Sanford Individual Simplicity $4,750
Starting at
$566
/month before subsidy
Sanford Individual Simplicity $4,750 is a 2026 Silver PPO health insurance plan from Sanford Health Plan, sold on the ACA Marketplace in North Dakota under plan ID 89364ND0120005. The monthly premium starts at $566 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $4,750 ($9,500 for a family), and the individual out-of-pocket maximum is $9,750 ($19,500 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 89364ND0120005
- Plan year
- 2026
- State
- North Dakota
- Metal level
- Silver
- Plan type
- PPO
- HSA-eligible
- No
Individual Deductible
$4,750
Family: $9,500
Out-of-Pocket Max
$9,750
Family: $19,500
Coinsurance
50%
You pay after deductible
Network Type
PPO
NDN003
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Not rated
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$6,720
your estimated cost
- Deductible
- $4,750
- Copays
- $10
- Coinsurance
- $1,900
Managing type 2 diabetes
A year of routine care
$1,720
your estimated cost
- Deductible
- $100
- Copays
- $1,600
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,500
your estimated cost
- Deductible
- $2,100
- Copays
- $400
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver PPO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.
Consider this plan if you:
- Visit the doctor a few times per year
- Take regular prescription medications
- Want moderate protection against high medical bills
- May qualify for Cost-Sharing Reductions (CSR) to lower deductibles
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,379/month
Annual Premium
$6,792
OOP Maximum
$9,750
💡 What this means:
With a $4,750 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $9,750 total. Then insurance covers everything else for the year.
More plans from Sanford Health Plan in North Dakota
- Sanford Individual Simplicity $10,600from $357/mo
- Sanford Individual TRUE $10,600from $296/mo
- Sanford Individual Simplicity $6,500from $406/mo
- Sanford Individual Simplicity $7,200 HSA Qualifiedfrom $418/mo
- Sanford Individual Simplicity Standardized $7,500from $400/mo
- Sanford Individual TRUE $6,500from $337/mo
- Sanford Individual TRUE $7,200 HSA Qualifiedfrom $341/mo
- Sanford Individual TRUE Standardized $7,500from $332/mo
Frequently asked questions about Sanford Individual Simplicity $4,750
How much does Sanford Individual Simplicity $4,750 cost per month?
Sanford Individual Simplicity $4,750 from Sanford Health Plan starts at $566 per month before any subsidy in North Dakota. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Sanford Individual Simplicity $4,750?
The individual medical deductible is $4,750, and the family deductible is $9,500. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Sanford Individual Simplicity $4,750?
The most you would pay in a year for covered in-network care is $9,750 for an individual and $19,500 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Sanford Individual Simplicity $4,750 HSA-eligible?
No. Sanford Individual Simplicity $4,750 is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Sanford Individual Simplicity $4,750 use?
Sanford Individual Simplicity $4,750 is a PPO plan. PPO plans let you see specialists without a referral and use out-of-network providers (at higher cost), offering the most flexibility.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.