Best Medicare Supplement Plans in North Dakota 2026
North Dakota has over 65,000+ Medigap enrollees. Plan G starts at $127/mo in Fargo and averages $178/mo statewide. We compared 15+ carriers to find the best coverage in the Peace Garden State.
North Dakota Has No Birthday Rule: Your Initial Plan Choice Matters
Unlike California, Oregon, and other states with birthday rules, North Dakota does not give you an annual window to switch Medigap carriers without underwriting. Once your 6-month Open Enrollment Period ends, you will face health questions if you try to change plans. Compare carriers carefully before you enroll and consider long-term rate stability, not just today's lowest premium.
North Dakota has over 90,000 residents enrolled in Medicare Supplement Insurance, also called Medigap. The state follows standard federal Medigap rules, offering plans A through N with no state-specific modifications. Plan G is the most popular choice for new enrollees, covering nearly all Medicare out-of-pocket costs except the annual Part B deductible ($283 in 2026).
North Dakota does not have a birthday rule or anniversary rule, which means your 6-month Open Enrollment Period when you first turn 65 and enroll in Part B is your best and most important opportunity to lock in coverage. After that window closes, carriers can use medical underwriting to deny your application or charge higher premiums based on your health history.
Plan G premiums in Fargo range from $127/mo (Mutual of Omaha) to $218/mo (AARP/UHC) for a 65-year-old. Sanford Health Plan is the dominant local carrier in North Dakota, offering integrated coverage with the Sanford Health system across Fargo, Bismarck, and Grand Forks. State Farm stands out with an A++ AM Best rating and a local agent network statewide.
Compare the Best Medicare Supplement Plans in North Dakota
Our top-rated Medigap carriers in North Dakota, ranked by the MedicareFAQ Score. Premiums shown are for a 65-year-old female nonsmoker in Fargo. Rates in Bismarck, Grand Forks, and Minot may vary slightly.
Atlantic Capital
Plan G
$127/mo
Plan N
$95/mo
AM Best
A- (Excellent)
Atlantic Capital offers the lowest Plan G in North Dakota at $127/mo, which is 29% below the state average of $178. Plan N at $95/mo is the second-lowest in the state. Atlantic Capital also offers a high-deductible Plan G option for budget-conscious enrollees.
Cigna
Plan G
$139/mo
Plan N
$91/mo
AM Best
A (Excellent)
Cigna offers the lowest Plan F in North Dakota at $144/mo (38% below average) and the lowest Plan N at $91/mo (33% below average). Plan G at $139/mo is also competitive. Cigna only offers Plans A, F, G, and N, but it is the price leader in all three of the most popular plan types.
Blue Cross Blue Shield of North Dakota
Plan G
$180/mo
Plan N
N/A/mo
AM Best
A (Excellent)
BCBS of North Dakota is the dominant local carrier with the lowest Plan A ($114/mo) and Plan C ($212/mo) in the state. As the largest insurer in North Dakota, BCBS has the widest provider network and strong name recognition. Plan G at $180/mo is above average but comes with local service and network advantages.
State Farm
Plan G
$160/mo
Plan N
N/A/mo
AM Best
A++ (Superior)
State Farm earns the highest possible AM Best rating (A++) and offers local agents across Fargo, Bismarck, Grand Forks, and rural North Dakota. State Farm has the lowest Plan D at $160/mo in the state. Plan G at $160/mo is competitive and comes with in-person service.
Transamerica
Plan G
$168/mo
Plan N
N/A/mo
AM Best
A (Excellent)
Transamerica is the only carrier in North Dakota offering all 10 standardized Medigap plan types. It offers the lowest Plan K ($75/mo) and Plan L ($111/mo) in the state. Issue-age pricing keeps rates stable over time.
