Health Insurance in North Dakota

Find plans and explore healthcare options in the Peace Garden State.

Navigating North Dakota's Healthcare System

North Dakota utilizes the federal Health Insurance Marketplace, **HealthCare.gov**, for residents seeking individual and family health insurance plans under the Affordable Care Act (ACA). This platform allows North Dakotans to compare private plan options and access federal subsidies to lower costs. While the state provides coverage through **North Dakota Medicaid** for eligible children, pregnant women, parents/caretakers below certain income limits, seniors, and people with disabilities, it has **not adopted the ACA's Medicaid expansion** to cover all low-income adults without dependents.

Understanding these coverage pathways is essential for residents. HealthCare.gov is the primary resource for purchasing subsidized private insurance, while eligibility for North Dakota Medicaid is more limited for adults compared to states that expanded. Equipping oneself with knowledge about these options and the specific eligibility requirements empowers North Dakotans to make informed decisions about their health coverage.

Staying informed about the Open Enrollment period for HealthCare.gov, potential financial assistance, and the details of available plans is crucial for securing coverage. Use our free tools to get an instant quote or evaluate local market rates for Marketplace plans in North Dakota.

Map of North Dakota highlighting healthcare

North Dakota Health Insurance Coverage ()

Employer

~58%

Non-Group

~8%

Medicaid/CHIP

~13%

Medicare

~15%

Military

~3%

Uninsured

~4.2%

Source: Approximate percentages based on KFF analysis of 2023 ACS data. Note: Categories may overlap; percentages may not sum exactly to 100%.

North Dakota Health Facts at a Glance

Overall Health Ranking

#18

Est. Population (2025)

~0.79 M

Avg. Lifespan

~77.6 yrs

Avg. Hospital Stay / Day

~$2,600+

Avg. Health Expenditure / Person

$11,301*

Number of Hospitals

~40

*Avg. Health Expenditure per capita (KFF, 2020 data). Other stats based on most recent available data (2021-2024) - All stats are illustrative and need updating.

Health Insurance Programs for North Dakota Residents

North Dakota residents have access to health coverage through several programs:

  • Health Insurance Marketplace (HealthCare.gov): North Dakota uses the federal marketplace where individuals and families can compare and enroll in private health insurance plans. Federal financial assistance (subsidies) is available here for eligible residents to lower costs.
  • North Dakota Medicaid: Provides essential health coverage to eligible low-income populations, including children, pregnant women, parents/caretakers with low incomes, seniors, and individuals with disabilities. **Note:** North Dakota has not expanded Medicaid under the ACA to cover low-income adults without dependents or disabilities.
  • Healthy Steps (CHIP): North Dakota's Children's Health Insurance Program offers low-cost health coverage for children in families with incomes too high to qualify for Medicaid but who cannot afford private insurance.
  • Medicare: The federal insurance program for people aged 65+, and younger individuals with certain disabilities.
  • Patient Assistance Programs: Various programs may help eligible individuals lower their prescription drug costs.

Employer-sponsored insurance remains a primary source of coverage for many North Dakotans.

North Dakota Short-Term Health Insurance

Short-term, limited-duration health insurance plans are permitted in North Dakota and generally follow **federal regulations**. These plans can offer temporary coverage for those experiencing brief gaps in comprehensive insurance. Key features under current federal rules include:

  • Initial plan terms can last **up to 364 days**.
  • Plans may be renewable, with potential total duration **up to 36 months**.

It is crucial to understand that short-term plans are **not ACA-compliant**. They are not required to cover pre-existing conditions, typically exclude essential health benefits (such as maternity care, mental health services, prescription drugs, and preventive care), and may have coverage limitations or caps. They do not count as minimum essential coverage.

While available in North Dakota, these plans should only be considered for very specific, temporary needs by individuals who understand the significant coverage limitations compared to ACA-compliant plans available on HealthCare.gov.

Finding Health Coverage In North Dakota

Securing health insurance in North Dakota provides financial protection and access to care. Understanding the available options, including employer plans, the federal marketplace, limited Medicaid, and CHIP, is the first step.

North Dakota Open Enrollment via HealthCare.gov

For North Dakotans purchasing individual or family health insurance, Open Enrollment occurs through the **Health Insurance Marketplace at HealthCare.gov**. The enrollment period typically runs from **November 1st to January 15th** each year for coverage starting in the upcoming year. Residents needing to enroll in or change private plans should use HealthCare.gov during this time. This is the only platform to access federal subsidies. Missing Open Enrollment generally requires a qualifying life event to enroll later through a Special Enrollment Period.

