There are different metal tiers available in North Dakota. These tiers differ in premiums, deductibles and maximum out-of-pocket (MOOP) costs. Medica and Sanford Health Plan offer the most affordable health plans across the state.
MoneyGeek also found the best health insurance in North Dakota by analyzing providers and plans balance cost and service.
Most Affordable Health Insurance in North Dakota
Cheapest Health Insurance in North Dakota by Metal Tier
Sanford TRUE - Standardized $5,800 from Sanford Health Plan is the most affordable Silver plan in North Dakota. On average, it costs $401 per month with a maximum out-of-pocket (MOOP) cost of $8,900.
Metal tiers, like Platinum and Gold, have lower out-of-pocket costs and expensive premiums. Silver and Bronze tiers are cheaper, but they have higher out-of-pocket costs. These are the most affordable plans by tier:
- Gold: Sanford TRUE - Standardized $2,000 from Sanford Health Plan ($395 per month)
- Silver: Sanford TRUE - Standardized $5,800 from Sanford Health Plan ($401 per month)
- Bronze: Essentia Choice Care with Medica Bronze Standard ($0 Virtual Care with Designated Providers) from Medica ($308 per month)
- Expanded Bronze: Sanford TRUE $7,000 from Sanford Health Plan ($260 per month)
- Catastrophic: Sanford TRUE $9,100 from Sanford Health Plan ($164 per month)
A more expensive monthly premium may result in cheaper out-of-pocket costs. The opposite also applies — the lower your premium, the higher your out-of-pocket costs.
Metal tiers are used to classify health insurance plans. A more valuable metal indicates a more expensive premium, but they have lower out-of-pocket costs. Silver plans balance an affordable premium and MOOP to fit the budget of most individuals.
In general, younger individuals can select less expensive plans because they may not require as much medical care as their more mature counterparts.
Cheapest Silver Plans in North Dakota
The cheapest Silver plan in North Dakota is Sanford TRUE - Standardized $5,800 from Sanford Health Plan. The average premium for this plan is $401 per month. The most affordable Silver plans are the following:
- Sanford TRUE - Standardized $5,800 from Sanford Health Plan: $401 per month
- Sanford TRUE Enhanced - Diabetes & Asthma/COPD Care Plan $3,700 from Sanford Health Plan: $415 per month
- Sanford TRUE $4,750 from Sanford Health Plan: $426 per month
Many people prefer Silver plans because they offer a suitable combination of price, coverage and MOOP. If you’re looking for a balance regarding your premium and deductible, Silver plans may be the best option for you.
In North Dakota, the most accessible plan type is an HMO. The recommendations in the table below focus on HMO plans.
Cheapest Gold Plans in North Dakota
Sanford TRUE - Standardized $2,000 from Sanford Health Plan is the cheapest Gold plan in North Dakota, with an average premium of $395 per month. Affordable options for Gold plans are:
- Sanford TRUE - Standardized $2,000 from Sanford Health Plan: $395 per month
- Sanford TRUE $1,750 from Sanford Health Plan: $401 per month
- Sanford TRUE Enhanced - Diabetes & Asthma/COPD Care Plan $1,250 from Sanford Health Plan: $408 per month
Gold plans can be a good option if you don't mind increasing your premium slightly. Even though Gold plans cost more than Bronze or Silver plans, you can have lower out-of-pocket costs.
Cheapest Bronze Plans in North Dakota
Essentia Choice Care with Medica Bronze Standard ($0 Virtual Care with Designated Providers) from Medica is the most affordable Bronze plan in North Dakota. The average premium for this plan is $308 per month. The cheapest options for this metal tier are:
- Essentia Choice Care with Medica Bronze Standard ($0 Virtual Care with Designated Providers) from Medica: $308 per month
- Altru Prime by Medica Bronze Standard ($0 Virtual Care with Designated Providers) from Medica: $335 per month
- Medica Individual Choice Bronze Standard ($0 Virtual Care with Designated Providers) from Medica: $403 per month
Bronze plans are more affordable than most but come with higher out-of-pocket costs.
