Since Original Medicare doesn't have an annual out-of-pocket maximum, many beneficiaries have supplemental coverage as well. This page explains Medicare Supplement plans in North Dakota, who qualifies, and when you should enroll.
What Is Medigap in North Dakota?
Medigap plans help pay a variety of your out-of-pocket costs when you have Original Medicare. This includes:
- Medicare Part A: Inpatient care received in a hospital or skilled nursing facility (SNF)
- Medicare Part B: Outpatient services like doctor visits, preventive care, and lab work
North Dakotans have 10 basic Medicare Supplement plans to choose from: A, B, C, D, F, G, K, L, M, and N, although not every Medigap insurer offers all 10 plans. Some insurance companies may also provide high-deductible versions of one or more plans.
Medigap plans are standardized, meaning Plan A (or B, D, etc.) has the same benefits no matter where you live or which insurance company you choose. Although benefits are standardized, Medigap insurers can set their own premiums as long as they work within state and federal guidelines.
Unlike Original Medicare, you are not guaranteed a Supplement plan just because you turn 65. Unless you have a guaranteed issue right, your application goes through medical underwriting, which involves answering a series of health-related questions. Insurance companies decide whether to sell you a Medigap policy and for how much based on your answers.
Who Qualifies for Medicare Supplement Insurance in North Dakota?
You qualify for Medicare Supplement Insurance in North Dakota once you are age 65 or older AND enrolled in Original Medicare. Most states also require Medigap insurers to offer plans to under-65 beneficiaries who qualify for Medicare due to a disability, but North Dakota is not one of them.
If you have Medicare due to a disability and are not yet 65 years old, you may be able to get assistance through the Comprehensive Health Association of North Dakota (CHAND). Click this link to learn more.
What Does Medigap Cover?
Medicare Supplement coverage varies depending on which plan you choose. At a minimum, though, every Medigap plan pays the Medicare Part A coinsurance and gives you 365 extra lifetime reserve days for inpatient hospital care.
The following table helps compare Medigap plan benefits:
Medicare Supplement Insurance does not include prescription drug coverage. These benefits are available with a Medicare Part D prescription drug plan. You can also join a Medicare Advantage Prescription Drug plan (MA-PD), but you won't be able to sign up for Medigap if you do.
Medigap Plan C and Medigap Plan F in North Dakota
Beginning January 1, 2020, Medigap plans may no longer cover the Medicare Part B deductible. Two plans include this benefit, Medigap Plan C and Medigap Plan F. Neither option is available to new Medicare beneficiaries. You may keep your plan if you already had it, though.
For new enrollees, we recommend Medigap Plan D or Medigap Plan G instead. These plans offer the same benefits as Plans C and F, respectively, minus the Part B deductible. You also usually pay less for one of these plans, despite having to cover the deductible out-of-pocket.
When Is the Best Time to Join a Medicare Supplement Plan in North Dakota?
The best time to join a North Dakota Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It begins the day you are at least 65 years old and enrolled in Medicare Parts A and B.
Your OEP is one of the few times you have guaranteed issue rights. During this 6-month period, Medigap insurers cannot deny you a policy or charge you a higher premium, even if you have preexisting medical conditions.
How to Choose a Medigap Plan in North Dakota
When choosing a North Dakota Medigap plan, you want the best coverage you can afford. If you wait until you're sick to get a more comprehensive plan, medical underwriting may make it impossible.
To compare costs, it helps to know how insurance companies arrive at their rates. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you age. These policies are usually the most expensive option over time.
- Community rated: Also known as no-age rated, these plans charge the same premium regardless of age. Over time, most experts agree that these are the cheapest Medigap plans.
- Issue-age rated: Premiums are based on your age at the time you join the plan, not your age throughout the life of the policy. They may rise over time due to inflation, though.
North Dakota Medigap insurers mostly use attained-age and issue-age pricing.
Our Find a Plan tool makes it easy to compare Medigap plans in North Dakota. Simply enter your location information and coverage start date to review Medicare plan options in your area.
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