North Dakota Health Insurance: 2023 Coverage Guide

North Dakota Affordable Healthcare Insurance

North Dakota residents have some options when it comes to buying health insurance. It’s important to understand your needs and the different types of coverage available to you. When you’re ready to shop, SmartFinancial is there to help you find the right plan at the right price.

When Is Open Enrollment in North Dakota?

November 1, 2022 – January 15, 2023

How to Get Health Insurance in North Dakota

Take a look at your health care costs during the past year. How many times did you visit the doctor? Did you have any surgeries or hospitalizations? You’ll need this important information to decide which type of coverage is right for you, and which level tier suits your needs and will be most economical. Sometimes, the higher priced premium ends up saving you money if you see health care providers regularly.

It’s important to compare health insurance companies and health insurance quotes before you buy a plan. After you submit the form you’ll get several competing health insurance rates to choose from, and we’ll connect you with an agent in your area so you can buy the coverage or ask questions about the plan you’re considering.

What Types of Health Insurance Are Available in North Dakota?

HMOs, EPOs, PPOs and POS plans are the most common types of health care plans available in North Dakota. Here, you’ll be able to choose from four different tiers of coverage: platinum, gold, silver or bronze. Bronze is the cheapest but there’s also a catastrophic plan which is even less expensive but has the most out-of-pocket costs.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

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Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

• If you lose or quit a job. You may lose a job, change jobs or even start your own business. If you do, you qualify to buy health insurance outside the enrollment period.
• If you turn 26. Young people on their parents’ health insurance plans can enroll in an individual health plan once they turn 26.
• If you move to another state or out of an HMO coverage area. Your health insurance eligibility may change once you move to another state or coverage area. You can sign up for a new health plan if your plan is no longer valid.
• If you extended your healthcare with Cobra and you’ve reached the end of the coverage term, you can enroll in a new health plan.
• If you divorce and you shared a health insurance plan with your spouse, you can enroll in a new health plan.
• If you recently married, you may be able to get added onto your spouse’s policy or start a new one together.
• If you became a new mom outside of the open enrollment date, you can buy health insurance for the new child.
• Death of spouse or partner. If you were covered under your spouse or partner’s health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
• Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in North Dakota?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in North Dakota?

Health insurance in North Dakota for a 40 year old costs an average of $320 a month. Health insurance is less expensive the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in North Dakota

The best way to save on health insurance in North Dakota is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.

Medicare in North Dakota

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in North Dakota?

17% of the population in North Dakota is on Medicare.

How Much Is Medicare in North Dakota?

If you do not qualify for Medicare, you can buy it for $499 a month for Part A in 2022 and a standard monthly premium for Medicare Part B was $170.10, or even higher depending on income. .

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2022, it was $7,550 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in North Dakota

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in North Dakota?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

North Dakota State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the North Dakota Health System are listed below:

• North Dakota: Overall Ranking: 13 of 51
• North Dakota: Overall Performance: Above U.S. Average
• North Dakota: Access and Affordability: 23
• North Dakota: Prevention and Treatment: 20
• North Dakota: Avoidable Hospital Use and Cost: 11
• North Dakota: Healthy Lives: 15
• North Dakota: Health Care Disparities: 11

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North Dakota Health Insurance Coverage

The people of North Dakota have different kinds of health insurance while some North Dakota residents are not insured at all. See the breakdown below:

• Private coverage: 63%
• Medicaid: 11%
• Medicare: 17%
• Uninsured: 9%

Report: America's Health Insurance Plans

North Dakota Health Insurance Companies

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