North Dakota's best Medicare Advantage plans center on PPO coverage, as HMO and HMO-POS options don't exist statewide. UnitedHealthcare ranks first with $42 per month premium, a $6,500 out-of-pocket maximum and 4.5-star CMS rating, while Aetna follows with $0 premiums and $4,750 MOOP.
Best Medicare Advantage Plans in North Dakota (2026)
Updated: January 29, 2026
Advertising & Editorial Disclosure
Key Takeaways
North Dakota's Medicare Advantage marketplace offers 12 PPO plans from five providers, but zero HMO or HMO-POS choices for residents.
Among the Peace Garden State's PPO options, UnitedHealthcare earns the highest quality ratings at 4.5 stars, though Aetna provides more affordable zero-cost alternatives.
Find plans where your doctors already practice, check what you'll pay for your prescriptions and weigh monthly savings against potential annual costs.
Best Medicare Advantage Providers in North Dakota
| UnitedHealthcare | 4.50 | $42 | $6,500 | 5.00 | AARP Medicare Advantage from UHC FG-0001 (PPO) |
| Aetna | 3.25 | $0 | $4,750 | 4.38 | Aetna Medicare Elite (PPO) |
| Align powered by Sanford Health Plan | 3.50 | $35 | $4,250 | 4.04 | Align ChoiceElite (PPO) |
| Medica | 3.50 | $92 | $4,750 | 3.73 | Medica Advantage Preferred (PPO) |
| Blue Cross Blue Shield | 3.50 | $104 | $7,375 | 3.39 | NextBlue Discover PPO (PPO) |
Medicare Advantage Plans Explained
Medicare Advantage offers an alternative way to get Medicare benefits through private insurance companies instead of Original Medicare. These plans bundle hospital and medical coverage while adding extras like dental, vision, and prescription drug benefits.
- CMS Star Ratings: Medicare scores plans from 1 to 5 stars based on quality of care and member satisfaction. Higher ratings show better overall performance and customer experience.
- Monthly premiums: You'll pay the standard Part B premium plus any additional plan costs. Many Medicare Advantage plans in the state charge $0 extra monthly fees.
- Maximum out-of-pocket (MOOP) limits: This annual cap protects you from unlimited medical expenses. Once you hit this limit, your plan covers all remaining costs for covered services.
- Prescription drug coverage: Most plans include Part D medication benefits as part of the package. Check that your prescriptions are covered and understand any restrictions or copays.
UnitedHealthcare
MoneyGeek Rating
5/ 5
5/5Affordability
5/5Quality
5/5Availability
CMS Star Rating
4.5Plan Types
PPO
Aetna Medicare
MoneyGeek Rating
4.4/ 5
4.8/5Affordability
3.8/5Quality
4.8/5Availability
CMS Star Rating
3.25Plan Types
PPO
Sanford Health Plan
MoneyGeek Rating
4.0/ 5
4.6/5Affordability
3.8/5Quality
2.5/5Availability
CMS Star Rating
3.5Plan Types
PPO
MEDICA
MoneyGeek Rating
3.7/ 5
3.9/5Affordability
3.8/5Quality
2.6/5Availability
CMS Rating
3.5Plan Type
PPO
PPO PROS AND CONS
PPO Medicare Advantage plans have higher monthly premiums and out-of-pocket maximums. What you get: total choice in providers. See any Medicare-approved doctor without referrals and use out-of-network care when you need it, though it costs more than staying in-network. This makes sense if you travel between states for part of the year, see specialists your network doesn't include or want immediate care without waiting for approval.
How to Find the Best North Dakota Medicare Advantage Plans
The best Medicare Advantage plan in the Peace Garden State depends on your specific doctors, prescription medications, and total healthcare budget, not just monthly premiums.
- 1Check Your Doctor and Hospital Network
Before selecting a Medicare Advantage plan, confirm that your current doctors, specialists and hospitals are part of the plan's network. HMO plans typically require referrals and have more limited networks compared to PPO plans, which offer greater flexibility at higher costs. Whether you're in Fargo or Bismarck, understanding these differences is crucial for maintaining your healthcare relationships. Learn more about health insurance network types.
