (PPO) plan offers comprehensive healthcare coverage with many essential services requiring no copay and no coinsurance, including primary care visits, telehealth, and preventive screenings. For inpatient hospital stays, members pay a $200 copay per day for days one through five and no copay for days six through ninety, while emergency room visits carry a $110 copay that is waived upon admission. Specialist doctor visits are also affordable, ranging from a $0 to $50 copay with no coinsurance. This plan also features valuable supplemental benefits to help lower your out-of-pocket costs, including dental, vision, and hearing coverage. Members benefit from a $1,000 annual maximum for covered dental services with no copay, a $200 yearly allowance for eyewear, and an $800 annual limit for prescription hearing aids. Additionally, the plan provides an over-the-counter reimbursement of up to $85 every three months with no copay and no coinsurance for health-related items.