UPDATED: SEPTEMBER 05, 2023 | 2 MIN READ
In 2022, North Dakota state residents pay an average of $382 each month for individual healthcare, a 4% decrease from the year before. When shopping for health insurance in North Dakota, you must consider your prescription costs, how often you visit the doctor, and other factors. To understand the coverage offered and the associated costs, learn more about the healthcare market in North Dakota below.
North Dakota Open Enrollment Dates For Health Insurance
In North Dakota, the Open Enrollment period for health insurance runs from November 1st to January 15th.
North Dakota Health Insurance Demographics
Health insurance companies consider many factors when calculating an individual’s rate: gender, age, zip code, and more. Here’s a quick glimpse into North Dakota’s demographics that may play a role in your healthcare costs:
- Median Household Income: The median household income in North Dakota is $65,315, slightly above the United States median income of $64,994.
- Median Age Range: North Dakota’s median age range is 25-34, at 15.2% of the state’s population. Residents over 65 are right behind at 15.2%. North Dakota’s largest age range is 35-54.
- Education: Around 93% of North Dakotans are high school graduates. Roughly 30% graduated college, and 6% are currently enrolled.
What Type Of Health Insurance Marketplace Does North Dakota Have?
North Dakota doesn’t have its Marketplace, so all enrollments are completed via HealthCare.gov or an approved enrollment entity.
How many people are insured through the North Dakota insurance Marketplace?
During North Dakota’s 2021 Open Enrollment Period, 22,709 people enrolled in private plans. During the first two and a half months of enrollment, 2,400 residents enrolled in coverage — more than double during the same period in prior years.
In many federally-run states, enrollment peaked in 2016 and decreased yearly through 2020, with enrollment rates increasing in 2021. In North Dakota, the first decline occurred in 2019, then again in 2020. Enrollment then reached a record high in 2021.
Did North Dakota implement the ACA’s Medicaid expansion?
North Dakota expanded Medicaid in January 2014, and the decision has been revisited over the years. Based on the initial legislation passed in 2013, the expansion was set to expire at the end of July 2017. North Dakota extended the program through July 2019 and enacted additional legislation to extend expansion through July 2021. The state reauthorized Medicaid expansion again in 2021.
As of May 2021, 111,357 North Dakota residents enrolled in Medicaid/CHIP.
When can you purchase ACA insurance in North Dakota?
North Dakota’s Open Enrollment Period for individual/family coverage runs from November 1 to January 15. If you don’t enroll during this window, you’ll need a qualifying event to enroll or make changes.
Types of ACA Plans In North Dakota
North Dakota’s ACA plans have five metal tiers: Catastrophic, Bronze, Bronze Expanded, Silver, and Gold. Your premium depends on the tier you choose. In North Dakota, Gold plans have the highest premiums, and Catastrophic plans have the lowest.
What carriers offer ACA health insurance in North Dakota?
North Dakota has three health insurance carriers in the Marketplace:
- Medica
- Blue Cross Blue Shield of North Dakota (Noridian)
- Sanford
Blue Cross Blue Shield of North Dakota and Sanford service the entire state. Medica covers all but a few counties in the northwestern and central areas of North Dakota.
How Much Does Health Insurance Cost In North Dakota?
On average, North Dakota state residents pay $382 for an individual healthcare plan. The actual rate depends on zip code, gender, and age.
Cheapest Health Insurance By Metal Tier In North Dakota
North Dakota has five metal tiers available. However, not everyone will qualify for a catastrophic plan. Below are the cheapest individual plans for type of plan.
| Metal Tier | Cheapest Plan | Monthly Premium | Deductible | Maximum Out-of-Pocket |
|---|---|---|---|---|
| Catastrophic | Sanford TRUE | $160 | $8,700 | $8,700 |
| Bronze | Altru Prime by Medica Bronze Value | $305 | $8,000 | $8,700 |
| Bronze Expanded | Sanford TRUE | $245 | $7,000 | $8,700 |
| Silver | Sanford TRUE | $420 | $4,750 | $8,700 |
| Gold | Sanford TRUE | $385 | $1,750 | $6,750 |
Cheapest Health Insurance By County
Health insurance costs often vary by location. However, North Dakota residents don’t see a large difference in prices for individual and family plans throughout the state.
| County Name | Cheapest Plan | Individual, Age 40 | Couple, Age 40 | Couple, Age 40 & Child |
|---|---|---|---|---|
| Burleigh | Sanford TRUE | $420 | $840 | $1,090 |
| Cass | Sanford TRUE | $420 | $840 | $1,090 |
| Grand Forks | Altru Prime by Medica Silver | $450 | $900 | $1,170 |
| Ward | Medica Individual Choice Silver | $515 | $1,030 | $1,340 |
| Williams | Medica Individual Choice Silver | $515 | $1,030 | $1,340 |
Are Subsidies Available In North Dakota?
In 2020, North Dakota’s average subsidy amount was $323 per month. Before the American Rescue Plan’s impact on subsidies, the state’s average subsidy exchange amounted to $420 monthly.
Can You Purchase Off-Exchange Insurance Coverage In North Dakota?
In North Dakota, you may buy standard health insurance plans from private insurers during the Open Enrollment Period. If you miss this enrollment window, you can still sign up or make changes if you have a qualifying life event.
Can You Purchase Short-Term Insurance In North Dakota?
Short-term health insurance can be a good option whether you’re between jobs, waiting for coverage to kick in, or seeking a more affordable healthcare option.
