Medicare in North Dakota runs on federal rules, but the state adds free SHIC counseling through the Insurance Department and its own process for applying to the Medicare Savings Programs. This guide covers every part of Medicare for North Dakota residents in 2026: what it costs, what plans exist, and how to get help paying.,

In This Guide

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or North Dakota SHIC at 1-888-575-6611.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government and has two parts. The mechanics and costs are identical in North Dakota and every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The hospital deductible rose $60 from 2025, to $1,736 per benefit period. A benefit period starts the day you're admitted and ends 60 days after you leave the hospital or SNF. Get readmitted after that and the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It doesn't cover routine dental, vision, or hearing.

Part B is technically optional, but nearly everyone signs up. Delay past your enrollment window without other creditable coverage and you'll owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B.

Medicare Advantage in North Dakota (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering. Most bundle in Part D drug coverage along with extras like dental, vision, and hearing.

North Dakota residents in the Fargo, Bismarck, and Grand Forks areas generally see the widest choice of plans. Rural counties across much of the state tend to have fewer options, and some areas may have very limited Medicare Advantage availability. Plan options, networks, and prices change every year and differ by county, so compare what's available at your address before you decide.

How These Plans Work

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions and it shows which plans cover them and your estimated cost. A North Dakota SHIC counselor can help you read the results for free.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, so that higher-cost middle stage is gone. Part D now moves through three phases:

  1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
  2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
  3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

That $2,100 cap is the number that matters most in Part D. It was $2,000 in 2025 and rises with drug-spending growth. The average standalone Part D premium for 2026 is about $40 to $50 a month, though actual plan premiums vary widely. Every plan also has to offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy. People who qualify for Extra Help often pay much less, sometimes nothing.

For a deeper look at how the redesigned Part D benefit works, see our guide to Medicare Part D drug coverage.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.

Medigap in North Dakota

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, never with Medicare Advantage.

North Dakota offers the federally standardized plans, labeled A through N, including high-deductible Plan F and Plan G, regulated under state insurance law. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.,

Your strongest opening is the federal Medigap Open Enrollment Period, the six months that begin when you're 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate regardless of your health. Outside it, North Dakota insurers may use medical underwriting, meaning they can review your health, charge more, or decline you.

North Dakota does not have a state law extending guaranteed-issue Medigap rights to under-65 beneficiaries on Medicare through disability, so access to Medigap before 65 depends on what individual insurers are willing to offer.

Medigap or Medicare Advantage?

You can't hold both. Choose Medigap and you stay on Original Medicare with the freedom to see any provider who takes Medicare nationwide, at a higher monthly premium. Choose Medicare Advantage and you trade some of that freedom for a network and a lower upfront cost. For a side-by-side look at the trade-off, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in North Dakota

If you're on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

North Dakota administers its Medicare Savings Programs through ND HHS Medicaid. The state uses the standard federal income tiers and resource limits, not higher state-set ones.

Program Federal name Individual Couple What it pays
QMB Qualified Medicare Beneficiary Up to about $1,350 Up to about $1,824 Part A and B premiums, deductibles, coinsurance
SLMB Specified Low-Income Medicare Beneficiary Up to about $1,616 Up to about $2,184 Part B premium
QI Qualifying Individual Up to about $1,816 Up to about $2,455 Part B premium

QMB is the most generous, covering your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. For all three programs the 2026 resource limit is $9,950 for one person and $14,910 for a couple. The income figures are tied to the Federal Poverty Level and update each April. You apply through ND HHS, and SHIC counselors (1-888-575-6611) can walk you through the application. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone, so everyone who qualifies now gets the full subsidy.

  • Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
  • Resource limits: $16,590 for an individual, $33,100 for a married couple
  • If you qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically

Apply through Social Security at ssa.gov/benefits/medicare/prescriptionhelp.html or call 1-800-772-1213.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and the same in North Dakota as everywhere else.