Cheapest Expanded Bronze Plans in North Dakota
Sanford TRUE $7,000 from Sanford Health Plan is the cheapest Expanded Bronze plan. The average premium for this plan is $260 per month. The most affordable Expanded Bronze plans are:
- Sanford TRUE $7,000 from Sanford Health Plan: $260 per month
- Sanford TRUE $6,000 from Sanford Health Plan: $262 per month
- Sanford TRUE $6,900 HSA/HDHP from Sanford Health Plan: $270 per month
Expanded Bronze plans are cheaper than most metal tiers, including regular Bronze plans. The main distinction between these tiers is that Expanded Bronze plans have lower deductibles. As a result, your policy can cover your health care expenses sooner than with other standard plans.
Cheapest Catastrophic Plans in North Dakota
Sanford TRUE $9,100 from Sanford Health Plan is the cheapest Catastrophic Plan in North Dakota, with an average premium of $131 per month for a 26-year-old. The most affordable Catastrophic plans are:
- Sanford TRUE $9,100 from Sanford Health Plan: $131 per month
- BlueEssential 100 from Blue Cross Blue Shield: $156 per month
- Sanford Simplicity $9,100 from Sanford Health Plan: $164 per month
Catastrophic plans frequently have low premiums but considerable out-of-pocket expenses. It could be a smart alternative if you’re eligible and want protection during emergencies without paying an expensive premium.
Cheapest Health Insurance in North Dakota for Those With Low Income
Individuals earning less than 250% of the Federal Poverty Level (FPL) are eligible for cost-sharing reductions. They can help reduce your out-of-pocket expenses during medical treatments or emergencies.
Your income bracket can determine your premium and MOOP. The cheapest plans in North Dakota vary depending on which group you fall into:
- Income lower than $20,385 per year (less than 150% of FPL): Sanford TRUE - Standardized $5,800 ($1,700 MOOP)
- Income from $28,386 to $27,180 per year (151% to 200% of FPL): Sanford TRUE - Standardized ($3,000 MOOP)
- Income from $27,181 to $47,565 per year (201% to 250% of FPL): Sanford TRUE - Standardized ($7,200 MOOP)
Poverty levels vary according to the members of your household. The information above is only for a single person interested in a Silver plan.
Cost-sharing plans don’t affect your premium, meaning you would pay the same each month as you would for a standard plan, but you can get a lower MOOP, deductible and copayment. Further, you can get more coverage for your medical expenses in case of a claim.
For instance, the average premium for a Sanford TRUE - Standardized plan, including standard and low-income, is $401 per month. However, the average MOOP cost for a regular plan is $8,900, compared to only $1,700 for individuals whose income is less than 150% of the FPL.
The Cheapest Health Insurance in North Dakota by Plan Type
Health Maintenance Organization (HMO) plans make up the majority of insurance plans in North Dakota. If you’re looking for other plan types, you can find Preferred Provider Organization (PPO) plans from certain providers. For instance, DakotaBlue Altru Silver 60 from Blue Cross Blue Shield is the cheapest PPO plan, with a premium of $459 per month.
HMO plans are cheaper than PPO plans. HMO can only cover your expenses if you get services from in-network professionals, hospitals and establishments. PPO plans have a broader network than HMO plans, making them more flexible and expensive.
HMO and PPO plans are available in North Dakota. Both of these plans have in-network coverages, but they vary in several aspects:
- Health Maintenance Organization (HMO) plans are popular because of their affordable premiums. They only cover services from your insurance company’s network of health care professionals. You’ll also need a referral before seeing a specialist. It’s a good option as long as the in-network providers are accessible.
- Preferred Provider Organization (PPO) plans can be more expensive than HMO plans. They offer broader in-network coverage without requiring a referral before consultations. A PPO plan may be a good option if you're looking for more flexibility.
Cheapest Health Insurance in North Dakota by County
There can be different insurance options, depending on where you live. Sometimes, the cheapest plan can change, even depending on the county.
In North Dakota, however, Sanford TRUE - Standardized $5,800 from Sanford Health Plan remains the most affordable plan in the largest and smallest counties, Cass and Slope, respectively. The average premium for this plan is $401 per month.
It’s best to check your county's health insurance, as rates may vary based on location.
Health Insurance Costs in North Dakota by Age and Metal Tier
Metal tiers significantly influence health insurance rates. In North Dakota, a 40-year-old person may pay the following premiums per month:
- Gold: $977
- Silver: $1,010
- Bronze: $357
- Expanded Bronze: $713
- Catastrophic: $449
Platinum and Gold plans are more expensive than Silver and Bronze plans. However, higher metal tiers have reduced out-of-pocket expenses than lower metal tiers. However, note that the plan that best meets your needs relies on your potential medical costs.