Medicare Supplement Prices in North Dakota
Sample monthly premiums from top carriers in Fargo for a 65-year-old female nonsmoker. Rates may include available household discounts. North Dakota uses attained-age rating for most carriers, so premiums will increase as you age.
| Insurance Company | Plan G Monthly | Plan N Monthly | Plan F Monthly |
|---|---|---|---|
| Atlantic Capital | $127 | $95 | $149 |
| Cigna | $139 | $91 | $144 |
| State Farm | $160 | N/A | N/A |
| Gov. Personnel Mutual | $161 | $105 | N/A |
| LifeShield National | $164 | N/A | $197 |
| USAA* | $165 | N/A | N/A |
| AFLAC | $166 | $111 | $189 |
| Transamerica | $168 | N/A | N/A |
| BCBS of ND | $180 | N/A | N/A |
Source: ND Insurance Department, FairSquare Medicare, MoneyGeek, May 2026. Rates shown for a 65-year-old female nonsmoker in Fargo.
Plan G vs. Plan N in North Dakota
Plan G and Plan N are the two most popular Medigap plans for new enrollees in North Dakota. Plan G offers more complete coverage; Plan N costs less each month but includes small copays.
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A hospital coinsurance | Covered | Covered |
| Part B coinsurance (20%) | Covered | Covered* |
| Part A deductible ($1,736) | Covered | Covered |
| Part B deductible ($283) | Not covered | Not covered |
| Part B excess charges | Covered | Not covered |
| Skilled nursing coinsurance | Covered | Covered |
| Foreign travel emergency | Covered | Covered |
| Office visit copay | $0 | Up to $20 |
| ER copay (no admission) | $0 | Up to $50 |
| Avg. monthly premium (Fargo) | $127-$145 | $93-$110 |
*Plan N covers Part B coinsurance but may charge up to $20 for some office visits and up to $50 for ER visits that do not result in inpatient admission. North Dakota allows excess charges, so Plan N enrollees should confirm their doctors accept Medicare assignment.
North Dakota has no birthday rule, so your initial enrollment decision is the most important one you will make. Mutual of Omaha at $127/mo is the lowest Plan G in Fargo and has an A+ AM Best rating with a strong track record of rate stability. If you want to stay within the Sanford Health system, Sanford Health Plan offers integrated coverage across Fargo, Bismarck, and Grand Forks. State Farm at $138/mo is the best pick if you want an A++ rating and prefer working with a local agent. BCBS of North Dakota is a strong regional option if you value local brand recognition and a large provider network. Call ND SHIP at ndshic.com for free, unbiased help.
North Dakota Medigap Rules You Should Know
No Birthday Rule in North Dakota
North Dakota does not have a birthday rule. Once your 6-month Open Enrollment Period ends, you will face medical underwriting if you try to switch carriers or plans. Your initial enrollment decision is the most important one you will make.
Attained-Age Pricing is the Dominant Method
Most North Dakota carriers use attained-age pricing, which means your premium increases as you get older. Transamerica is a notable exception, offering issue-age pricing that locks your rate at enrollment age.
Open Enrollment Period: 6 Months Starting at 65
Your Medigap Open Enrollment Period begins the month you turn 65 and enroll in Medicare Part B. During this 6-month window, no carrier can deny you coverage or charge higher rates due to health conditions.
Plan F Closed to New Enrollees Since 2020
Plan F is only available if you were eligible for Medicare before January 1, 2020. New enrollees must choose Plan G or another available plan.
Under-65 Medigap Coverage Not Required
North Dakota does not require carriers to offer Medigap to Medicare beneficiaries under age 65. If you have Medicare due to disability before age 65, you may have limited options and higher premiums.
ND SHIC Free Counseling Available
The North Dakota Senior Health Insurance Counseling Program (ND SHIC) offers free, unbiased Medicare guidance from certified volunteers. Visit ndshic.com to find a counselor in your area.
MedicareFAQ Scoring Methodology
The MedicareFAQ Score rates Medicare Supplement carriers on a scale of 1.0 to 5.0 based on five key factors. Our ratings are independent and not influenced by advertising relationships.
