Medicare Advantage in North Dakota

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North Dakota state

Information about Medicare Advantage Plans in North Dakota

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17 percent of Medicare beneficiaries in North Dakota were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 396 different North Dakota Medicare Advantage plans in 2019.1 Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of North Dakota. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in North Dakota

In 2019, the average Medicare Advantage plan premium paid by a beneficiary in North Dakota was $112 per month.

  • Average in-network out-of-pocket spending limit: $3,743
  • Average deductible in 2019 (weighted): $43.591

Individual plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

You can view the 2019 average North Dakota Medicare Advantage plan monthly premiums by county listed below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare North Dakota Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

If you want to enroll in Medicare Advantage in North Dakota, you must first be enrolled in Medicare Part A and Part B, often referred to as Original Medicare.

To be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

It’s important to note that if you have ESRD, you may not qualify for most Medicare Advantage plans. If you have ESRD, you may be able to enroll in a North Dakota Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in North Dakota

The first time you may be able to enroll in a North Dakota Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday. It includes the month of your 65th birthday and then continues for another three months after your birthday.

Additional times at which you may sign up for a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, from January 1 to March 31 every year, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year for qualifying circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a North Dakota Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in North Dakota 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans using a system of one to five stars.2

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 342 top-rated 2019 Medicare Advantage plans in North Dakota that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in North Dakota in 2019

To view a list of plans offered in your area within North Dakota, use our plan comparison tool.

Find a North Dakota Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in North Dakota

Multiple insurance carriers may offer Medicare Advantage plans in North Dakota, depending on where you live.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in North Dakota, you can compare plans from several different carriers by using some of the following information:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

North Dakota Medicare Advantage plans by county

The chart below provides some more information about 2019 North Dakota Medicare Advantage plans by county.1

2019 ND Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Number of Plans Available
Adams 84 12% 7
Barnes 469 17% 11
Benson 55 5% 7
Billings 18 10% 7
Bottineau Data not available 0% 1
Bowman 81 11% 7
Burke Data not available 0% 1
Burleigh 4230 24% 17
Cass 5725 22% 16
Cavalier 110 10% 7
Dickey 164 14% 7
Divide Data not available 0% 1
Dunn 103 13% 7
Eddy 83 12% 7
Emmons 233 23% 7
Foster 144 18% 7
Golden Valley Data not available 0% 1
Grand Forks 1907 17% 12
Grant 147 20% 7
Griggs 129 18% 7
Hettinger 101 14% 7
Kidder 198 30% 11
LaMoure 254 23% 7
Logan 121 22% 7
McHenry 182 13% 7
McIntosh 185 20% 7
McKenzie 15 1% 1
McLean 384 15% 7
Mercer 293 16% 7
Morton 1686 27% 16
Mountrail 12 1% 1
Nelson 89 9% 7
Oliver 97 21% 11
Pembina 230 12% 7
Pierce 179 16% 7
Ramsey 201 7% 7
Ransom 161 12% 7
Renville #DIV/0! 0% 1
Richland 813 24% 16
Rolette 45 2% 7
Sargent 71 7% 7
Sheridan 68 15% 7
Sioux 38 8% 7
Slope 27 16% 7
Stark 601 12% 7
Steele 76 15% 7
Stutsman 1567 30% 16
Towner 29 4% 7
Traill 253 14% 11
Walsh 357 13% 7
Ward 1565 15% 7
Wells 90 7% 7
Williams 307 8% 7

ND Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 North Dakota Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of North Dakota enrollees (2019)
Medicare Cost Plan 99.56%
Local PPO <1%
PFFS <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.

    Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.

    PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the patient will pay when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

    Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 North Dakota Medicare Advantage plans that are available where you live.

Local health insurance resources in North Dakota

  • The Senior Health Insurance Counseling Program of North Dakota supplies free help with Medicare and other types of public health insurance to the state’s beneficiaries.

    The program is free and support is provided by trained volunteers who aim to help North Dakota’s seniors make better use of their insurance.

    The program may be reached at 888-575-6611 or 701-328-2440.
  • You can also explore more information about the insurance industry in North Dakota by visiting the state’s Department of Insurance website.

  • North Dakota Prescription Drug Assistance Programs
    The state of North Dakota has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.