Alignment Health Plan, a Medicare Advantage insurer, has achieved a prestigious 5-star rating from the Centers for Medicare & Medicaid Services (CMS) for 2025, making coverage available to over 660,000 Medicare-eligible beneficiaries across 16 North Carolina counties, including Wake County.
The company is one of only 7 plans nationwide to earn this top rating for the third consecutive year.
Here’s what you need to know.
What’s Happening
Alignment Health Plan received a 5-star rating from CMS for its Medicare Advantage HMO plans in North Carolina. The rating applies to coverage across 16 counties, including major markets like Wake (Raleigh), Guilford (Greensboro), Forsyth (Winston-Salem), and Buncombe (Asheville).
With this achievement, Alignment Health Plan members gain access to Special Enrollment Periods throughout the year, allowing them to make plan changes beyond the standard Annual Enrollment Period, which runs from October 15th to December 7th.
Why It Matters
Alignment Health Plan’s 5-star achievement is significant because only 7 Medicare Advantage plans nationwide earned this distinction for 2025.
The company also earned recognition from U.S. News & World Report as a “Best” Medicare Advantage insurer in North Carolina for the third consecutive year.
The 5-star rating indicates “excellent” performance across multiple categories, including:
- Health plan administration and member experience
- Clinical care management and health outcomes
- Customer service and complaint resolution
- Preventive care and chronic condition management
Here’s what Alignment Health CEO, Dawn Maroney, said in the press release.
“We’re incredibly proud that our HMO plan in North Carolina is one of only seven in the nation to earn a 5-star rating from CMS. This recognition underscores our commitment to offering high-quality, affordable care that meets the unique health needs of North Carolina seniors.”
What Alignment Health Plan Offers
Alignment Health Plan’s 2025 North Carolina portfolio includes five plans:
Four 5-Star Rated HMO Plans:
- Standard HMO: $0 monthly premium with $590 deductible
- SmartHMO: $0 monthly premium with $0 deductible, includes Part B premium reduction
- Heart & Diabetes Special Needs Plan: $0 monthly premium for members with chronic conditions
- NC Duals Plan: $24.60 monthly premium for dual-eligible members
One PPO Plan:
- AVA PPO: $10 monthly premium with flexible provider network options
All plans include 24/7 concierge service for appointment scheduling, transportation assistance, and health-related questions at no additional cost.
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