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North Dakota has many affordable health insurance solutions to protect your health and finances, including employer-sponsored health plans, Medicare, and Medicaid. The state coordinates with the Health Insurance Marketplace to provide affordable individual and family health insurance and funds several low-income assistance plans.
This guide explains your North Dakota affordable health insurance options in detail.
Most states, including North Dakota, use HealthCare.gov to help you find, compare, select, and enroll you in affordable health insurance plans. After you’ve created an account on the website, you’ll answer questions to verify your identity based on your credit record.
You can browse plans without creating an account, but you must log in to enroll. The website tool requires basic information about you before it can provide plans that fit your circumstances, including:
Based on your answers, the Health Insurance Marketplace will indicate if you qualify for tax premium credits. Some of the questions are optional, but the more information you provide, the better your chances of finding a suitable plan. You can even filter by options like premium, deductible, and plan type, and sort based on the lowest premium or lowest deductible.
Some of the insurers managing health plans for North Dakota include:
Premiums vary based on age and the number of people insured. For example, the rate for a single young adult will be considerably different from the rate for a couple in their 50s or a family of six. So make sure you’re comparing apples to apples when looking at affordable health insurance plans in North Dakota and consider the health needs of all the people the plan will cover.
It’s always easier to shop just for yourself, as you only have your own needs to consider. Are you in good health, only visiting a doctor for a rare cold or injury, or do you have a chronic condition that requires expensive medication and regular tests? The answers will help you decide if you can save premiums by opting for a high deductible plan or if you should invest in higher premiums with lower out-of-pocket expenses.
The type of insurance plan will also determine where you receive health care and how certain aspects of your care are handled.
You’ll want to consider each family member’s health status and age to determine whether a strict in-network-only policy is worth the lower rate or if your family needs access to a wider variety of providers. Some things to look into with family insurance include pediatricians and children’s hospitals if you have young family members, obstetricians and their associated hospitals if your family is growing, and out-of-state care if you or a family member attends college away from home or travels.
Deductibles are assigned on a family and individual basis. Once each individual meets their deductible, the insurance begins to pay claims for that person. The family deductible is a maximum amount that, once met, allows all individual claims to be paid, even if that specific family member didn’t meet their individual deductible.
As you budget for health insurance, consider not only the monthly premiums but the deductible and coinsurance. A plan with a lower premium may end up costing you more if you have high out-of-pocket expenses. Making a list of annual health needs can help you decide if a low deductible is more beneficial than a low premium.
The Health Insurance Marketplace categorizes plans — Bronze, Silver, Gold, and Platinum — to make it easier for you to compare similar service offerings. Plans in the Bronze category typically have the lowest premiums and those in the Platinum the highest, though there may be exceptions.
You may receive a premium tax credit when enrolling via the Health Insurance Marketplace based on your annual income. This amount can vary each year and can be applied directly to the insurance company to help lower monthly premiums.
|Average premiums in North Dakota||2018||2019||2020||2021||2022|
|Most affordable Bronze plan||$299||$309||$273||$273||$288|
|Most affordable Silver plan||$368||$438||$372||$464||$478|
|Most affordable Gold plan||$451||$468||$409||$432||$448|
North Dakota helps low-income individuals obtain affordable health insurance through Medicaid, Children’s Health Insurance Program, CHAND, and Indian Health Services.
Eligible persons can apply to the state for Medicaid health insurance coverage which offers benefits such as hospital, medical, vision, dental care, therapy treatments, and prescription medication. The state’s Health and Human Services website lists the requirements for applicants, including those with low income, in foster care, and disabled. State residents can complete an application online or in-person at a county social service office.
The state updates the income levels of individuals and families yearly and offers an expanded access program to aid more North Dakotans up to 138% of the federal poverty level.
CHIP provides health insurance coverage for children below 18 years of age whose parents or guardians aren’t eligible for Medicaid yet still can’t afford to purchase a health insurance plan. In many cases, an employer’s plan may only cover the working adult. Income guidelines and applications are available on the North Dakota DHS website.
If you’re having a hard time finding affordable health insurance due to high-risk medical conditions or if you’ve been denied coverage through your employer’s plan, you may be eligible for CHAND. Through CHAND, you can enroll in major medical care or Medicare supplemental coverage. State and federal funding help subsidize the program to keep premiums affordable.
Health insurance through CHAND can include major medical care with deductibles from $500 to $1,000 or a Medicare supplement plan. The major medical portion has creditable prescription drug coverage.
North Dakota has four designated reservations, and numerous American Indians live throughout the state independent of the reservations. Indian Health Service provides health care to eligible members of federally recognized tribes. However, you can choose an affordable health insurance plan through the Health Insurance Marketplace, where cost-sharing benefits (for tribal membership) are available to help offset the cost of premiums.
Medicare is the federal health plan that pays for medical care for seniors and disabled individuals. North Dakota residents have several options for Medicare coverage, some of which they can mix and match.
If you choose Original Medicare, you can also purchase supplemental plans to extend your coverage. Medicare Part D covers prescription medications, while Medicare Supplement Insurance (Medigap) covers deductibles, copays, and other out-of-pocket Medicare costs.
If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:
Trained counselors can help explain Medicare basics to seniors and their family members through North Dakota’s State Health Insurance Counseling (SHIC) program. The counselors aren’t affiliated with any insurance carrier, so you can be sure of objective, unbiased advice.
Short-term health insurance plans can offer cheap health insurance coverage, but these plans are limited. In 2021, North Dakota enacted a bill concerning short-term health insurance (ND SB2073). Plans for an individual can be in effect for up to 12 months, and association health plans can last as long as 36 months. While short-term health insurance may be necessary for certain circumstances, it carries risks.
If a short-term plan seems too good to be true, it probably is.
No – the Affordable Care Act removed the penalty for not having health insurance in 2019, and North Dakota doesn’t have a mandatory health insurance law in place.
You can contact insurers directly in North Dakota without using the Health Insurance Marketplace. However, if you’re hoping to receive a premium tax credit, you’ll need to apply through the marketplace website. Additionally, marketplace plans are federally approved to provide necessary coverage.
The most popular form of cost-sharing plans are faith-based plans. In a faith-based plan, members share health care costs with other members. You don’t need to be a member of a particular denomination (or even religious), to participate in a plan. While these plans can be relatively low-cost, most faith-based plans don’t conform to Affordable Care Act’s standards and don’t cover pre-existing conditions, mental health care, or pregnancy.
Yes, although the accounts apply to different situations. A Flexible Spending Account helps pay out-of-pocket medical expenses associated with an employer’s health plan. It doesn’t carry over from year to year, although there are some exceptions. A Health Savings Account works in tandem with a high-deductible health insurance plan. The monies saved can be used for out-of-pocket costs, and an HSA can roll over each year. With either type of account, you’ll still need health insurance to reduce the cost of medical expenses.
If you’re seriously injured and can no longer work, your health insurance may cover the cost of the medical bills, but it won’t pay for car loans, utility bills, and other fees. Short-term disability pays a percentage of your salary, typically for three to six months, depending on the policy.
Your health insurance pays hospital and medical expenses, not your costs of living. So it’s a good idea to sign up for long-term disability coverage to help you continue to meet mortgage payments or rent if you’re unable to work. Long-term policies vary in length, anything from two to 10 years and may also differentiate between continuing to do your trained job and another type of job. Long-term policies usually have a short grace period before starting up, which is why many people opt for both long-term and short-term disability.