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick MA or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch MA plans, move between MA and Original Medicare, change Part D
MA Open Enrollment Jan 1 - Mar 31 Switch MA plans or drop MA for Original Medicare (if already in MA)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your initial window
Medigap Open Enrollment 6 months from age 65 + Part B Buy any Medigap plan at the standard rate, no health screening

Changes you make during Annual Open Enrollment take effect the following January 1. If you're already getting Social Security before 65, you're enrolled in Parts A and B automatically; if not, you sign up yourself through Social Security. If you're still working past 65 with health coverage from a current employer, you can delay Part B without penalty and use an eight-month Special Enrollment Period to sign up after that job or coverage ends; miss that window and you wait for the General Enrollment Period (January 1 to March 31) and may owe a late penalty.

Free Medicare Help: North Dakota SHIC

You don't have to figure this out alone, and you don't have to pay a broker. North Dakota runs the State Health Insurance Counseling program, known as SHIC. It's the state's version of the federal State Health Insurance Assistance Program (SHIP), housed inside the North Dakota Insurance Department. Counselors are trained, give free and unbiased help, and don't sell insurance.

A North Dakota SHIC counselor can help you:

  • Understand your Medicare options and what each part covers
  • Compare Medicare Advantage, Part D, and Medigap plans side by side
  • Apply for Medicare Savings Programs and Extra Help
  • Sort out claims, denials, and appeals

Call 1-888-575-6611 or email ndshic@nd.gov. You can also find local counseling resources through insurance.nd.gov/consumers/medicare.

Key North Dakota Medicare Contacts

North Dakota SHIC (State Health Insurance Counseling) Free, unbiased one-on-one Medicare counseling and plan comparison statewide; counselors do not sell insurance. Email ndshic@nd.gov. 1-888-575-6611 North Dakota Insurance Department
North Dakota Health and Human Services (Medicaid) Applications for the QMB, SLMB, and QI Medicare Savings Programs that help pay your Medicare premiums and cost-sharing. Medicare Financial Assistance Programs
Social Security Extra Help (the Part D Low-Income Subsidy) applications, plus automatic Part A and Part B enrollment questions. 1-800-772-1213 Apply for Extra Help
Medicare Compare Medicare Advantage, Part D, and Medigap plans by ZIP code and get answers to general Medicare questions (1-800-MEDICARE). 1-800-633-4227 Medicare Plan Finder
Your next step Call North Dakota SHIC at 1-888-575-6611 for a free appointment with a trained counselor who can compare your Medicare Advantage, Part D, and Medigap options and screen you for the QMB, SLMB, and QI programs that lower your costs, without ever selling you anything.

Frequently Asked Questions

What does Medicare cost in North Dakota in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the 2026 average runs about $40 to $50), and many Medicare Advantage plans charge no extra premium. Your total depends on the plan you pick and the care you use.

How many Medicare Advantage plans are available in North Dakota?

Plan availability varies by county. Fargo, Bismarck, and Grand Forks residents generally have the widest choice, while many rural areas of the state have few or no Medicare Advantage plans. Use the Medicare Plan Finder or call SHIC at 1-888-575-6611 to see exactly what's available at your address.

What are the Medicare Savings Programs in North Dakota?

North Dakota's Medicare Savings Programs (QMB, SLMB, QI) are administered through ND HHS Medicaid using standard federal income tiers. QMB pays your Part A and B premiums plus all cost-sharing; SLMB and QI pay the Part B premium. You apply through ND HHS, and enrolling automatically qualifies you for Extra Help with Part D.

Who runs Medicare counseling in North Dakota?

The North Dakota Insurance Department runs SHIC (State Health Insurance Counseling), the state's free, one-on-one Medicare counseling program. Call 1-888-575-6611 or email ndshic@nd.gov to reach a trained counselor who doesn't sell insurance.

Learn More

MedicareMedicare Plans by State: What Varies and What Doesn'tOriginal Medicare is the same in all 50 states. Medicare Advantage, Part D, and Medigap rules are not. See what changes by state, then open your state guide. MedicareMedicare: The National GuideWhat is Medicare? A plain guide to Parts A, B, C, and D, who qualifies, 2026 costs, when to enroll, and what it doesn't cover, with help-paying options. MedicareOriginal Medicare vs. Medicare AdvantageCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareHow Medigap WorksMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedicare Part D Drug CoverageMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs.

Find personalized help with Medicare in North Dakota 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.

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