Medicare 2026

Medigap Letter Plans Explained for Minot Medicare Users

MINOT, N.D. — Turning 65 in Minot means facing one of the biggest Medicare choices you'll ever make: stick with Original Medicare and add a Medigap policy, or enroll in a Medicare Advantage plan instead. These two paths are built very differently, and the structure — not the marketing — is what shapes how you'll get care and pay for it in the years ahead.

Two different structures, not two versions of the same thing

Original Medicare is the federal program itself — Part A (hospital) and Part B (medical). You can see any doctor or hospital in the country that accepts Medicare, and there's no network. Medicare pays its share, and you're responsible for the rest, which is why most people pair it with a Medigap (Medicare Supplement) policy to cover coinsurance and deductibles. You'd also add a stand-alone Part D plan for prescription drugs.

Medicare Advantage (Part C) is different. It's private insurance that replaces the way you get your Part A and Part B benefits. The federal government pays the plan a set amount each month to manage your care. Most Advantage plans bundle in Part D drug coverage and often extras like dental or vision, but they typically use provider networks (HMO or PPO) and may require prior authorization for certain services.

How care and costs flow on each path

With Original Medicare + Medigap + Part D, you're usually looking at three monthly costs: your Part B premium (paid to Medicare), a Medigap premium (paid to a private insurer), and a Part D premium. In exchange, once your Medigap kicks in, most bills at the doctor or hospital are predictable — you know what's covered before you walk in.

With Medicare Advantage, you still pay your Part B premium, plus any premium the plan itself charges. Costs then come as copays or coinsurance when you use services, up to the plan's annual out-of-pocket maximum. You generally can't add a Medigap policy to an Advantage plan — the two structures aren't designed to work together.

What Minot residents should know about local availability

Minot sits in Ward County, and Medicare Advantage and Part D plan availability is set at the county level. That means the menu of plans a Minot resident can choose from is the same across Ward County, but may look different than what a relative in Bismarck or Fargo sees.

Rural areas across North Dakota have historically leaned more heavily on Original Medicare because provider networks in Advantage plans can be thinner outside metro areas. If you travel to see specialists — say, to Bismarck, Minneapolis, or the Mayo Clinic — the network question matters. Original Medicare travels with you nationwide; an Advantage plan's network usually doesn't.

The drug coverage piece in 2027

No matter which path you pick, prescription drug rules are the same in 2026. Part D has a out-of-pocket cap ($2,100 in 2026, $2,400 in 2027) on covered drugs, and the maximum allowable deductible is $615. The old "donut hole" coverage gap is gone as of 2025, replaced with a simpler three-phase design. If your drug costs land unevenly across the year, the Medicare Prescription Payment Plan lets you spread payments into monthly installments at no added cost.

Higher-income beneficiaries also pay an IRMAA surcharge on Part B and Part D — that kicks in above $109,000 in income for a single filer in 2026, based on your tax return from two years earlier.

The Medigap timing trap

Here's the part many people don't hear until it's too late: your best window to buy a Medigap policy is the six-month Medigap Open Enrollment Period that starts when you're 65 and enrolled in Part B. During that window, insurers can't turn you down or charge more because of your health.

If you start with Medicare Advantage and later want to switch to Original Medicare with a Medigap, insurers in most states — including North Dakota — can medical-underwrite you. That means they can decline you or charge more based on your health history. It's not a reason to avoid Advantage, but it's a reason to go in with your eyes open.

Key dates to remember

• Annual Enrollment Period: Oct. 15 – Dec. 7, when you can join, switch, or drop Advantage and Part D plans.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, when Advantage enrollees can switch plans once or return to Original Medicare.