North Dakota Medicare Supplement Plans: Apply Early, 63-Day Rules

Insurers selling Medicare Supplement plans in North Dakota can't turn you down or charge more because of your health if you apply by the end of your six-month open enrollment window.1 North Dakota's six-month Medigap open enrollment window starts the first month you are 65 or older and enrolled in Medicare Part B, and after it a Medicare Supplement insurer may underwrite your application and can turn you down unless a guaranteed issue situation applies.1

In This Guide

• Can you apply for Medigap before your Part B starts?
• Will a health condition delay your North Dakota Medigap coverage?
• Can you change your Medicare Supplement plan later in North Dakota?
• When must a North Dakota insurer sell you a policy later?
• What does turning 65 mean if you have Medicare under 65?
• Which plans can you buy, and how are they priced?
• What must the insurer give you once you buy?
• What changes if you pick Medicare Advantage instead of Medigap?
• How do North Dakota's Medicare Supplement deadlines line up?
• Where can you get Medicare Supplement help in North Dakota?
• Frequently Asked Questions
• Learn More

Can you apply for Medigap before your Part B starts?

Yes. North Dakota's open enrollment rule, North Dakota Administrative Code (N.D. Admin. Code) 45-06-01.1-09, bars an issuer from denying, conditioning, or pricing a Medicare supplement policy based on health status, claims experience, receipt of health care, or medical condition when the application is submitted "prior to or during" the six-month period that begins with the first day of the first month the applicant is both 65 or older and enrolled in Medicare Part B.1 A North Dakotan whose Part B starts in April can therefore send a Medigap application in the months before April and keep the open enrollment protections.

Three details of the North Dakota rule matter when you plan the application:1

• Every policy on offer: each Medicare supplement policy an insurer currently offers in North Dakota must be made available to every applicant who qualifies under the open enrollment rule, without regard to age.
• The clock follows Part B: the North Dakota Medigap window starts in the first month you are both 65 or older and enrolled in Part B, so someone who delays Part B past 65 starts the six months when Part B begins.
• No health-based pricing: during the window, a North Dakota Medigap insurer may not charge you more because of your health or claims history.

The North Dakota Insurance Department says the same thing in plain terms: if you are 65 or older and apply within the six-month period, you cannot be denied Medigap insurance because of health problems, and you can choose any Medigap policy sold by any insurer selling Medigap in North Dakota.1 The Department also warns that after the six months you can still apply, but you may be subject to underwriting, where the company can turn down your application.1

North Dakota's window sits on top of the federal Medigap Open Enrollment Period. Section 1882 of the Social Security Act gives the same protection nationwide to an application submitted before or during the six months beginning with the first month a person is 65 or older and enrolled in Part B, and Medicare.gov calls it a one-time period that doesn't repeat every year.2 Brevy's guide to the Medigap open enrollment period covers the federal window in depth.

Will a health condition delay your North Dakota Medigap coverage?

A pre-existing health condition can delay North Dakota Medigap benefits for up to six months, though prior creditable coverage or a guaranteed issue right can shorten or remove the wait. N.D. Admin. Code 45-06-01.1-09 still allows a North Dakota Medigap policy to exclude benefits during its first six months for a pre-existing condition that was treated or diagnosed during the six months before the coverage took effect, except where the rule's creditable coverage and guaranteed issue provisions say otherwise.1

Prior health coverage shrinks that wait for a North Dakota open enrollment applicant:1

• Six months or more of continuous creditable coverage as of the application date: the North Dakota Medigap issuer may not exclude benefits based on a pre-existing condition.
• Less than six months: the issuer must reduce any pre-existing condition exclusion by the total period of creditable coverage.

Gaps matter. Medicare's guide Choosing a Medigap Policy says many types of health coverage can count as creditable coverage for Medigap, but only if the break in coverage was no more than 63 days.1

North Dakota's insurance statute sets an outer limit too. Under North Dakota Century Code (N.D.C.C.) chapter 26.1-36.1, a Medicare supplement policy may not deny a claim for losses incurred more than six months after the coverage's effective date because of a pre-existing condition.1 The same North Dakota statute bars a policy from defining a pre-existing condition more restrictively than a condition for which a physician gave medical advice or recommended or provided treatment within the six months before coverage began.1 Brevy's guide to Medigap and pre-existing conditions explains the waiting period nationally.

Can you change your Medicare Supplement plan later in North Dakota?

