Sanford Individual Simplicity $3,500
Silver · PPO · Sanford Health Plan · North Dakota
At age 40 it costs between $538.26 and $628.26 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $3,500 | $9,750 | $45 | $30 |
| up to 150% of the federal poverty level | $0 | $1,800 | No Charge | No Charge |
| 150% to 200% | $1,500 | $3,000 | $15 | $10 |
| 200% to 250% | $3,500 | $7,750 | $45 | $30 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 89364ND0120003 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Silver |
| Plan type | PPO |
| Deductible (individual) | $3,500 |
| Deductible (family) | $7,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,750 |
| Family maximum | $19,500 |
| Primary care visit | $45 |
| Specialist visit | $70 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $30 |
| Preferred brand drugs | $40 |
| Specialty drugs | 50% 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 | $421.17 | $478.03 | $538.26 | $752.21 | $1,143.05 |
| Morton County | $421.17 | $478.03 | $538.26 | $752.21 | $1,143.05 |
| Cass County | $429.45 | $487.42 | $548.83 | $766.99 | $1,165.51 |
| Grand Forks County | $465.24 | $528.05 | $594.57 | $830.91 | $1,262.65 |
| Adams County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Barnes County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Benson County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Billings County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Bottineau County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Bowman County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Burke County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Cavalier County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Dickey County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Divide County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Dunn County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Eddy County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Emmons County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Foster County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Golden Valley County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Grant County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Griggs County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Hettinger County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Kidder County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| LaMoure County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Logan County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| McHenry County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| McIntosh County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| McKenzie County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| McLean County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Mercer County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Mountrail County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Nelson County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Oliver County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Pembina County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Pierce County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Ramsey County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Ransom County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Renville County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Richland County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Rolette County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Sargent County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Sheridan County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Sioux County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Slope County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Stark County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Steele County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Stutsman County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Towner County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Traill County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Walsh County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Ward County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Wells County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
| Williams County | $491.60 | $557.97 | $628.26 | $877.99 | $1,334.19 |
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.