North Dakota Health Insurance Guide 2025

Everything you need to know about health coverage in the Peace Garden State

Medicaid Expanded

Key Facts

Medicaid Status Expanded (2014)
Marketplace Federal (HealthCare.gov)
Open Enrollment Nov 1 - Jan 15
Uninsured Rate 7.4%

Medicaid in North Dakota

North Dakota expanded Medicaid in 2014, extending health coverage to thousands of previously uninsured adults. The state's Medicaid Expansion program provides comprehensive health benefits for eligible low-income residents.

Who Qualifies for Medicaid Expansion?

  • Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals)
  • Adults without dependent children (newly eligible under expansion)
  • North Dakota residents who meet citizenship or immigration requirements
  • Not currently enrolled in Medicare
Comprehensive coverage: North Dakota Medicaid Expansion covers doctor visits, hospital care, prescriptions, mental health and substance abuse treatment, preventive care, and more - often at no cost to eligible enrollees.

Traditional Medicaid Coverage

In addition to expansion, traditional Medicaid continues to cover:

  • Pregnant women with income up to 152% FPL
  • Children under 19 through Medicaid and Healthy Steps (CHIP)
  • Seniors and people with disabilities
  • Low-income parents and caretakers

How to Apply

You can apply for North Dakota Medicaid through:

  • Online at apps.nd.gov/itd/recert
  • By phone: 1-800-755-2716
  • In person at your local human service zone
  • Through a certified application counselor or navigator

Health Insurance Marketplace

North Dakota uses the federal Health Insurance Marketplace at HealthCare.gov. Residents who earn more than 138% FPL can shop for private health insurance plans with premium tax credits to reduce costs.

Available Plan Types

  • Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
  • Silver: Moderate premiums and costs (70% coverage) - best for subsidies
  • Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
  • Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
Limited plan options: North Dakota's smaller population means fewer insurance carriers participate in the marketplace. However, premium tax credits ensure that at least one affordable plan option is available in every county.

Enrollment Periods

Open Enrollment: November 1, 2024 - January 15, 2025

Medicaid accepts applications year-round - you don't have to wait for Open Enrollment if you think you qualify.

Average Costs in North Dakota

Health insurance costs in North Dakota vary based on your age, location, plan type, and tobacco use. Here are typical monthly premiums before subsidies:

Plan Type Individual (Age 40) Family of 4
Bronze $380 - $460 $1,200 - $1,500
Silver $480 - $580 $1,500 - $1,900
Gold $550 - $660 $1,750 - $2,150
Medicaid Expansion $0 $0
Subsidies help: Most North Dakota marketplace enrollees receive premium tax credits that significantly reduce their monthly costs. Some may qualify for $0 premium Bronze plans.

Frequently Asked Questions

Has North Dakota expanded Medicaid?

Yes, North Dakota expanded Medicaid in 2014. Adults ages 19-64 earning up to 138% of the federal poverty level ($20,783 for an individual in 2025) qualify for Medicaid Expansion coverage in North Dakota.

What is North Dakota Medicaid Expansion?

North Dakota Medicaid Expansion provides comprehensive health coverage to low-income adults who don't qualify for traditional Medicaid. Benefits include doctor visits, hospital care, prescriptions, mental health services, and preventive care at little to no cost.

When is Open Enrollment for North Dakota health insurance?

Open Enrollment for 2025 marketplace coverage runs from November 1, 2024 through January 15, 2025. North Dakota uses the federal marketplace at HealthCare.gov. Medicaid accepts applications year-round.

How much does health insurance cost in North Dakota?

The average monthly premium for a benchmark Silver plan in North Dakota is approximately $480-580 before subsidies. Many North Dakota residents qualify for premium tax credits that significantly reduce costs, with some paying under $100 per month.

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