Medicare plays a key role in providing health and financial security to beneficiaries residing in North Dakota. With more than 133,500 North Dakota beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in North Dakota. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in North Dakota?

Medicare covers most North Dakota residents who are 65 or older, and it also covers disabled North Dakota residents. Medicare enrollment in North Dakota works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, 80% of your health care costs will be covered.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

North Dakota Medicare Enrollments

107,015

Original Medicare Plans
(Part A and B)

26,513

Medicare Advantage & Other Health Plans

88,646

Stand-alone Medicare
Part D (Drug plans)

133,528

Total Medicare Beneficiaries
in North Dakota

North Dakota Medicare Advantage Plans (Part C)

More than 37% of North Carolina Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in North Dakota who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 14 Medicare Advantage plans are available in North Dakota. The average monthly Medicare Advantage premium is $70.28 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in North Dakota.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are only 26,513 beneficiaries enrolled in Medicare Advantage and other plans in North Dakota. Only 18% of North Dakota Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Depending on your county, North Dakota Medicare beneficiaries can select from between one and 18 Medicare Advantage plans. Medicare Advantage plans are available in all 53 counties in North Dakota.

North Dakota Medicare Supplement (Medigap) Insurance Plans

North Dakota’s pre-ACA high-risk pool is still operational and offers Medigap plans for people who aren’t able to qualify for private plans.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. 

As of 2020, there are 48 insurers that offer Medigap plans in North Dakota. Since North Dakota allows Medigap insurers to pick their own rating approach, nearly all of the plans for sale use attained-age rating. Also, federal rules require Medigap insurers in North Dakota to offer plans on a guaranteed-issue basis during an enrollee’s open enrollment period. This open enrollment period begins when an individual is at least 65 years old and enrolled in Medicare Part B.

North Dakota doesn’t have rules enacted to ensure access to Medigap plans for disabled enrollees under age 65. However, North Dakota has maintained its pre-ACA high-risk health insurance pool. CHAND, the Comprehensive Health Association of North Dakota, allows Medicare beneficiaries who are unable to qualify for a Medigap plan to enroll in Medicare supplemental coverage. CHAND includes basic supplement and standard supplement options.

North Dakota Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 88,646 Medicare beneficiaries in North Dakota enrolled in stand-alone Part D prescription drug plans and 8,099 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 29 stand-alone Part D plans available in North Dakota, with premiums ranging from about $15 to $94 per month. About 19% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in North Dakota

  • North Dakota Insurance Department regulates the private insurance companies that are allowed to offer Part C coverage in the state and administers the State Health Insurance Counseling (SHIC) program, which provides invaluable advice to seniors about what kind of coverage they are eligible for, how to sign up and how to appeal a denial of claim. Trained counselors working for SHIC are fully independent and not affiliated with any private insurance company to ensure conflict-free advice seniors can rely on.
    Contact: Call 1-888-575-6611 or email [email protected].

  • North Dakota Department of Veterans Affairs assists veterans of North Dakota and their dependents in obtaining all benefits to which they are entitled, both federal and state, either by direct contact or through the assistance of County Veterans Service Officers, Tribal Veterans Service Officers, or National Service Officers. Veterans who need help researching or signing up for Medicare Advantage can contact the department for advice and referrals to professional senior care planners.
    Contact: Call 1-866-634-8387 or email through the online contact form.

  • Federal Indian Health Services (IHS) office operates 15 hospitals and several smaller clinics in the Great Plains division, which serves over 130,000 Native Americans in the region. Based in Aberdeen, South Dakota, this office works with tribal elders across its service area, including 17 Native American nations in North Dakota. Counselors working with the office, and with individual tribes, help eligible seniors sign up for Medicare and Medicare Advantage plans, locate Part D benefits and other prescription assistance and apply for Medicaid supplemental coverage for gaps in existing health services.
    Contact: Call 605-226-7581 and online inquiries can be made through the office’s contact form.

  • North Dakota Department of Human Services administers programs and services that help older adults and adults with physical disabilities to live safely and productively in the least restrictive, appropriate setting.
    Contact: Call 1-800-472-2622

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of North Dakota. Our process makes it easier for you to access your Medicare eligibility in North Dakota so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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