How Much Is Health Insurance in North Dakota?

On this page

• What a North Dakota Marketplace plan costs before subsidies
• What you’d pay after a tax credit
• Costs beyond the premium
• North Dakota Marketplace facts
• When to enroll
• Other options in North Dakota
• Frequently asked questions

What a North Dakota Marketplace plan costs before subsidies

Age	Benchmark silver plan, per month (2026 estimate)
21	$446
30	$506
40	$570
50	$797
60	$1,210
64	$1,338
Child under 15	$341

Two 40-year-old parents with two young children would pay about $1,822 a month for benchmark plans before any tax credit.

What you’d pay after a tax credit

When household income falls between 100% and 400% of the federal poverty level, a premium tax credit limits what you pay for the benchmark plan to a share of your income. A single 40-year-old in North Dakota earning $40,000 would pay about $287 a month for the benchmark plan in 2026, so the credit would be about $283. In 2027, that person’s share would be about $289. Above 400% of the poverty level, which is $62,600 for one person for 2026 coverage and $63,840 for 2027, there’s no credit.

Tax credits here are smaller than average, partly because the benchmark plan they’re pegged to costs less. The average North Dakota credit was $462 a month in 2026, against $650 nationally. Enrollees who got one paid $126 a month on average, and about 15% of all enrollees paid less than $10 a month.

If your income is below 138% of the poverty level, you may qualify for Medicaid instead. Our guide to health insurance for low-income families covers the options.

Costs beyond the premium

A low premium can still come with high costs when you get care. Check each plan’s deductible and copays. Your yearly spending on covered care stops at the out-of-pocket maximum, $10,600 for one person in 2026 and $12,000 in 2027. Since 2026, bronze plans can be paired with an HSA, and silver plans carry cost-sharing reductions if your income is under 250% of the poverty level.

North Dakota Marketplace facts

• Marketplace: HealthCare.gov. North Dakota doesn’t run a state exchange.
• Enrollment: 41,014 plan selections for 2026, down about 4% from 42,901 in 2025. About 78% got a premium tax credit, and the average enrollee paid $229 a month after it.
• Insurers: Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan, all returning for 2027. Blue Cross Blue Shield of North Dakota covers about 32,000 of the state’s Marketplace enrollees.
• 2027 prices: Still proposed as of late September 2026, and the state hadn’t announced final rates. healthinsurance.org calculates a weighted average of 19.2%, and ACA Signups calculates 19.6%. By insurer, healthinsurance.org lists requests of 7.5% for Sanford Health Plan, 13.6% for Medica and 21.4% for Blue Cross Blue Shield of North Dakota.
• State help: North Dakota’s reinsurance program has run under a federal waiver since 2020, and CMS extended it through 2029. In 2025 it paid 75% of an enrollee’s claims between $100,000 and $1 million, and CMS estimated premiums that year were about 13.5% lower than they’d have been without it. North Dakota has no state premium subsidy or individual mandate.
• Medicaid: North Dakota expanded Medicaid in January 2014 for adults up to 138% of the poverty level, and Blue Cross Blue Shield of North Dakota has managed coverage for the expansion group since 2022. Children qualify up to 205% of the poverty level through CHIP. Under federal Medicaid work requirements starting January 1, 2027, many expansion adults ages 19 to 64 will need 80 hours a month of work, job training, volunteering or school.

When to enroll

North Dakota is on HealthCare.gov’s schedule. Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027, and a plan chosen by December 15 starts January 1. If you miss the window, a qualifying life event may still let you sign up; see missed open enrollment.

Other options in North Dakota

• Health coverage from an employer, typically the least expensive route when it’s available.
• Medicaid for adults up to 138% of the poverty level, and CHIP for children up to 205%; see health insurance for children.
• Medicare at 65.

Health insurance costs in nearby states: Minnesota, South Dakota and Montana. You can also compare health insurance costs in every state.

Compare 2027 plans in your North Dakota county: get quotes by ZIP code.

Frequently asked questions

What’s the average cost of health insurance in North Dakota?

The 2026 benchmark silver plan for a 40-year-old averaged $570 a month before subsidies. After tax credits, the average enrollee paid $229 a month, and those who received a credit paid $126.

How much will North Dakota health insurance go up in 2027?

Insurers have proposed average increases of 19.2% to 19.6% before subsidies, depending on how the average is calculated, and Blue Cross Blue Shield of North Dakota asked for 21.4%. Final rates hadn’t been announced as of late September 2026.

Does North Dakota have Medicaid work requirements?

Yes, starting January 1, 2027, for many adults ages 19 to 64 in the Medicaid expansion group. They’ll need 80 hours a month of work, training, volunteering or school, and the state expects 5,000 to 7,000 members to be affected.

Does North Dakota have a reinsurance program?

Yes. It has run since 2020 under a federal waiver that’s now approved through 2029, and it lowers full-price premiums by paying part of insurers’ largest claims.

This article is general information, not insurance or tax advice. Prices are averages and estimates; what you pay depends on your county, age, income and the plan you pick. Last reviewed September 2026.