Benzinga readers prefer UnitedHealthcare as the most affordable North Dakota Medicare provider.
Are you a North Dakota resident in need of affordable Medicare plans? Whether you are new to Medicare or are considering switching plans, it’s important to understand all of your options. Benzinga has put together this guide to help you find the best North Dakota Medicare insurance plans to help you make an informed decision.
Quick Look: Best Medicare in North Dakota
- Best Overall in North Dakota: Humana
- Most Affordable in North Dakota: UnitedHealthcare
- Best Customer Service: HealthPartners
- Best for Cost Plan: Medica
- Best for Medical Savings Account: Lasso Healthcare
Best Medicare Insurance Providers in North Dakota
You might be wondering which health insurers offer Medicare Advantage insurance plans in North Dakota. Below are some of the options you may be able to find in your area.
1. Best Overall in North Dakota: Humana
Humana is a health insurance provider that has offered Medicare Advantage plans for as long as the Medicare program has been around. It offers a large network of reputable doctors and hospitals across the country.
There are several Humana Medicare Advantage plans to choose from. You can select a plan with or without drug coverage, based on your needs. You may also be able to receive additional benefits from your Humana plan, including vision, hearing, dental coverage and fitness benefits.
Pros
- Wide network of doctors and healthcare providers
- Variety of coverage options to choose from
- Offers additional benefits including vision, hearing, dental coverage
Cons
- Limited coverage outside of the network
- Some plan options are not available in certain regions or states
2. Most Affordable in North Dakota: UnitedHealthcare
UnitedHealthcare offers affordable Medicare Advantage plans for residents across North Dakota. With UnitedHealthcare, you may be able to find a plan with a health plan deductible as low as $0. It also offers some of the lowest drug deductibles. UnitedHealthcare also offers vision, hearing and dental coverage as well as telehealth services.
Pros
- Access to large provider network
- Comprehensive coverage for medical services including hospital stays and nursing home facilities
- Offers additional benefits including vision, dental and telehealth services
Cons
- Premiums and out-of-pocket costs can be high
3. Best for Customer Service: HealthPartners
HealthPartners is a good choice if you’re looking for a company that is committed to helping you understand and find the best Medicare option for you. Its website offers a number of resources, including information about Medicare.
You can also compare its Medicare Advantage plans and get a quote for a plan. HealthPartners offers meetings for those who have questions about Medicare, allowing you to meet its sales team in person and talk with other people who are considering their Medicare options.
Pros
- Offers additional benefits and resources
- Provides online and in person customer support
Cons
- Limited choice of health care providers
- Potential for higher costs
4. Best for Cost Plan: Medica
A cost plan is a unique offering that combines the benefits of Original Medicare and Medicare Advantage plans. It allows you to receive coverage outside of your plans network. If the service you receive is covered by Medicare, Original Medicare will pay for the out-of-network service. If you enroll in a cost plan, you can decide to return to Original Medicare at any time. Medica offers cost plans with deductibles as low as $0. It also offers low out-of-pocket maximums.
Pros
- Wide network of healthcare providers for access to quality care
- Offers Medicare cost plans with $0 deductibles
Cons
- Limited coverage for certain services and treatments
5. Best for Medical Savings Account: Lasso Healthcare
Medical Savings Account (MSA) plans are also a unique offering. It combines a high-deductible health plan with a special savings account. The Medicare MSA plan will deposit money into your medical savings account, which you can use to pay health care costs while you are waiting to meet your deductible. After meeting your deductible, Lasso Healthcare offers copays as low as $0. You may also be able to receive hearing benefits with a Lasso plan.
Pros
- Wide range of plans and options to suit individual health care needs
- Offers coverage for additional services including vision, hearing and dental care
- Provides a dedicated customer service team to assist with any questions or concerns
Cons
- Some options may not be available in all areas
What is Medicare?
Medicare is a federal health insurance program. It is offered and regulated by the federal government. You may qualify for Medicare if:
- You are 65 or older.
- You have a disability.
- You need dialysis or a transplant due to end-stage renal disease.
Medicare differs from other types of health insurance. There are multiple parts of Medicare, each of which offer specific coverage.
Part A: Part A is your hospital insurance. This is for inpatient hospital stays, hospice care and care in a skilled nursing facility. You may also be able to receive coverage for home health care.
Part B: Part B is your medical insurance. This covers your outpatient care, medical supplies, preventive care and other types of medical services.
Part C: Part C of Medicare refers to Medicare Advantage plans. Medicare Advantage plans are an alternative Medicare option that is offered by private insurance companies. They combine Part A and Part B Medicare coverage.
Part D: Medicare Part D is your prescription drug coverage. These plans are offered as a supplemental plan that you can add to other parts of Medicare. Some Medicare Advantage plans also include this coverage.
Legalities of Medicare in North Dakota
Medicare is a form of health insurance that is offered and regulated by the federal government. With an Original Medicare plan, you can see any doctor that you would like as long as they accept Medicare insurance.
Medicare Advantage plans are a bit different than Original Medicare. Medicare Advantage plans are offered by private insurance companies, so they are not held to the same regulations as Original Medicare. Medicare Advantage plans are controlled by the insurance provider.
This means that your Medicare Advantage plan may restrict the doctors and specialists that are covered by your plan. It may also require that you receive a referral from your primary care doctor to receive coverage for a specialist visit. Your Medicare Advantage plan may require you to use generic drug treatments instead of brand-name prescription drugs.
If you have a Medicare Advantage plan, you are prohibited from also carrying Medicare Supplemental Insurance. Also known as Medigap coverage, this Medicare supplement plan is designed to fill gaps in your Medicare coverage.
