Sanford Individual Simplicity $1,750
Gold · PPO · Sanford Health Plan · North Dakota
At age 40 it costs between $589.23 and $687.76 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 89364ND0120001 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Gold |
| Plan type | PPO |
| Deductible (individual) | $1,750 |
| Deductible (family) | $3,500 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,000 |
| Family maximum | $18,000 |
| Primary care visit | No Charge |
| Specialist visit | $60 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | 30% Coinsurance after deductible |
| Adult dental included | No |
| Child dental included | Yes |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-800-752-5863 · TTY 1-877-652-1844 |
Where it is sold, and what it costs there
53 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Burleigh County | $461.06 | $523.30 | $589.23 | $823.44 | $1,251.30 |
| Morton County | $461.06 | $523.30 | $589.23 | $823.44 | $1,251.30 |
| Cass County | $470.12 | $533.58 | $600.81 | $839.62 | $1,275.89 |
| Grand Forks County | $509.30 | $578.05 | $650.88 | $909.60 | $1,382.23 |
| Adams County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Barnes County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Benson County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Billings County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Bottineau County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Bowman County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Burke County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Cavalier County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Dickey County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Divide County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Dunn County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Eddy County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Emmons County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Foster County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Golden Valley County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Grant County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Griggs County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Hettinger County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Kidder County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| LaMoure County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Logan County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| McHenry County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| McIntosh County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| McKenzie County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| McLean County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Mercer County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Mountrail County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Nelson County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Oliver County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Pembina County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Pierce County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Ramsey County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Ransom County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Renville County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Richland County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Rolette County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Sargent County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Sheridan County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Sioux County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Slope County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Stark County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Steele County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Stutsman County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Towner County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Traill County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Walsh County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Ward County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Wells County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
| Williams County | $538.16 | $610.81 | $687.76 | $961.14 | $1,460.55 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.