You can apply to change, but the new insurer can say no. The North Dakota Insurance Department's Medicare Supplement FAQ says you may change your supplement plan at any time, but you may be subject to underwriting for approval.1 The Department's advice for a switch is to buy only one supplement and not to cancel your current plan until the new one has an effective start date.1

Federal rules frame the same risk from the other side. Medicare.gov states that, under federal rights, in most cases you won't be able to switch Medigap policies outside your six-month Medigap Open Enrollment Period unless you have a guaranteed issue right, and that switching outside it may mean paying more and answering medical questions.3 Medicare.gov also warns that if you drop a Medigap policy, you might not be able to get it or any policy back later.3

One federal protection helps once a new insurer says yes. Under Section 1882(s)(2)(C) of the Social Security Act, a Medigap policy that replaces one in effect for six months or longer may not impose a new pre-existing condition, waiting, elimination, or probationary period for similar benefits.3

When must a North Dakota insurer sell you a policy later?

After certain coverage losses. N.D. Admin. Code 45-06-01.1-09.1 says that for an eligible person, a Medigap issuer may not deny or condition certain Medigap policies it offers to new enrollees, may not price them based on health status, claims experience, receipt of health care, or medical condition, and may not impose a pre-existing condition exclusion.1 The North Dakota guaranteed issue right reaches only certain Medigap policies, not every plan an insurer sells, so read Brevy's guide to Medigap guaranteed issue rights and ask the insurer which policies your situation opens.

Which situations open a North Dakota guaranteed issue window?

The people eligible for guaranteed issue under N.D. Admin. Code 45-06-01.1-09.1 include those in these situations:1

• Employer coverage ends: you are in an employee welfare benefit plan that supplements Medicare, and the plan ends or stops providing all of those supplemental benefits to you.
• A Medicare Advantage plan ends or you move: among other listed circumstances, the plan's certification is terminated, the organization stops offering the plan where you live, or you are no longer eligible because you moved.
• Your Medigap insurer fails: your Medicare supplement coverage ends because the insurer became insolvent, or because of another involuntary termination.
• A first-time switch doesn't work out: you dropped a Medigap policy to enroll for the first time in a Medicare Advantage plan or another listed arrangement, then ended that enrollment within the first 12 months.
• A plan chosen at 65 doesn't work out: on first becoming eligible for Part A at 65, you joined a Medicare Advantage plan or a Program of All-Inclusive Care for the Elderly (PACE) provider and left no later than 12 months after enrollment took effect.

The North Dakota Insurance Department gives employer group coverage that ends and leaving a Medicare Advantage plan for the first time during the 12-month trial period as examples, and adds that there may also be other circumstances.1

Proof and deadlines

N.D. Admin. Code 45-06-01.1-09.1 requires a guaranteed issue applicant to submit evidence of the date of termination, disenrollment, or Medicare Part D enrollment with the Medigap application.1 Medicare's Choosing a Medigap Policy guide says to keep copies of letters, notices, emails, or claim denials with your name on them as proof that your coverage was terminated, and says you may need to include some or all of them with your Medigap application to prove a guaranteed issue right.1

The same North Dakota rule sets how long each guaranteed issue window lasts:1

• Employer coverage ends: the window begins on the later of the date you receive the termination notice (or, with no notice, a claim denial caused by the termination) and the date coverage ends, and it closes 63 days after that.
• Certain involuntary terminations: the window opens on the date you receive the termination notice and closes 63 days after the coverage ends.
• Certain voluntary disenrollments: the window opens 60 days before the disenrollment takes effect and closes 63 days after that date.

The 60-day early start lets a North Dakotan who is leaving a plan voluntarily apply for Medigap before the old coverage ends. N.D. Admin. Code 45-06-01.1-09.1 also requires the organization, issuer, or plan administrator to tell you about your guaranteed issue rights at the same time it notifies you of the termination, and, where the rule applies to a disenrollment, within ten working days of the issuer receiving notification of it.1

What does turning 65 mean if you have Medicare under 65?

North Dakota's open enrollment rule is written around applicants who are both 65 or older and enrolled in Part B.1 Medicare.gov states that people under 65 who have Medicare because of a disability might not be able to buy a Medigap policy until they turn 65, because federal law generally doesn't require insurance companies to sell Medigap policies to people under 65, although insurers in some states do offer them.2

Turning 65 changes the picture. Because both the federal Medigap Open Enrollment Period and North Dakota's window begin in the first month a person is both 65 or older and enrolled in Part B, someone who already has Part B through disability reaches that month at 65.2,1 If you are under 65 and want a Medigap policy now, ask the North Dakota Insurance Department about your options.

Which plans can you buy, and how are they priced?

