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.
According to the North Dakota Insurance Department, there are several ways for residents to access health insurance:
Where do most North Dakota residents get their health insurance coverage?
| 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.
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:
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.
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.
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.
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 2019:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $309 | $438 | $468 | |
| 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.
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.
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:
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:
There are additional services that providers need to offer coverage for. Find the entire list on cms.gov.
Medicare and Medicaid are both government-funded programs available to qualifying ND residents. Medicare covers seniors, whereas Medicaid helps low-income families and children.
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:
Medicaid aids low-income families and children. These are the state’s 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 |
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