Medicare in North Dakota

Medicare enrollment in North Dakota

As of February 2026, there were 152,864 people covered by Medicare in North Dakota.¹ Most people become eligible for Medicare when they turn 65. But nationwide, there are about 6.5 million people under the age of 65 who are covered by Medicare, accounting for about 9% of all Medicare beneficiaries.² This is because Medicare eligibility is also triggered when a person has been receiving disability benefits for 24 months, or has end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). In North Dakota, only about 8% of Medicare beneficiaries – a little more than 12,000 people – are under age 65.¹

• Read about Medicare’s open enrollment period and other important enrollment deadlines.
• Learn how North Dakota’s Medicaid program can provide assistance to Medicare beneficiaries with limited income and assets.

Medicare Advantage plan availability and enrollment in North Dakota

Medicare Advantage plans are offered by private insurers, so plan availability varies from one area to another. There are Medicare Advantage plans for sale in 2026 in all 53 counties in North Dakota. The average Medicare beneficiary in North Dakota can choose from among 10 Medicare Advantage plans in 2026.³

As of February 2026, about 36% of North Dakota Medicare beneficiaries were enrolled in Medicare Advantage.¹ Nationwide, the average was above 50% at that point.²

The other 64% of North Dakota Medicare beneficiaries were enrolled in Original Medicare as of February 2026.¹

Learn more about Medicare Advantage, Medicare’s annual open enrollment period, and the Medicare Advantage open enrollment period.

Sources: Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings, KFF.org, Dec. 9, 2025; Fact Sheet: Medicare Open Enrollment for 2026, Centers for Medicare & Medicaid Services. Sep. 26, 2025

Medicare supplement (Medigap) plan availability in North Dakota

According to AHIP, 50,422 North Dakota residents were enrolled in Medigap plans in 2024,⁴ to supplement their Original Medicare coverage.

Twenty-two insurers offer Medigap plans in North Dakota in 2026.⁵

Learn how Medigap plans are regulated and standardized.

Federal rules require Medigap insurers to offer plans on a guaranteed-issue basis during an enrollee’s open enrollment period, which begins when the person is at least 65 years old and enrolled in Medicare Part B (and Part A; you have to be enrolled in both to obtain Medigap). But federal rules do not guarantee access to Medigap plans for people under age 65.

No access to Medigap for new enrollees under age 65

Many states require Medigap insurers to make coverage available to applicants under age 65, but North Dakota does not. Prior to 2026, North Dakota offered high-risk pool coverage (CHAND) to Medicare beneficiaries under age 65 who were unable to obtain private Medigap coverage.

However, North Dakota enacted legislation in 2025⁶ that ended new enrollments in the high-risk pool as of May 1, 2025. Coverage for existing enrollees terminated at the end of 2025.⁷

Existing enrollees who lost their CHAND coverage had guaranteed-issue access to Medigap coverage (Plans A, B, C, F, high-deductible F, G, K, or L.)⁶

But the legislation did not ensure any form of guaranteed-issue access to Medigap for other North Dakota Medicare beneficiaries under age 65. As of June 2026, Blue Cross Blue Shield of North Dakota was the only insurer that offered Medigap policies to beneficiaries under age 65, and it was only Medigap Plan F. This is important because Plan F is only available to people who became eligible for Medicare prior to 2020.⁸ So Medigap is not available to North Dakota beneficiaries under the age of 65 who are newly eligible for Medicare (or who have become eligible since the start of 2020).

Learn what Medigap covers, who’s eligible for Medigap and when you can enroll.

Medicare Part D plan availability and enrollment in North Dakota

There are 11 stand-alone Medicare Part D plans for sale in North Dakota in 2026 with premiums that start at $4.70/month.⁹

As of February 2026, 88,898 Medicare beneficiaries in North Dakota had stand-alone Medicare Part D plans, and another 31,675 had Medicare Advantage plans that included integrated Medicare Part D coverage.¹

Learn how Medicare Part D prescription drug coverage works, what it pays for, how and when to enroll.

Source: Fact Sheet: Medicare Open Enrollment for 2026, Centers for Medicare & Medicaid Services. Sep. 26, 2025

Resources for Medicare beneficiaries in North Dakota

Have questions about Medicare enrollment or Medicare eligibility in North Dakota?

• You can contact SHIC, the North Dakota State Health Insurance Counseling Program.
• The state’s department of insurance website includes several informational pages that can help to guide you with your Medicare application in North Dakota:
  • Medicare Advantage plans in North Dakota
  • General info about Medicare Supplement plans (Medigap) and North Dakota Medicare Supplement FAQs
  • Medicare Part D plans in North Dakota
• The Medicare Rights Center website provides information geared to Medicare beneficiaries, caregivers, and professionals.