North Dakota Open Enrollment 2027: Dates, Insurers and Rate Changes

By Michael Sprague, Licensed Health Insurance Agent · Reviewed by Heather Sprague, Licensed Health Insurance Agent

North Dakota open enrollment runs from November 1, 2026 to January 15, 2027 on HealthCare.gov. Pick a plan by December 15 if you want coverage to start January 1. All three Marketplace insurers are back for 2027, but approved rates are up an average of about 17.5% before subsidies.

This guide covers the key dates, which insurers are selling plans in North Dakota for 2027, how much rates are changing and how to keep your costs down. For free help comparing plans, call a licensed Vivna agent at 888-730-6031.

Key Dates for North Dakota Open Enrollment

Date	What happens
November 1, 2026	Open enrollment starts on HealthCare.gov
December 15, 2026	Last day to enroll for coverage starting January 1, 2027
January 15, 2027	Open enrollment ends. Plans picked by this date start February 1
After January 15	You need a qualifying life event for a special enrollment period

If you have a plan now and do nothing, HealthCare.gov may automatically renew you into the same or a similar plan. Auto-renewal can cost you money when rates and subsidies change, so compare before December 15.

Which Insurers Sell Plans in North Dakota for 2027

North Dakota has the same three Marketplace insurers for 2027 that it had in 2026:

Insurer	2027 status	Approved average rate change
Blue Cross Blue Shield of North Dakota	Returning	19.0%
Medica Health Plans	Returning	13.3%
Sanford Health Plan	Returning	7.0%

Plan choices vary by county, and Medica does not sell plans in every county. Enter your ZIP code on HealthCare.gov, or have a licensed agent check it for you.

How Much Are Rates Going Up in North Dakota

North Dakota regulators approved average increases of 19.0% for Blue Cross Blue Shield of North Dakota, 13.3% for Medica and 7.0% for Sanford Health Plan. Each insurer asked for more, and the state cut the Blue Cross and Medica requests. Across the market, the average approved increase is about 17.5%.

North Dakota runs a state reinsurance program that helps lower full-price premiums. Insurers noted that the program will cover less for 2027, which adds to this year's increases. Rate changes are before subsidies, so many people who get a premium tax credit will see a smaller change.

How Subsidies Work in North Dakota for 2027

The enhanced federal subsidies that were in place from 2021 through 2025 expired. For 2027, premium tax credits are available to households with income from 100% to 400% of the federal poverty level that do not have access to affordable employer coverage. Above 400%, there is no subsidy.

Your subsidy is tied to the cost of the second-lowest-cost silver plan in your area. When that benchmark plan goes up, your subsidy usually goes up too. That is why some people see little change in what they pay, while people who earn too much for a subsidy pay the full increase.

If your income is near the 400% line, small changes can make a big difference. See our guide to the ACA subsidy cliff.

Medicaid in North Dakota

North Dakota expanded Medicaid. Adults with income up to 138% of the federal poverty level may qualify, and you can apply any time of year. HealthCare.gov will send you to North Dakota Medicaid if your income looks eligible.

How to Enroll in North Dakota

• Gather your information: household members, Social Security numbers, income estimate for 2027 and current coverage details.
• Estimate your 2027 income carefully. Your subsidy is based on it, and you reconcile it at tax time.
• Compare plans: look at premiums, deductibles, out-of-pocket maximums, networks and drug lists, not just the monthly price.
• Check your doctors and prescriptions in each plan's network and formulary.
• Enroll on HealthCare.gov or with a licensed agent at no extra cost.
• Pay your first premium to start coverage.

Ways to Lower Your Costs in North Dakota

• Compare bronze, silver and gold plans. If your income is under 250% of the poverty level, a silver plan may give you cost-sharing reductions.
• Consider an HSA-eligible bronze plan if you are healthy and want a tax-free savings account.
• Add hospital indemnity or accident insurance to a lower-premium plan to cover big bills.
• Use our open enrollment checklist so you do not miss a step.

Missed Open Enrollment in North Dakota

After January 15, you can only enroll in a Marketplace plan if you have a qualifying life event, such as losing other coverage, moving, getting married or having a baby. Medicaid enrollment is open all year. If you do not qualify for either, a licensed agent can walk you through dental, vision and supplemental plans you can buy any time. See how to buy health insurance after open enrollment.

North Dakota Open Enrollment: FAQ

When is open enrollment in North Dakota for 2027

November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15 for coverage that starts January 1.

How many insurers sell Marketplace plans in North Dakota for 2027

Three: Blue Cross Blue Shield of North Dakota, Medica Health Plans and Sanford Health Plan.

Are North Dakota health insurance premiums going up in 2027

Yes. Approved increases are 19.0% for Blue Cross, 13.3% for Medica and 7.0% for Sanford, about 17.5% on average before subsidies.

Can I get a subsidy in North Dakota

Yes, if your household income is between 100% and 400% of the federal poverty level and you do not have affordable job-based coverage. Adults under 138% usually qualify for Medicaid instead.

What if I miss the deadline

You need a qualifying life event, such as losing other coverage or moving, for a special enrollment period. Otherwise you wait for the next open enrollment.

Next Steps for North Dakota open enrollment

Review your 2027 options before December 15, especially if your insurer is leaving or your rate is going up. Compare plans in your ZIP code and update your income estimate. See our national guide to open enrollment deadlines by state and our North Dakota health insurance page.

Want a licensed agent to help? Call 888-730-6031, Monday through Friday, 9 a.m. to 6 p.m. Eastern, or request a free quote.

Sources

1. Valley News Live: North Dakota premiums set to rise in 2027
2. ACASignups: North Dakota 2027 rate changes
3. healthinsurance.org: North Dakota Marketplace
4. HealthCare.gov

Related Guides

• Open enrollment deadlines by state
• Open enrollment checklist
• ACA subsidy cliff
• North Dakota health insurance

Vivna Insurance is a licensed independent agency, not a government website. Our help is free; we are paid by the insurance companies we work with. Coverage options, deadlines and costs vary by plan and state.