Short-term health insurance plans in North Dakota offer coverage for up to 185 days. The insurer must offer one renewal period, meaning short-term plans can only last up to 12 months.
Health Coverage Options For Low-Income People In North Dakota
In North Dakota, Medicaid provides comprehensive medical, dental, vision, and prescription coverage to children and adults through a variety of programs and waivers, including but not limited to:
- Medical: Children with Disabilities Medicaid Coverage, Intellectual Disabilities/Developmental Disabilities Waiver, Healthy Steps, and more.
- Dental: Safety Net Dental Clinics, North Dakota Donated Dental Services, Smiles Change Lives, and more.
- Vision: InfantSEE®, New Eyes for the Needy, and VSP Sight for Students.
- Prescription: Prescription Connection for North Dakota, ND Prescription Drug Repository Program, Partnership for Prescription Assistance, and others.
Review the state’s online Coverage Options booklet for a complete list of North Dakota health insurance options for low-income people.
What Medicare Options Are Available In North Dakota?
In 2022, there are 23 Medicare Advantage plans available in the state, with an average monthly premium of $41.14.
North Dakota offers four types of plans in their Medicare Advantage program:
- Health maintenance organization (HMO)
- Preferred provider organization (PPO)
- Private fee-for-service (PFFS)
- Special needs plan (SNP)
North Dakota residents 65 or older or younger adults with a disability or illness may be eligible for Medicare. Unlike Medicaid, you may have to pay for some coverage through a Medicare plan. Medicare plans are significantly cheaper than exchange plans.
Medicaid In North Dakota
Medicaid is available to the following North Dakota residents:
- Adults with household income up to 138% of the federal poverty level (income limits for family sizes apply)
- Children aged 0 – 18 with household income up to 170% of the poverty level
- Pregnant people with household income up to 157% of the poverty level
You don’t need to wait for an Open Enrollment Period to apply for Medicaid.
Cheapest Health Insurance Plans In North Dakota
The cheapest North Dakota health insurance in 68% of the state’s counties is the Medica Individual Choice Silver Copay ($0 Virtual Care + Online Wellness) plan. The Sanford TRUE $4,750 plan isn’t as widely available, but it’s the cheapest Silver plan in the five counties.
Cheapest health plan in North Dakota with low out-of-pocket maximums
If you have frequent doctor visits or higher medical expenses, it’s best to enroll in a plan with low out-of-pocket maximums. You’ll pay higher monthly premiums but reach your set maximum sooner.
North Dakota’s cheapest plan with low out-of-pocket maximums is BlueDirect 90 Gold from Blue Cross Blue Shield of North Dakota. It costs $485 a month for an average 40-year-old male.
Cheapest health plan in North Dakota with high out-of-pocket maximums
A high out-of-pocket maximum plan may be your best choice if you’re generally healthy with low medical costs. They typically have lower premiums, but medical emergencies will be more expensive.
The state’s cheapest high out-of-pocket max plan is Sanford Health Plan’s Sanford TRUE 8550, costing $123 per month for a 26-year-old person.
Cheapest health plan in North Dakota with an HSA option
Healthy individuals who don’t frequently visit a doctor may want to consider an insurance plan with an HSA option.
Based on all the metal tiers for a 40-year-old male, the cheapest plans with an HSA in North Dakota are:
- Expanded Bronze: Sanford TRUE $6,900 HSA/HDHP provided by Sanford Health Plan, at $241 per month.
- Silver: BlueDirect 80 Silver PPO by Blue Cross Blue Shield of North Dakota, at an average cost of $551 monthly.
- Gold: BlueDirect 90 Gold PPO by Blue Cross Blue Shield of North Dakota, at an average of $485 per month.
Cheapest HMO/PPO health plans in North Dakota
For an average 40-year-old individual, the cheapest HMO/PPO silver plans in North Dakota are:
- HMO: Altru Prime by Medica Silver Copay from Medica at an average of $408 monthly.
- PPO: Sanford Simplicity $4,750 by Sanford Health Plan at an average of $513 per month.
FAQs
Do you have to have health insurance in North Dakota?
The Affordable Care Act requires all North Dakota residents to maintain minimum healthcare coverage.
Is United Healthcare in North Dakota?
United Healthcare offers Critical Illness insurance and supplemental insurance plans in North Dakota.
What’s the income limit for Medicaid in ND?
To be eligible for Medicaid in ND, you must have a pre-tax annual household income below the following amounts:
| Household Size | Maximum Pre-Tax Annual Income |
|---|---|
| 1 | $18,075 |
| 2 | $24,353 |
| 3 | $30,630 |
| 4 | $36,908 |
| 5 | $43,186 |
| 6 | $49,463 |
| 7 | $55,741 |
| 8 | $62,018 |
What does Medicaid cover in North Dakota?
Medicaid covers a list of medical services with some limitations. It’s still the patient’s responsibility to ensure their provider’s service is covered by Medicaid.
Does North Dakota Medicaid cover dental?
North Dakota Medicaid will cover certain dental procedures, but a service authorization (SA) must be obtained. See the Codes Requiring Service Authorizations spreadsheet on the ND Medicaid website to view a complete list of all services that require service authorization and the documentation requirements.
How To Find Affordable Health Insurance In North Dakota?
You may enroll or change your individual or family coverage during open enrollment. If you don’t enroll during Open Enrollment, a qualifying life event will allow you to purchase a plan or make changes to existing coverage.
To find the best rates, use our rate comparison tool to compare options.
