The Best Medicare Supplement (Medigap) Plans in North Dakota
- North Dakota Medicare Supplement (Medigap) insurance covers Medicare deductibles, copays and other medical expenses. Find a plan that's right for you through our review of North Dakota's available Medigap plans.
In North Dakota, seniors can purchase Medicare supplement insurance, or Medigap, to help defray the out-of-pocket costs that accompany Original Medicare. This can include coverage of up to 100% for expenses such as deductibles, copays and even the cost of additional days of inpatient hospital care after Part A benefits have been exhausted. Currently, nearly 54,000 North Dakotans make use of this supplemental insurance, making up about 48% of North Dakota’s Original Medicare participants.
If you're struggling with the high cost of medical expenses despite Medicare coverage, a Medigap plan may help, but selecting a policy can be confusing. Let’s take a look at the types of coverage available and the basics of enrollment so you can choose a plan that’s right for you.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best North Dakota Medicare Supplement Plans?
Medigap policies are sold through private insurers, but these companies must adhere to the federal guidelines that govern this supplemental coverage, which includes 10 distinct plan types. The plans are identified by single letters ranging from A to N, and terms vary depending on the letter designation.
Depending on the plan you choose, you may be reimbursed for up to 100% of the amount remaining after Medicare pays for covered services and supplies. This may include Part A and B coinsurance, hospice copays and the blood that’s needed for transfusions. Some plans also cover services that aren’t reimbursable under Original Medicare, such as medical care received while you’re traveling overseas.
Each plan letter is standardized so the same benefits are offered regardless of the issuing company. Essentially, the coverage you’ll receive through Plan C is the same no matter which company administers the policy. However, premiums may vary by issuer, and not all companies offer the same selection of policies. Plans A, C and F must be offered by all Medigap issuers, but the sale of other plans is at the insurer’s discretion.
You’ll find a more detailed comparison of benefits by plan letter in the accompanying chart.
Popular Medigap Plans
When it comes to the popularity of plans, three plans top the list:
- Plan F: Because it covers the Part B deductible, Plan F isn't available for purchase by Medicare enrollees who weren't eligible for coverage until January 1, 2020, or later. In some areas, this plan may be available with a high-deductible option, making it more affordable for seniors on a budget. However, it doesn’t have an annual out-of-pocket spending limit, so it may not be ideal for seniors who have medical conditions requiring expensive ongoing treatment.
- Plan G: Plan G is one of the few Medigap plans that covers charges that exceed the amount approved by Medicare Part B. It may also be available in certain areas as a high-deductible option. There are no annual out-of-pocket limits.
- Plan N: In addition to other benefits, Plan N covers 100% of Part B's coinsurance. However, it requires policyholders to pay up to a $20 copay for certain office visits and as much as $50 for ER visits that don't lead to hospital admission. No annual out-of-pocket limits apply.
How Do I Enroll in a North Dakota Medigap Plan?
If you think you'll benefit from a Medigap plan, it’s best to purchase a policy during the program’s open enrollment period. This time period varies by person, beginning on the first day of your 65th birthday month and remaining open for six months. Because Medicare supplement insurance isn’t designed to be used as standalone coverage, you must be enrolled in Part B before you can purchase a Medigap plan
If you have underlying medical issues, it’s especially important to purchase a policy during open enrollment because all Original Medicare beneficiaries are guaranteed coverage during this time period, regardless of risk, and they can’t be charged higher premiums for a policy. This is true even for seniors with pre-existing conditions, but wait periods may apply.
If you’re turning 65 but haven’t yet retired, you don’t have to give up your employer-sponsored coverage. If you have a group plan through an employer, a union or COBRA, your Medigap open enrollment period won’t begin until you retire and enroll in Original Medicare. Once that occurs, you’ll still have six months to choose and purchase a supplemental plan, and insurers may not use medical underwriting practices to deny you coverage or raise your premiums.
What Happens If I Miss Open Enrollment?
If you don’t purchase a Medigap plan during open enrollment and the window closes, you may still qualify for coverage, but it’s no longer guaranteed. After open enrollment ends, Medigap providers are legally permitted to use medical underwriting practices to determine the risk of insuring you. If the company decides you’re a high risk, you can be denied coverage or you may have to pay more for a policy.
Can I Qualify for a Guaranteed Issue Right?
There are times when you can purchase a plan outside of the open enrollment window without going through a medical underwriting process. This happens when certain situations trigger a guaranteed issue right.
Guaranteed issue rights are federal protections that safeguard your right to purchase a Medigap plan outside of the open enrollment period without the possibility of being denied coverage or incurring higher premiums due to the quality of your health. Guaranteed issue rights are typically invoked when a Medicare-eligible senior loses their pre-existing coverage or finds their coverage fundamentally changed through no fault of their own.
This can happen when a Medicare Advantage enrollee loses coverage due to the discontinuation of their plan or a change in its service area, resulting in a reversion to Original Medicare. It can also happen if a previous Medigap policyholder relinquishes their supplemental coverage because of misleading policies or loses coverage when their issuer goes bankrupt. Guaranteed issue rights may also apply if a working senior loses supplemental coverage provided by an employer or union.
To qualify for a guaranteed issue right, beneficiaries must enroll in Medicare Plan B rather than opting for another Medicare Advantage plan. Qualified individuals should be able to supply relevant documentation to prove their right to this federal protection.