North Dakota Medicare Advantage plans provide 54,612 beneficiaries with benefits in 2022. Fargo, ND, has the most significant Medicare Advantage participation rate at 32.79%. Of all enrollees with Medicare Advantage, slightly more than half are female.
Understanding the ins and outs of Medicare Advantage plans is vital for your success in getting adequate coverage.
North Dakota Medicare Advantage plans
Medicare Advantage plans cover Original Medicare Part A and Part B expenses while providing additional benefits. Enrollees apply through the state’s available private insurance carriers. This all-in-one solution may include additional benefits in some areas, including dental, vision, and drug coverage.
Most Medicare beneficiaries have around 39 plans available. In some parts of North Dakota, beneficiaries have a maximum of 32 plans to consider. However, other areas have only two policies.
Medicare Advantage plans offers in North Dakota
The government doesn’t standardize Medicare Advantage, so plan details change among different areas, unlike with Medigap. Depending on your location in North Dakota, some plans may not be available or offer different levels of coverage.
The following sections detail the Medicare Advantage plan offerings in North Dakota with zero-dollar premiums, no-cost drug deductibles, some with five-star ratings, and some with Part B give-backs.
Medicare Advantage plans with a zero-dollar premium
A policy with a zero-dollar premium could be good for those who need affordable, continued coverage. However, you’ll have higher out-of-pocket costs than plans with no deductible.
Aetna offers a Local PPO plan with a zero-dollar premium and a three-star rating. With this plan, North Dakota beneficiaries have a $6,700 maximum out-of-pocket cost (MOOP).
NextBlue’s Local PPO plan has no star rating but features a zero-dollar premium and a $6,000 MOOP. Patients choose it for its extra benefits, like dental and hearing coverage.
Medica’s 1876 Cost plan is another zero-premium plan. Beneficiaries select it for its low copay for inpatient care. They also have a low $4,500 MOOP with this four-star plan.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Aetna | $0 | $6,700 | LOCAL PPO | 3 |
| NextBlue | $0 | $6,000 | LOCAL PPO | N/A |
| Medica | $0 | $4,500 | 1876 COST | 4 |
| $0 | $6,700 | LOCAL PPO | 4 | |
| Humana | $0 | $4,900 | LOCAL PPO | 4 |
Medicare Advantage plans with a zero-dollar drug deductible
A Medicare Advantage plan with a no-cost drug deductible typically has a high premium. North Dakota features two options.
The Local PPO plan from Aetna has no monthly premium. Patients also have a $6,700 maximum out-of-pocket cost for three-star performance.
Local PPO also features a plan with a zero-dollar drug deductible. This option features a $99 monthly premium and an impressively low $3,500 MOOP for four-star plan effectiveness.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Aetna | $0 | $6,700 | LOCAL PPO | 3 |
| $99.00 | $3,500 | LOCAL PPO | 4 |
Medicare Advantage plans with a 5-star rating
If you have a five-star plan in your area, you may be eligible to switch from your lower-rated plan to the better option during a Special Enrollment Period. The following North Dakota policy offers five stars.
HealthPartners offers an 1876 Cost plan for $35.70 per month. This policy gets excellent ratings for additional perks, like online telehealth diagnoses and prescriptions. In addition, there is no maximum out-of-pocket cost.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| HealthPartners | $35.70 | N/A | 1876 COST | 5 |
Medicare Advantage plans with a Part B reduction
Since policy inclusions vary per ZIP code, not all beneficiaries have a plan offering a Part B premium reduction. Two Medicare Advantage plans in North Dakota give patients a discount on Medicare Part B.
Humana has a zero-dollar premium plan with a $4,900 maximum out-of-pocket limit. Plan enrollees can enjoy the four-star performance and receive a $55 monthly Part B reduction with this plan.
also offers a Part B premium reduction and a zero-dollar monthly premium. This plan has a $6,700 maximum out-of-pocket cost and offers a $30 give-back. This plan also has an excellent four-star rating.
| PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATINGS |
| Humana | $0 | $4,900 | $55.00 | 4 |
| $0 | $6,700 | $30.00 | 4 |
Ancillary/DVH
Medicare Advantage plans don’t just cover your medical costs. You could also get dental, vision, or hearing benefits depending on your plan. In addition, enrolling in a Medicare Advantage plan with Prescription Drug coverage (MAPD) gives you Part D coverage.
Estimated premiums for cities in North Dakota with Medicare Advantage coverage
You can find charts with estimated premiums for various types of Medicare Advantage coverage for the below cities:
FAQs
Is Medicare Advantage available in North Dakota?
Medicare Advantage is available in North Dakota. Top plans from Aetna, , Humana, and other well-known carriers exist.
What is the Maximum Out-of-Pocket for Medicare Advantage plans in North Dakota?
The maximum out-of-pocket cost for Medicare Advantage in North Dakota is the amount of money you may spend on out-of-pocket expenses, like co-payments for inpatient and outpatient medical services, including doctor’s appointments and surgeries.
Not everyone reaches the limit. If you do, your insurance carrier provides complete coverage for further treatments.
Who is eligible for Medicare Advantage in North Dakota?
Residents eligible for a Medicare Advantage plan include senior North Dakotans 65 years old or older. Those younger than 65 with specific disabilities or chronic conditions may also be eligible for Medicare Advantage.
To enroll in a Medicare Advantage plan, you must have both Original Medicare Parts A and B.
Can I be turned down for a Medicare Advantage Plan in North Dakota?
A private carrier can deny you coverage for prescriptions or Medicare Advantage. However, many rules prevent undeserved coverage denials. For example, you can’t get a coverage denial if you already meet eligibility requirements through Original Medicare.
You can file an appeal to dispute your coverage denial, but this doesn’t guarantee your desired outcome.
When can you change Medicare Advantage plans in North Dakota?
You can sign up for Medicare Advantage during your Initial Enrollment Period. Afterward, you can switch to a better Medicare Advantage plan during the Annual Enrollment Period or the Medicare Advantage Open Enrollment Period.
Alternatively, if you move, you may qualify for a Special Enrollment Period under special circumstances.
How to get help enrolling in a North Dakota Medicare Advantage plan
At Medigap.com, we understand all North Dakota Medicare Advantage plans and their benefits. We can assist you whether you want to compare the top policies or get help enrolling.
Our agents will walk you through enrollment and help you understand your benefits and plan costs. The team makes getting the coverage you need simple without confusion, frustration, or stress.
So call us today. Or fill out our online quote form today to receive the best rates in your part of North Dakota.
