North Dakota Medicare beneficiaries have access to a range of coverage options, state-specific protections, and free counseling services. This comprehensive North Dakota Medicare guide covers your SHIP office contacts, Medigap plan availability, birthday rule protections, Medicare Savings Program eligibility, Medicare Advantage options, and how to compare plans. Whether you are turning 65, helping a parent navigate Medicare, or re-evaluating your coverage, understanding North Dakota Medicare rules is essential for making informed decisions.
All information in this guide has been verified against official state sources, CMS data, and NAIC reports as of April 2026.
In This North Dakota Medicare Guide:
North Dakota SHIP — Free Medicare Counseling
Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased Medicare counseling. North Dakota’s SHIP program can help you understand your coverage options, compare plans, resolve billing issues, and navigate enrollment periods at no cost.
| SHIP Program | North Dakota State Health Insurance Assistance Program (SHIP), administered by the North Dakota Insurance Department |
| Phone | 1-888-575-6611 |
| Website | https://www.insurance.nd.gov/consumers/medicare |
SHIP counselors are trained volunteers and staff who are not affiliated with any insurance company. They do not sell plans. Contact your North Dakota SHIP office before making any major Medicare decisions.
North Dakota Medigap (Medicare Supplement) Plans
Medigap plans in North Dakota help cover out-of-pocket costs not paid by Original Medicare, including the Part A deductible, Part B coinsurance, and skilled nursing facility copays. Medigap plans are standardized by federal law, meaning Plan G from one carrier covers the same benefits as Plan G from another carrier. The difference is premium cost.
Plans available in North Dakota: A, B, C, D, F, G, K, L, M, N (all 10 standardized plans plus high-deductible F and high-deductible G)
Most popular plan: Plan G (over 19000 enrollees among those who turned 65 after January 1 2020) is the most popular Medigap plan in North Dakota. Plan G covers all gaps in Original Medicare except the annual Part B deductible ($240 in 2026). Plan N is the most popular lower-premium alternative, with small copays for some doctor visits and ER visits.
Pricing method: North Dakota uses community-rated Medigap pricing. This is the most favorable method for consumers because premiums are the same regardless of age. Your premium will not increase simply because you get older.
The average monthly Plan G premium for a 65-year-old in North Dakota is approximately 169.50. Plan N averages approximately $136 per month. Actual premiums vary by carrier, age, gender, tobacco use, and zip code. Always compare quotes from at least three carriers.
North Dakota Medigap Switching Rights
North Dakota does not have a Medigap birthday rule. Your primary opportunity to buy or switch Medigap plans without medical underwriting is during your initial Medigap Open Enrollment Period, which lasts 6 months starting when you first enroll in Medicare Part B at age 65 or older.
After your initial OEP closes, you may face medical underwriting if you apply for a new Medigap policy. However, federal law provides guaranteed issue rights in specific situations, such as losing employer coverage or leaving a Medicare Advantage plan during your first year.
North Dakota guaranteed issue protections: North Dakota follows only the federal minimum guaranteed issue rights. There are no state-level expanded guaranteed issue protections beyond the standard federal 6-month Medigap Open Enrollment Period. Federal guaranteed issue rights apply in specific situations such as loss of employer group coverage or disenrollment from a Medicare Advantage plan within the first 12 months (trial right).
North Dakota Medicare Advantage (Part C)
Approximately 150446 people in North Dakota are enrolled in Medicare. About 35% of North Dakota Medicare beneficiaries choose Medicare Advantage plans, with the remainder on Original Medicare with or without Medigap supplement coverage.
Medicare Advantage plans in North Dakota are offered by private insurers as an alternative to Original Medicare. Most MA plans include prescription drug coverage (Part D) and often add dental, vision, and hearing benefits. However, MA plans use provider networks, which can limit your choice of doctors and hospitals.
Key Medicare Advantage considerations in North Dakota:
- Networks matter: HMO plans require you to use in-network providers except in emergencies. PPO plans allow out-of-network care at higher cost.
- $0 premium plans: Many North Dakota MA plans have $0 monthly premiums (you still pay your Part B premium).
- Maximum Out-of-Pocket (MOOP): MA plans cap your annual spending, unlike Original Medicare which has no cap.
- Star ratings: CMS rates MA plans 1-5 stars. Higher-rated plans often have lower costs and better coverage.
Top Medicare Advantage carriers in North Dakota by enrollment:
- UnitedHealthcare
- Sanford Health Plan (Align)
- NextBlue of North Dakota
- Medica
- Aetna
North Dakota Medicare Financial Help Programs
North Dakota offers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay for premiums, deductibles, and copays. The four programs are:
- QMB (Qualified Medicare Beneficiary): Pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premiums only.
- QI (Qualifying Individual): Pays Part B premiums (limited funding, first-come first-served).
- QDWI (Qualified Disabled Working Individual): Pays Part A premiums for disabled workers.
North Dakota MSP eligibility: QMB: 1235/month single, 1663/month married; SLMB: 1478/month single, 1992/month married; QI: 1660/month single, 2239/month married. Asset limits: 9090 single, 13630 married.
Apply through your local SHIP office or your state Medicaid agency for free help determining eligibility.
Top Medicare Insurance Companies in North Dakota
Top Medigap carriers in North Dakota:
- Blue Cross Blue Shield of North Dakota
- State Farm
- UnitedHealthcare
- Mutual of Omaha
- Aetna
When comparing carriers, focus on premium cost (for identical standardized Medigap plans, benefits are the same — only price differs), financial strength ratings from AM Best (A or higher), customer satisfaction ratings, and claims processing speed.
North Dakota Medicare Enrollment Periods
Understanding Medicare enrollment deadlines prevents costly late enrollment penalties:
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, birthday month, 3 months after). Enroll in Parts A and B during this period.
- Medigap Open Enrollment: Standard federal 6-month Medigap Open Enrollment Period beginning the first month you are both age 65 or older and enrolled in Medicare Part B. North Dakota does not extend this period beyond the federal minimum.. During this period, insurance companies cannot deny you Medigap coverage or charge higher premiums based on health conditions.
- Annual Enrollment Period (AEP): October 15 through December 7 each year. Switch between Original Medicare and Medicare Advantage, change MA plans, or add/change Part D drug plans.
- Medicare Advantage Open Enrollment Period (OEP): January 1 through March 31. Switch MA plans or return to Original Medicare (and add a Medigap plan, subject to underwriting).
- Special Enrollment Periods (SEP): Available when you lose employer coverage, move, or qualify for other life events.
Additional North Dakota Medicare protections: North Dakota relies only on federal minimum Medigap protections. No birthday rule, no continuous open enrollment, no state mandate requiring Medigap availability to beneficiaries under age 65. North Dakota does require all Medigap policies to cover pre-existing conditions after the policy has been in effect for 6 months. North Dakota has the highest Medigap enrollment rate in the nation with approximately 51% of Original Medicare beneficiaries enrolled in a Medigap plan.
Compare North Dakota Medicare Plans
Ready to compare Medicare options in North Dakota? Use the official Medicare Plan Finder or contact your local SHIP counselor for free, unbiased help.
Official Sources & Resources
- Medicare.gov: medicare.gov
- North Dakota Insurance Department: https://www.insurance.nd.gov
- North Dakota State Health Insurance Assistance Program (SHIP), administered by the North Dakota Insurance Department: https://www.insurance.nd.gov/consumers/medicare
- CMS.gov: cms.gov
- NAIC: naic.org
This North Dakota Medicare guide was last verified against official sources in April 2026. If you notice outdated information, please contact us.