Find Affordable Coverage in North Dakota
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North Dakota ACA Marketplace Overview
In 2026, approximately 22,000 North Dakota residents are enrolled in ACA Marketplace coverage. North Dakota uses the federal exchange, Healthcare.gov for health insurance enrollment.
North Dakota has expanded Medicaid under the ACA, meaning adults earning up to 138% FPL qualify for free or near-free coverage through Medicaid.
How Much Does ACA Coverage Cost in North Dakota?
The benchmark Silver plan (second-lowest-cost Silver plan) in North Dakota costs approximately $488/month before subsidies in 2026. However, most North Dakota residents who qualify for premium tax credits pay significantly less.
- $0/month premium: Possible for North Dakota households earning up to 150% of the Federal Poverty Level
- Low premiums: Households earning up to 400% FPL qualify for substantial subsidies
- Above 400% FPL: Still eligible if the benchmark plan exceeds 8.5% of household income
Use our ACA Subsidy Calculator to estimate your specific monthly costs based on your North Dakota household income.
Top ACA Health Insurance Companies in North Dakota
The following carriers offer ACA Marketplace plans in North Dakota for 2026:
- Sanford Health
- Blue Cross Blue Shield ND
Plan availability varies by county in North Dakota. Use Healthcare.gov to see exact plans available in your ZIP code.
ACA Plan Tiers Available in North Dakota
- Bronze: Lowest premiums, highest deductibles. Best for healthy North Dakota residents who rarely need care.
- Silver: Mid-range. Strongly recommended for North Dakota households earning 100–250% FPL — Silver plans unlock Cost-Sharing Reductions that significantly lower deductibles and copays.
- Gold: Higher premiums, lower out-of-pocket. Best for North Dakota residents who use healthcare frequently.
- Platinum: Highest premium, lowest cost per service. Available in most North Dakota counties.
When to Enroll in North Dakota
- Open Enrollment: November 1 – January 15 on Healthcare.gov
- January 1 coverage: Enroll by December 15
- February 1 coverage: Enroll by January 15
- Special Enrollment: Available year-round if you lose job-based coverage, move, get married, or have a baby
North Dakota Insurance Resources
- Healthcare.gov — Official North Dakota enrollment portal
- North Dakota Department of Insurance — Plan complaints and consumer protection
- Complete ACA Guide — Full explanation of ACA Marketplace rules
- Subsidy Calculator — Estimate your 2026 premium tax credit