Health insurance premiums can be more expensive as you age. A 40-year-old adult's average monthly premium for a Silver plan is $1,010, while a senior’s average premium for the same tier is $2,145 per month.
What to Know About North Dakota Health Insurance
To determine which health insurance policies were the most affordable, MoneyGeek analyzed information from private companies. These plans are available to those with various coverage needs during the open enrollment period.
Government programs may be available to eligible individuals. These include Medicaid for those with low income and Medicare for seniors and people with disabilities. These programs are less expensive than standard plans.
Private Health Insurance in the North Dakota Marketplace
You can get private health insurance in North Dakota during open enrollment. This period is from November 1 to January 15.
Keep in mind that the last day to enroll for coverage starting on January 1, 2024, would be December 15, 2023. Early enrollment, before your policy expires, ensures that you do not experience coverage gaps.
Only those who meet the requirements for a Special Enrollment Period may purchase a policy outside regular open enrollment. Qualifying life events for a Special Enrollment Period would include marriage, relocation, loss of income or childbirth. This time frame may be 30 days for job-based plans and 60 days before or after the life event for any other case.
What Are Health Insurance Metal Tiers?
Health insurance plans are classified into metal tiers. More valuable metals, like Gold, are more expensive but offer more coverage, while the opposite is true for less valuable metals, like Bronze. You can get Gold, Silver, Bronze, Expanded Bronze and Catastrophic plans in North Dakota.
- Gold: Gold plans tend to be expensive but have smaller deductibles. If you don’t mind paying a little more for your premium, Gold plans are great options to minimize your out-of-pocket costs.
- Silver: Many people choose a Silver plan to balance the deductible and premium. These plans are less expensive than Gold or Platinum plans but not as cheap as Bronze plans. Nonetheless, you won’t have to pay much out of pocket with a Silver plan. If your income is below the FPL, you may qualify for cost-sharing reductions for Silver plans only.
- Bronze: Premiums for Bronze plans are cheap, but the out-of-pocket costs can be expensive. This might be an excellent alternative if you don't require routine medical care or don't plan on getting any treatments.
- Expanded Bronze: These plans are as cheap as regular Bronze plans, but they have smaller out-of-pocket costs. As a result, policyholders can have more coverage.
- Catastrophic: Catastrophic plans are only available to those younger than 30 or who qualify for a hardship exemption. These plans are much cheaper than standard plans, but their deductibles can be high. You may have to pay for your doctor’s visits and other medical expenses with personal funds.
Metal levels don’t dictate the quality of service you can get from your insurance provider. Only your coverage, premium and out-of-pocket expenses change with your metal tier. They may have a significant impact on your health insurance rates. Nevertheless, your circumstances will determine the best health insurance plan for your personal and medical needs.
Medicaid in North Dakota
Medicaid offers free health insurance coverage, making it the most affordable option for qualified individuals. North Dakota is a Medicaid expansion state, meaning coverage is obtainable even with a low income. If your income falls between 138% and 250% of the FPL, you can be eligible for Medicaid.
Medicare in North Dakota
Medicare is a federal government program accessible to those over 65 with qualifying illnesses or disabilities. This program covers the following categories of medical expenses:
- Part A takes care of the costs incurred if you're admitted to a hospital, nursing home or hospice.
- Part B includes outpatient treatment, doctor's fees, medical supplies and preventative services.
- Part D can cover vaccines and prescription medications.
Expert Advice on Most Affordable Health Insurance In North Dakota
- What makes North Dakota health insurance plans unique compared to those in other states?
- What factors should individuals and families in North Dakota consider when selecting a plan with the lowest out-of-pocket maxes?
- Are Health Savings Accounts (HSA) a viable option for those looking for the cheapest coverage in North Dakota?
- Are there any special considerations that should be taken into account when selecting a plan in North Dakota for people with pre-existing conditions?
- In your view, what can be done to make health insurance more affordable in North Dakota?
Assistant Professor of Economics at North Dakota State University
North Dakota Health Insurance Frequently Asked Questions
Those looking for the cheapest health insurance in North Dakota may have various concerns about pricing and availability. MoneyGeek addressed some of these questions.
About Mark Fitzpatrick
- HealthCare.gov. "Special Enrollment Period (SEP)." Accessed January 13, 2023.