Medicare Plan Options
North Dakota residents can secure Medicare coverage through the government or private insurers. You can stick with Original Medicare, add a Medigap supplement, or choose a plan from North Dakota’s Medicare Advantage program.
Original Medicare includes two components. Part A hospital insurance pays for inpatient care, emergency room services, and in-home care. It includes benefits for hospice and up to 100 days in a skilled nursing facility. Part B medical insurance covers primary and specialty care, wellness visits, diagnostic services, and some durable medical equipment and supplies. It pays for 100% of preventive care and part of other services deemed medically necessary.
Medicare Advantage Plans
North Dakota residents can choose from more than 50 Medicare Advantage Plans that are available in select geographic areas. Also known as Part C, Advantage Plans are provided by private insurers that receive a stipend from the government for each enrollee. These plans include all Part A and B services plus several value-added benefits, such as dental, vision, SilverSneakers gym memberships, and transportation. Most Advantage Plans include prescription drug coverage.
Medicare Prescription Drug Coverage Plans
Medicare Part D is a standalone prescription drug plan that’s available to Original Medicare beneficiaries and some enrollees who have qualifying Advantage Plans. Purchasing this type of optional insurance can help you avoid late enrollment penalties by helping you maintain qualifying drug coverage. You’ll pay a monthly Part D premium along with copays that are based on the type of drug and its coverage tier. A number of tools can help you estimate these costs before you enroll.
Medicare Supplement Insurance Plans
Medigap insurance supplements are sold by private insurers. If you have Original Medicare Parts A and B, your Medigap supplement can lower your copay and out-of-pocket costs. It may even pay some or all of your deductible. Medicare supplements are different from Advantage Plans, and they don’t cover things like vision, dental, hearing, long-term care, or skilled nursing. Since 2006, Medigap supplements cannot offer prescription drug coverage. However, policies are guaranteed to be renewable even if your health changes.
Medicare in North Dakota by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|108,056||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in North Dakota
Medicare is a complex federal program that includes many different components. If you need help navigating your options, understanding your benefits, or paying for coverage, the following agencies can provide personal assistance or direct you to local partners that serve seniors in your community.
State Health Insurance Counseling (SHIC)
Part of the North Dakota Insurance Department, SHIC is a free program available to seniors and family members who have questions about Medicare, prescription drug coverage, and insurance supplements. Specially trained counselors help with initial enrollment, plan comparisons, and billing issues. You can call the SHIC helpline to request a one-on-one consultation or to find a local counselor. General informational resources are available online.
Contact Information: Website | 888-575-6611
North Dakota Senior Medicare Patrol
The state’s Senior Medicare Patrol is located at Minot State University’s Center for Persons with Disabilities. Thanks to federal grants, SMPs work to educate consumers and give seniors the tools that they need to detect billing errors and fraudulent or unnecessary charges that inflate health care costs and government spending. If you have questions about a medical bill, insurance claim, or appeal, the SMP can review your case and work with other state and federal agencies to take appropriate action.
Contact Information: Website | 800-233-1737
North Dakota Aging and Disability Resource Link
North Dakota’s Aging & Disability Resource Link is a comprehensive resource for seniors who want to learn more about government programs and organizations that are active in their community. It can direct you to senior centers, insurance counselors, caregiver supports, prescription drug assistance, and programs sponsored by the division of Adults & Aging Services. You can search for resources by name, type, or geographic area or call the ADRL for help with specific questions.
Contact Information: Website | 855-462-5465
Legal Services of North Dakota
If you’re having trouble accessing health insurance, medical services, or government benefits, such as Medicare or Medicaid, Legal Services of North Dakota may be able to help. This statewide legal aid society assists seniors, low-income residents, and vulnerable adults from six regional offices located in Bismarck, Fargo, Minot, and several other major cities. It provides educational guides, self-help forms, advice, and direct representation on topics, such as elder law, consumer rights, and wills.
Contact Information: Website | 866-621-9886
Learn More From Our Sources
- AARP | Your Guide To Public Benefits In North Dakota | Last accessed June 2021
- Medicare.gov | Medicare Costs at a Glance | Last accessed June 2021
- Kaiser Family Foundation | Total Medicare Beneficiaries | Last accessed June 2021
- Social Security Administration | Medicare: Your Insurance Coverage | Last accessed June 2021
- Medicare.gov | How Original Medicare Works | Last accessed June 2021
- North Dakota Insurance Department | Medicare Advantage Plans | Last accessed June 2021
- Medicare.gov | How to Get Prescription Drug Coverage | Last accessed June 2021
- Medicare.gov | What’s Medicare Supplement Insurance (Medigap)? | Last accessed June 2021
- Department of Insurance | State Health Insurance Counseling | Last accessed June 2021
- ND Center for Persons with Disabilities | Senior Medicare Patrol | Last accessed June 2021
- CareChoiceND | North Dakota Aging and Disability Resource Link | Last accessed June 2021
- LegalAssist.org | Legal Services of North Dakota | Last accessed June 2021