Best Health Insurance Plans in North Dakota

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Curious about health care in the Peace Garden State? According to a study by US News, ND has the 14th best health care in the nation. That study considers access, quality, and overall public health.

Health Care Choices in North Dakota

According to the North Dakota Insurance Department, there are several ways for residents to access health insurance:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most North Dakota residents get their health insurance coverage?

North Dakota (ND) Health Insurance Sources
Sources Percent
Employer-Provided 55%
Individual or family 8%
Medicaid 12%
Medicare 13%
Other Public Care 4%
Uninsured 8%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Eight percent of North Dakota residents are uninsured, less than the national average. That’s great for policyholders. Why? A high percentage of uninsured people raises costs for insured people.

North Dakota Health Insurance Costs and Rate Factors

ND residents spend an average of $9,851 per year on health care, more than the national average. So, what determines health care prices in your state? Costs vary person to person, but depend mostly on these factors:

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Body Mass Index

According to the CDC, a high body mass makes you more likely to suffer from serious health conditions. That’s why insurers assess your BMI when determining your risk-level. A high BMI leads to higher insurance prices.

In 2016, ND had a 33.2 percent obesity rate, the 13th highest rate in the country. Of the many ND residents who used QuoteWizard to compare health insurance plans, 40 percent had a BMI in the obese range.

Tobacco Use

Smokers tend to pay more for health insurance because of the serious risks from tobacco use. About 19.8 percent of ND residents are smokers, the 37th lowest rate in the country.

Age

Health care plans can cost up to three times more for older people than younger people. State residents who used QuoteWizard to shop for health insurance are, on average, 38 years old.

Plan Type

Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. The higher level of coverage you want, the more you’ll have to pay.

How much should you expect to pay in the Peace Garden State? These are the average monthly premiums for each plan type for a middle-aged ND resident in 2018:

North Dakota Martketplace Plan Rates
Bronze Silver Gold
$299 $368 $451
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

Premiums for a gold plan cost about 51 percent more than a bronze plan. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.

You may also qualify for a catastrophic plan, the lowest level of coverage available in the health insurance marketplace. Catastrophic plans have low monthly premiums and a yearly deductible of $7,150. Because of that high deductible, it may save you money to invest in a bronze or silver plan if you end up using your insurance. Catastrophic plans aren’t great for day-to-day or preventative care.

Location

Where you live plays a big role in your rates. That’s because every state has different health care rules, laws, and providers.

Also, health insurance companies use community-rating, so your rates are partly based on the combined claims everyone files. If your state files a high number of rates, your prices could go through the roof.

That means how health-conscious your state is helps determine your rates. According to America’s Health Rankings, ND is the 18th healthiest state in the country.

North Dakota Health Insurance Companies

ND residents have several choices when it comes to health insurance companies in their state. These providers offer individual and family plans in North Dakota:

North Dakota Health Insurance Laws

The Affordable Care Act limits what factors insurance companies can use when pricing your policy.

There’s a limit to how much you’ll pay out-of-pocket for marketplace plans. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

ND state law requires health insurance companies to offer at least some coverage for the following services:

  • Mental disorder coverage
  • Substance abuse coverage
  • Breast reconstruction surgery
  • Postdelivery coverage for mothers and newborns
  • Coverage for off-label uses of drugs
  • Dental anesthesia and hospitalization

There are additional services that providers need to offer coverage for. Find the entire list on cms.gov.

Medicare and Medicaid in North Dakota

Medicare and Medicaid are both government-funded programs available to qualifying ND residents. Medicare covers seniors, whereas Medicaid helps low-income families and children.

Medicare

People 65 and older qualify for Medicare. There are several different coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. Residents may also qualify for a Medicare Savings Program:

Qualified Medicare Beneficiary (QMB):

  • Single person with a monthly income lower than $1,032 and resources less than $7,560.
  • Couple with a monthly income lower than $1,392 and resources less than $11,340.

Specified Low-Income Medicare Beneficiary (SLMB):

  • Single person with a monthly income lower than $1,234 and resources less than $7,560.
  • Couple with a monthly income lower than $1,666 and resources less than $11,340.

Qualifying Individual (QI):

  • Single person with a monthly income lower than $1,386 and resources less than $7,560.
  • Couple with a monthly income lower than $1,872 and resources less than $11,340.

Qualified Disabled and Working Individuals Program (QDWI):

  • Single person with a monthly income lower than $4,132 and resources less than $4,000.
  • Couple with a monthly income lower than $5,572 and resources less than $6,000.

Medicaid

Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements:

North Dakota Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $15,800
2 $21,307
3 $26,813
4 $32,319
5 $37,825
6 $43,331
7 $48,851
8 $54,384

North Dakota Insurance Department

Website:
Homepage
Insurance Commissioner:
Jon Godfread
Insurance Hotline:
(800) 247 – 0560
Office Hours:
Monday - Friday
8:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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