- 2Compare Maximum Out-of-Pocket Costs
Look beyond just the monthly premium and focus on the maximum out-of-pocket costs when comparing plans. This figure represents the most you'll pay for covered services in a year, which is crucial for understanding your potential financial exposure. For example, a plan with a $0 premium but $7,833 maximum out-of-pocket could cost more than one with a $29 premium and $6,750 maximum if you need frequent medical care in North Dakota.
- 3Review Prescription Drug Coverage
Check the plan's prescription drug coverage by reviewing the medication formulary to see if your medications are covered. Pay attention to the tier placement of your drugs, as this affects your out-of-pocket costs under Part D coverage. Most Medicare Advantage plans include prescription drug coverage, while others require you to purchase a separate Part D plan to ensure complete medication coverage.
- 4Evaluate Additional Benefits
Consider the additional benefits offered by different plans, such as dental, vision, hearing aids, fitness programs and transportation services to medical appointments. These extra benefits can significantly enhance your healthcare experience and may vary widely among plans available in North Dakota. Match these supplemental services to your specific health needs and lifestyle preferences to maximize the value of your Medicare Advantage plan.
- 5Consider CMS Star Ratings
Review each plan's CMS star rating, which ranges from 1 to 5 stars and indicates the quality of care and services provided. Higher ratings reflect better performance in areas like customer service, member satisfaction and health outcomes. Plans earning 4 or 5 stars typically deliver superior care coordination and customer support, helping you make a more informed choice for your healthcare needs.
Average North Dakota Medicare Advantage Cost
North Dakota's Medicare Advantage costs depend on plan type and network flexibility. Plans with broader provider networks typically cost more than those with restricted access to specialists and facilities.
PPO plans are the primary Medicare Advantage option available in the state, with a $50 median monthly premium and $61 average monthly cost. These plans come with a $5,576 average maximum out-of-pocket limit annually. PPO plans cost more because they offer greater flexibility to see out-of-network providers and don't require referrals for specialist visits.
| PPO | $50 | $61 | $5,575 |
Best North Dakota Medicare Advantage: FAQ
Get answers about North Dakota Medicare Advantage plans:
When can I enroll in a Medicare Advantage plan in North Dakota?
In North Dakota, you can enroll during the Annual Enrollment Period from October 15 to December 7, or the Medicare Advantage Open Enrollment Period from January 1 to March 31. You may also qualify for a Special Enrollment Period if you experience qualifying life events like relocating or losing other coverage.
Does Medicare Advantage cover prescription drugs in North Dakota?
Yes, most Medicare Advantage plans in North Dakota include prescription drug coverage as part of their benefits. Before enrolling, confirm your medications appear on the plan's formulary and review their tier levels, which directly impact your out-of-pocket costs at the pharmacy.
Do I need to change Medicare Advantage plans if I move to a different county in North Dakota?
Moving counties may impact your plan's availability since Medicare Advantage networks are location-specific. Contact your current plan within 30 days of relocating to verify coverage in your new area, and utilize the Special Enrollment Period to select a different plan if needed.
Our Methodology: How We Chose the Best North Dakota Medicare Advantage Plans
We assessed Medicare Advantage plans in North Dakota using a scoring system that emphasizes cost and quality. Three core criteria identify plans with the strongest value:
- Affordability (50%): Costs represent half the total score due to their significant influence on your spending. We analyzed combined monthly premiums for Part C and Part D coverage (weighted at 30%) and in-network maximum out-of-pocket limits (weighted at 20%). Plans with lower premiums and MOOP thresholds score higher by reducing annual health care expenses.
- Star Ratings (40%): CMS star ratings assess plan performance in care quality, customer service and member experience. The Overall Star Rating merges Part C (medical benefits) and Part D (prescription drug coverage) scores into one rating on a 1 to 5-star scale. Higher-rated plans score better in our evaluation.
- Availability (10%): We consider each insurer's coverage area across the United States. Providers serving more states score higher, as broader availability indicates more robust infrastructure, better support and better continuity if you relocate.
These factors create a fair comparison of Medicare Advantage plans, weighing costs against care quality and service.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.