The North Dakota Insurance Department says consumers in North Dakota can currently buy one of 10 standardized supplement plans offered by private companies, each with a letter designation.1 Benefits are identical for every Medicare supplement plan of the same letter, which the Department calls standardization, but premiums vary by company, so the Department says it is important to compare companies.1

Medicare's 2026 Choosing a Medigap Policy guide charts the lettered plans as A, B, C, D, F, G, K, L, M, and N, and says every insurance company that sells Medigap must offer at least Plan A.1 Medigap Plans C and F are closed to people new to Medicare: the Centers for Medicare & Medicaid Services (CMS) states that plans sold to people new to Medicare on or after January 1, 2020 can't cover the Part B deductible, so those people have the right to buy Plans D and G instead.1 Brevy's comparison of Medigap Plan G and Plan N sets two common letters side by side.

How a North Dakota Medigap premium changes over time depends on the rating method. The Department describes three:1

• Attained age: the premium increases annually as you age.
• Issue age: the premium is based on the age at which you bought the policy.
• No age: everyone pays the same premium regardless of age.

CMS names the same three methods as community-rated (no-age-rated), issue-age-rated (entry-age-rated), and attained-age-rated.1 The North Dakota Insurance Department says it monitors and approves the rates supplement companies charge, and tells buyers to look for the words "Medicare Supplement" on the policy.1 Brevy's guide to how Medigap premiums are priced explains the rating methods in more detail.

What must the insurer give you once you buy?

North Dakota law adds four protections once you buy a Medicare supplement policy:1

1. An outline of coverage at application: under N.D.C.C. 26.1-36.1-05, no Medicare supplement policy may be delivered in North Dakota unless an outline of coverage is given to the applicant when the application is made.
2. A 30-day return right: under N.D.C.C. 26.1-36.1-06, the policy's first page must say you may return it within 30 days of its delivery and have the premium refunded if you are not satisfied for any reason.
3. Guaranteed renewability: for North Dakota Medigap coverage effective on or after June 1, 2010, N.D. Admin. Code 45-06-01.1-06.1 requires every policy to be guaranteed renewable and bars the insurer from canceling or nonrenewing it for any reason other than nonpayment of premium or material misrepresentation.
4. Automatic benefit updates: for coverage effective on or after June 1, 2010, benefits designed to cover Medicare cost-sharing must change automatically to match changes in Medicare's deductibles, copayments, or coinsurance, and premiums may be adjusted to match.

CMS calls the 30-day window the "free look period" and says it starts when you get your new Medigap policy.1 CMS also states that any new Medigap policy issued since 1992 is guaranteed renewable even if you have health problems.1

What changes if you pick Medicare Advantage instead of Medigap?

The two don't combine. The CMS booklet Understanding Medicare Advantage Plans says you can't use Medigap to pay Medicare Advantage Plan copayments, coinsurance, deductibles, or premiums.4 The same CMS booklet says it's illegal for anyone to sell you a Medigap policy while you're in a Medicare Advantage Plan unless you're switching back to Original Medicare, and it tells readers to report such a sales attempt to the State Insurance Department.4 Brevy's guide to illegal Medigap sales walks through that federal rule.

Leaving Medigap for Medicare Advantage can be hard to undo. CMS states that in most cases, if you drop a Medigap policy to join a Medicare Advantage Plan, you may not be able to get the same policy back.4 CMS also describes a federal "trial right": a person who joins a Medicare Advantage Plan for the first time and isn't happy with it can buy a Medigap policy on returning to Original Medicare within 12 months of joining.4 North Dakota's version appears in the guaranteed issue situations above, and Brevy's comparison of Original Medicare and Medicare Advantage covers the wider choice.

How do North Dakota's Medicare Supplement deadlines line up?

Sources for the table: N.D. Admin. Code 45-06-01.1-09 and 45-06-01.1-09.1, N.D.C.C. 26.1-36.1-06, and the North Dakota Insurance Department's Medicare Supplement pages.1

Where can you get Medicare Supplement help in North Dakota?

The North Dakota Insurance Department's Medicare Supplement page lists its phone number as (701) 328-2440.1 For more information on guaranteed issue situations, the Department points readers to its State Health Insurance Counseling (SHIC) program.1 Medicare's Choosing a Medigap Policy guide says to visit shiphelp.org to find the number for your local State Health Insurance Assistance Program (SHIP).1

For questions about Original Medicare itself, 1-800-MEDICARE (1-800-633-4227) is the official Medicare line run by CMS; TTY users call 1-877-486-2048, and Medicare.gov says you can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays.5 Brevy's North Dakota Medicare hub covers the state's other Medicare options, and Brevy's guide to North Dakota Medicare Savings Programs covers help paying Medicare costs.

Learn More

Find personalized help timing a North Dakota Medigap application around your Part B start date or a 63-day guaranteed issue window at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.