North Dakota Health Insurance Quotes

ACA-compliant private health plans are available for purchase on **HealthCare.gov**. Eligible North Dakotans can receive federal financial assistance (premium tax credits and cost-sharing reductions) exclusively through this platform, making coverage more affordable. Comparing plans offered by carriers like Sanford Health Plan, BCBSND, and Medica based on costs, benefits, and provider networks is essential. Our free quoting service can help you explore these Marketplace options. Enter your zip code to compare quotes and connect with local agents or navigators for enrollment assistance.

Major Health Insurance Providers in North Dakota

Several insurance carriers offer individual and family plans on the North Dakota Health Insurance Marketplace (HealthCare.gov). Key participants typically include:

  • Sanford Health Plan
  • Blue Cross Blue Shield of North Dakota (BCBSND)
  • Medica

Plan availability may vary by county. It is important to use the plan comparison tools on HealthCare.gov to see the specific options available in your area.

Carefully review the network of doctors and hospitals associated with each plan, along with the coverage details and costs, before making a selection. Consider seeking help from certified assisters if needed.

Frequently Asked Questions About Health Insurance North Dakota

Is Health Insurance Mandatory in North Dakota?

No, **North Dakota does not have a state law requiring** residents to have health insurance. The federal penalty for not having coverage under the ACA was also eliminated (reduced to $0) starting in 2019. Therefore, there is no financial penalty for being uninsured in North Dakota. However, coverage is strongly recommended due to the high cost of healthcare services.

What's the Cost of Health Insurance in North Dakota?

Health insurance costs in North Dakota vary based on factors like age, location, plan choice, tobacco use, and family size. Federal financial assistance (subsidies) is available exclusively through **HealthCare.gov** for eligible individuals and families purchasing private plans, which can significantly reduce premium and out-of-pocket costs. **North Dakota has not expanded Medicaid** eligibility under the ACA for low-income adults without dependents, meaning some individuals may fall into a "coverage gap" where they earn too much for traditional Medicaid but too little to easily afford Marketplace plans, even with subsidies. Comparing plans and subsidy eligibility on HealthCare.gov is crucial. Use our free estimate tool for baseline market rate information.

How to Secure Health Insurance in North Dakota?

North Dakota residents can get health coverage through these methods:

  • Employer-Sponsored Plans: Coverage offered through work.
  • Health Insurance Marketplace (HealthCare.gov): Compare and enroll in private plans, access federal subsidies. Enroll during Open Enrollment (Nov 1 - Jan 15) or SEP.
  • Directly from Insurance Companies: Buy plans off-marketplace (no subsidies).
  • North Dakota Medicaid / Healthy Steps (CHIP): For eligible children, pregnant women, parents/caretakers with low incomes, seniors, and people with disabilities. Eligibility for adults without dependents is very limited due to no expansion. Apply year-round via ND Health and Human Services.
  • Medicare: Federal program for those 65+ or with certain disabilities.
  • Short-Term Plans: Temporary, limited-benefit plans purchased directly (follows federal rules).
Free enrollment help is available through navigators listed on HealthCare.gov or local insurance agents.

The Impact of Obamacare on North Dakota Insurance Rates

The ACA (Obamacare) impacted North Dakota primarily by establishing the **Health Insurance Marketplace (HealthCare.gov)**, providing a standardized platform for individuals to purchase insurance and access federal subsidies. It also introduced key consumer protections, like coverage for pre-existing conditions and essential health benefits. However, a major aspect of the ACA – **Medicaid expansion** for low-income adults – **was not adopted** by North Dakota. This decision means that unlike in expansion states, many low-income adults without dependents in North Dakota remain ineligible for Medicaid and may struggle to afford other coverage options, creating a significant coverage gap.

Bottom Line

Finding health insurance in North Dakota involves exploring employer options, checking limited eligibility for ND Medicaid or Healthy Steps CHIP, or using HealthCare.gov to compare private plans from carriers like Sanford, BCBSND, and Medica. Utilize the Open Enrollment period (Nov 1 - Jan 15) on HealthCare.gov to secure coverage and access potential subsidies. Be aware of the state's decision not to expand Medicaid, which affects coverage options for some low-income adults. While short-term plans are permitted, understand their limitations. Use our quote tool or estimate tool to explore Marketplace options and make an informed choice about your health coverage in North Dakota.