North Dakota ACA Health Insurance
53 counties, 3 issuers, 59 plans
Premium Range
Premiums in North Dakota range from $243/mo to $725/mo (age 27 base rate).
Reading the North Dakota Marketplace
The ACA marketplace in North Dakota lists 59 plans from 3 issuers spread across 53 counties. The statewide average premium is $499/mo for a 27-year-old, $608/mo at age 40, and $1,292/mo at age 60 — reflecting the ACA's 3-to-1 age rating band. Individual plan premiums run from $243 at the low end to $725 at the high end, before subsidies.
Geography drives most of the within-state variation: Adams posts the highest Silver average at $603/mo, while Burleigh sits at $465/mo — a gap shaped by local issuer competition, hospital pricing, and risk-pool composition rather than benefit differences, since every marketplace plan must cover the same 10 essential health benefits. The statewide average annual deductible is $5,161, the amount most enrollees must pay before non-preventive coverage begins.
Premium tax credits (APTCs) further reduce what most enrollees pay out of pocket, with the size of the subsidy keyed to each county's benchmark (second-lowest Silver) premium. This page is informational only and is not insurance, medical, or tax advice — confirm your exact plan options, network providers, and subsidy eligibility at HealthCare.gov before enrolling. Source: CMS Marketplace Public Use Files.
Top 5 most-expensive counties — North Dakota (Silver avg)
Source: CMS Healthcare.gov + state-based exchange rate filings (PY 2025) North Dakota ACA marketplace premiums by county and metal tier (Plan Year 2025 Rate Filing) · 2025 CMS publishes Healthcare.gov rate filings annually for the federal exchange; state-based exchanges publish on their own schedules. Premiums shown are pre-subsidy and reflect age-27 Silver averages.
Most Expensive Counties
| # | County | Silver Avg | Plans | Issuers |
|---|---|---|---|---|
| 1 | Adams | $603/mo | 28 | 3 |
| 2 | Barnes | $603/mo | 28 | 3 |
| 3 | Billings | $603/mo | 28 | 3 |
| 4 | Bowman | $603/mo | 28 | 3 |
| 5 | Dickey | $603/mo | 28 | 3 |
Most Affordable Counties
| # | County | Silver Avg | Plans | Issuers |
|---|---|---|---|---|
| 1 | Burleigh | $465/mo | 37 | 3 |
| 2 | Morton | $469/mo | 28 | 2 |
| 3 | Cass | $479/mo | 40 | 3 |
| 4 | Burke | $540/mo | 19 | 2 |
| 5 | Divide | $540/mo | 19 | 2 |
All Counties in North Dakota
| County | Silver Avg | Bronze Avg | Gold Avg | Plans | Issuers | YoY |
|---|---|---|---|---|---|---|
| Adams | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Barnes | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Benson | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Billings | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Bottineau | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Bowman | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Burke | $540 | N/A | $523 | 19 | 2 | +19.7% |
| Burleigh | $465 | N/A | $470 | 37 | 3 | +17.0% |
| Cass | $479 | N/A | $485 | 40 | 3 | +19.6% |
| Cavalier | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Dickey | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Divide | $540 | N/A | $523 | 19 | 2 | +19.7% |
| Dunn | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Eddy | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Emmons | $561 | N/A | $574 | 37 | 3 | +17.9% |
| Foster | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Golden Valley | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Grand Forks | $543 | N/A | $541 | 31 | 3 | +24.8% |
| Grant | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Griggs | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Hettinger | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Kidder | $603 | N/A | $602 | 28 | 3 | +26.1% |
| LaMoure | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Logan | $603 | N/A | $602 | 28 | 3 | +26.1% |
| McHenry | $594 | N/A | $593 | 28 | 3 | +25.7% |
| McIntosh | $561 | N/A | $574 | 37 | 3 | +17.9% |
| McKenzie | $540 | N/A | $523 | 19 | 2 | +19.7% |
| McLean | $554 | N/A | $566 | 37 | 3 | +17.9% |
| Mercer | $561 | N/A | $574 | 37 | 3 | +17.9% |
| Morton | $469 | N/A | $474 | 28 | 2 | +11.3% |
| Mountrail | $540 | N/A | $523 | 19 | 2 | +19.7% |
| Nelson | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Oliver | $561 | N/A | $574 | 37 | 3 | +26.1% |
| Pembina | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Pierce | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Ramsey | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Ransom | $567 | N/A | $563 | 31 | 3 | +27.0% |
| Renville | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Richland | $567 | N/A | $563 | 31 | 3 | +27.0% |
| Rolette | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Sargent | $567 | N/A | $563 | 31 | 3 | +27.0% |
| Sheridan | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Sioux | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Slope | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Stark | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Steele | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Stutsman | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Towner | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Traill | $561 | N/A | $574 | 37 | 3 | +26.1% |
| Walsh | $561 | N/A | $558 | 31 | 3 | +26.7% |
| Ward | $594 | N/A | $593 | 28 | 3 | +25.7% |
| Wells | $603 | N/A | $602 | 28 | 3 | +26.1% |
| Williams | $603 | N/A | $602 | 28 | 3 | +26.1% |
Health Insurance Guides
Related Health & Cost Data
ACA Health Insurance in North Dakota
The Affordable Care Act marketplace in North Dakota offers 59 health insurance plans from 3 issuers across 53 counties. Premiums vary significantly by geography: the most expensive county (Adams) averages $603/mo for a Silver plan, while the most affordable (Burleigh) averages $465/mo.
Many consumers qualify for premium tax credits that significantly reduce monthly costs. Subsidies are based on household income relative to the federal poverty level. The average deductible across plans is $5,161, though lower-deductible options are available at higher monthly premiums.
Frequently Asked Questions
How much does health insurance cost in North Dakota? ▼
What is the cheapest health insurance plan in North Dakota? ▼
How many health insurance companies operate in North Dakota? ▼
Where is health insurance most expensive in North Dakota? ▼
What is the average deductible for health plans in North Dakota? ▼
Disclaimer: This page is for informational purposes only and does not constitute insurance or financial advice. Premiums shown are base rates for a 27-year-old non-tobacco user unless otherwise noted. Actual premiums vary by age, location, tobacco use, and subsidy eligibility. Source: CMS Marketplace PUF.
Read our methodology — how this data is sourced, computed, and verified.
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