Prime Health Complete (HMO D-SNP) H2926-001 • 2027 • Swift County, MN
- Monthly Premium
- $24.60Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Swift County, MN
- Local Enrollment
- 23 beneficiaries in Swift County
Introduction
CMS Plan ID H2926-001 identifies Prime Health Complete, a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by PrimeWest Health. Its provider network is a Health Maintenance Organization (HMO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $24.60 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.
Enrollment in this plan requires you to live in Swift County, Minnesota. CMS reports 23 beneficiaries enrolled in this plan in Swift County. New members can call the plan directly at (877)600-4913 (TTY 711) for assistance.
Eligibility
Prime Health Complete is a Medicare D-SNP plan for people who qualify for both Medicare and Medicaid.
- Special Needs Plan Type
- Dual-Eligible Special Needs Plan (D-SNP)
- Medicare Requirement
- Medicare Part A and Part B
- Special Needs Requirement
- Must qualify for Medicaid
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Swift County
Compare this plan with the most-enrolled other HMO D-SNP plan available in Swift County, Minnesota. Enrollment is based on CMS local enrollment data.
| Plan Detail | Prime Health Complete | PrimeWest Senior Health Complete |
|---|---|---|
| CMS Plan ID | H2926-001-0 |
H2416-001-0 |
| Local Enrollment | 23 | 15 |
| Monthly Premium | $24.60 | $24.60 |
| Medical Deductible | Coming soon | Coming soon |
| Maximum Out-of-Pocket | $9,850.00 | $9,850.00 |
| Part B Giveback | Coming soon | Coming soon |
| Primary Care | Coming soon | Coming soon |
| Specialist | Coming soon | Coming soon |
| Part D Deductible | $700.00 | $700.00 |
| CMS Star Rating | Not yet rated | Not yet rated |
| Dental | Coming soon | Coming soon |
| Vision | Coming soon | Coming soon |
| Hearing | Coming soon | Coming soon |
Plan Benefits
Prime Health Complete has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H2926-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2926-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0 copay
Preventive and Wellness Services
- Annual wellness exam
- Not covered
- Telehealth benefit
- Not covered
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $0 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150 - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$0 per day for days 21-100 - Ground ambulance
- In-network: $0 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
- Outpatient group therapy
- In-network: $0 copay
- Inpatient psychiatric hospital care
- Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: $0 copay
- Prosthetics
- In-network: $0 copay
Medicare Part B Drugs
- Chemotherapy
- In-network: $0 copay
- Other Part B drugs (Medicare-covered)
- In-network: $0 copay
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- In-network: $0 copay
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- Not covered
- Contact lenses
- Not covered
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- Not covered
- Upgrades
- In-network: $0 copay
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Prime Health Complete as a Part B benefit.
Prescription Drug Coverage
Prime Health Complete includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $24.60 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $24.60 |
| Low-Income Premium Subsidy: | $24.60 |
| Low-Income Premium Subsidy Paid by CMS: | $24.60 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before PrimeWest Health starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Prime Health Complete may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | 25% coinsurance |
| Generic drugs | 25% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H2926)
Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for PrimeWest Health
- Website
- PrimeWest Health Plan Page
- Providers
- PrimeWest Health Providers Page
- Formulary
- PrimeWest Health Formulary Page
- Pharmacy
- PrimeWest Health Pharmacy Page
- New Member Health Plan Help
- (877)600-4913
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (877)600-4913
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| PrimeWest Health (official source) | http://www.primewest.org/phc | October 4, 2026 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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