Types of Medicare Advantage Plans
If you decide to look into Medicare Advantage plans, you should know that there are a few different types of plans that are offered. Here’s a quick overview of the 2 most common types of plans.
HMO: HMO plans are health maintenance organization plans that include both Part A and Part B of Medicare insurance. It may also include Medicare Part D, as well as vision, dental and hearing benefits.
Each insurance company has its own network of providers that participate with the plan. An HMO plan only covers visits with in-network medical service providers. It may also require a referral from an in-network primary care doctor before the plan covers a visit with a specialist.
PPO: PPO plans are preferred provider organization plans that include both Part A and Part B of Medicare insurance. Like HMO plans, it may also include Part D of Medicare with vision, dental and hearing coverage.
Networks are different with PPO plans. Your PPO has a network of participating doctors and hospitals, but you are not restricted to only visiting in-network providers. Know that if you visit a provider that is out-of-network, you can expect to pay more for your visit. One of the benefits of a PPO plan is that it typically does not require a referral before you can receive coverage for a specialist visit.
When comparing plans, there are a few key terms to pay attention to:
Deductible: Each health insurance plan comes with its own deductible. Your deductible is the amount of money that you have to pay out-of-pocket for your medical services before your insurance provider contributes toward your medical bills.
Coinsurance: After you’ve met your deductible, your insurance plan may require you to pay coinsurance amounts. Coinsurance is a percentage that you will have to pay of each medical bill you receive after meeting your deductible. This means that the price that you need to pay will vary depending on how much the medical bill is.
Copayment: You may find that a plan uses copayment, or copay, instead of coinsurance. Copays are a set amount of money that you are required to pay for each medical visit after you have met your deductible. The amount you need to pay may vary depending on the type of service you receive. For example, a visit with your primary care doctor may have a $10 copay, but you may need to pay a $30 copay for a specialist visit or $50 for an outpatient hospital visit. If your plan uses copays, the plan information will detail the costs for each type of service.
Premium: Your premium is the amount of money you will pay each month to keep your health insurance plan active. Some plans offer low premiums with higher costs in other places, such as a higher deductible. Be sure to take this into account when you are comparing your health insurance options.
Out-of-pocket maximum: Each plan also comes with an out-of-pocket maximum. This amount is the most you will have to pay out-of-pocket for your medical services. This includes the money you pay for your deductible, as well as your copays and coinsurance payments. After you’ve met the plans out-of-pocket maximum, the insurance company will pay 100% for your covered medical services.
How to Sign Up for Medicare in North Dakota
There are a few ways you can sign up for Medicare Part A and Part B coverage in North Dakota:
- Enroll online.
- Call Social Security Monday through Friday from 7 a.m. to 7 p.m. at 800-772-1213.
- Visit a Social Security office near you.
If you’re interested in a Medicare Advantage plan, you will first need to find the plans available in your area. You can enter your ZIP code online to find the plans that are available to you.
Once you’ve found a Medicare Advantage plan that you’d like to enroll in, you can:
- Visit the insurance company’s website to see if it offers the option to enroll online.
- Contact the insurance company to request a paper enrollment form.
- Call 800-MEDICARE (800-633-4227).
Average Cost of Medicare Advantage Plans in North Dakota
When comparing Medicare Advantage plans, you will probably notice that the cost of each plan can be very different. You should pay close attention to the terms listed above to understand each plan’s coverage option and true cost. Here are some examples of North Dakota Medicare Advantage costs.
| Plan Name | Company | Plan Type | Health & Drug Costs |
|---|---|---|---|
| AARP Medicare Advantage Headwaters | UnitedHealthcare | PPO | $0 |
| HumanaChoice H5216-086 | Humana | PPO | $13.52 |
| Medica Prime Solution Core | Medica | Cost | $1,009 |
| Lasso Healthcare | Lasso Healthcare | MSA | $2,844 |
| HealthPartners Sanford Basic | HealthPartners | Cost | $3,271 |
*A cost plan is a unique offering that combines the benefits of Original Medicare and Medicare Advantage plans. It allows you to receive coverage outside of your plans network.
Your Next Steps
Now that you’re more familiar with Medicare, take some time to consider what your medical needs are. If you’re in good health, you might feel comfortable with a plan that offers low premiums and high deductibles. If you have prescription drug needs, you may want to look into Medicare Part D plans or find a Medicare Advantage plan with drug coverage included.
Once you’ve identified your needs, you’re ready to compare health plans. Be sure to consider all parts of Medicare before deciding which plan you’d like to enroll in. Keep in mind that Medicare Advantage plans may vary from county to county. You’ll want to be sure that you’re only looking at plans offered in your area before making any decisions.
The best Medicare option is the one that works for you and your health needs.
Frequently Asked Questions
What are the different parts of Medicare?
Medicare has four parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Is Medicare free?
Because there are four parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.
Should I keep my health insurance if I have Medicare?
Yes, it is recommended to keep your health insurance even if you have Medicare. While Medicare provides coverage for certain medical expenses, it may not cover everything. Having additional health insurance can help fill in the gaps and provide you with more comprehensive coverage. Additionally, having multiple sources of insurance can offer you more flexibility in choosing health care providers and accessing different services. It is important to review your existing health insurance coverage and consult with a qualified health care professional to determine the best course of action for your specific situation.
About Ashley Hart
Ashley Hart is a personal finance writer passionate about helping people feel empowered to take control of their finances. She has more than eight years of writing experience, focused on insurance.