Financial Strength (AM Best Rating)
AM Best ratings from A++ to A- indicate the carrier's ability to pay claims. We weight this heavily because Medigap is a long-term product.
Premium Competitiveness
Plan G and Plan N rates compared to the North Dakota state average. Lower premiums relative to the market earn higher scores.
Customer Satisfaction and Complaint Ratio
NAIC complaint index scores and J.D. Power ratings. Lower complaint ratios indicate better claims handling and customer service.
Pricing Method Stability
Issue-age and community-rated plans score higher than attained-age plans because premiums are more predictable over time.
Plan Availability and Discounts
Carriers offering more plan types and household discounts (typically 5-7% for two people in the same household) score higher.
Last updated: May 2026 | Data sources: NAIC complaint ratios, AM Best ratings, CMS Medicare Plan Finder, ND Insurance Department, FairSquare Medicare
Frequently Asked Questions
What is the cheapest Medicare Supplement plan in North Dakota?
Plan K is the cheapest plan type in North Dakota at $84/mo on average. For comprehensive coverage, Plan G starts at $127/mo (Atlantic Capital) and Plan N starts at $91/mo (Cigna). The right plan depends on your health needs and budget.
Does North Dakota have a birthday rule for Medigap?
No. North Dakota does not have a birthday rule. Unlike California, Oregon, and other states that give you an annual window to switch carriers without underwriting, North Dakota follows standard federal rules. Once your Open Enrollment Period ends, you will face health questions if you try to change plans.
What is the best Medicare Supplement carrier in North Dakota?
For the lowest Plan G premium, Atlantic Capital at $127/mo is the best choice. For the lowest Plan N and Plan F, Cigna at $91/mo and $144/mo respectively are the price leaders. For the highest financial strength with local agents, State Farm at $160/mo with an A++ rating is the top pick.
Is BCBS of North Dakota a good Medigap option?
Yes. BCBS of North Dakota is the largest insurer in the state with the widest provider network. Plan G at $180/mo is above average, but BCBS offers the lowest Plan A ($114/mo) and Plan C ($212/mo). It is a strong choice if you value local service and network breadth over the lowest premium.
What does Plan G cover in North Dakota?
Plan G covers nearly all Medicare out-of-pocket costs: the Part A hospital deductible ($1,736 in 2026), Part A coinsurance, Part B coinsurance (20%), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost not covered is the annual Part B deductible ($283 in 2026).
Can I switch from Medicare Advantage to Medigap in North Dakota?
Yes, but it is harder after your first year on Medicare. During your first 12 months on Medicare Advantage, you have a trial right to switch back to Original Medicare and enroll in Medigap without underwriting. After that, you will generally need to pass medical underwriting unless you qualify for a guaranteed issue right.
What is attained-age pricing and why does it matter?
Attained-age pricing means your Medigap premium increases as you get older. Most North Dakota carriers use this method. Your premium at age 75 will be significantly higher than at age 65. Transamerica offers issue-age pricing, which locks your rate at your enrollment age and is generally more favorable long-term.
How do I get free Medicare counseling in North Dakota?
The North Dakota Senior Health Insurance Counseling Program (ND SHIC) offers free, unbiased Medicare guidance from certified volunteers. Visit ndshic.com to find a counselor in your area. The ND Department of Insurance also publishes rate comparisons and handles consumer complaints.
Free Medicare Counseling in North Dakota
The North Dakota SHIP (State Health Insurance Assistance Program) provides free, unbiased Medicare counseling. Call ndshic.com or visit nd.gov/aging to connect with a counselor in your area. SHIP counselors can help you compare plans, understand your enrollment rights, and navigate the Medicare system at no cost.
Find the Best Medigap Rate in Your North Dakota ZIP Code
North Dakota has no birthday rule, so your Open Enrollment Period is your best chance to lock in coverage without health questions. Plan G starts at $127/mo in Fargo. Compare all available carriers in your area before enrolling.