North Dakota Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in North Dakota.
7.6 million Medicaid long-term care recipients nationwide
North Dakota Department of Health and Human Services - Medical Services Division
Processing Time
30-45 days for standard Medicaid; A&D Waiver applications take 45-60 days. North Dakota generally has adequate capacity with minimal waiting lists.
North Dakota Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in North Dakota, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). North Dakota follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$3,000
Community Spouse (At-Home Spouse)
$6,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
North Dakota Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $9,733/month average (semi-private), $10,678/month (private) (the average monthly nursing home cost in North Dakota).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in North Dakota
Nursing Home Care
Medicaid pays 100% of nursing home costs in North Dakota once eligibility is established. The average monthly cost is $9,733/month average (semi-private), $10,678/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Aged and Disabled Waiver - Assisted Living Facility Services: North Dakota's A&D Waiver explicitly includes "assisted living facility services" as a covered benefit. Participants residing in licensed assisted living facilities can receive Medicaid-covered personal care, medication management, and care coordination. However, room and board costs are not covered by Medicaid—residents must pay housing costs from their income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
North Dakota offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Aged and Disabled (A&D) Waiver
Serves individuals age 65+ or adults age 18-64 with physical disabilities who meet nursing facility level of care. Provides adult day care, assisted living facility services, case management, chore services, home-delivered meals, home modifications, homemaker services, personal care, respite care (in-home and out-of-home), specialized equipment and supplies, and transportation. Approximately 3,000 participants.
Program Details →Community Transition Services
One-time services to help individuals transition from institutions to community living. Covers moving expenses, utility setup/deposits, essential household items, and minor accessibility modifications.
Program Details →How to Apply for Medicaid in North Dakota
North Dakota Medicaid applications typically take 30-45 days for standard Medicaid; A&D Waiver applications take 45-60 days. North Dakota generally has adequate capacity with minimal waiting lists.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in North Dakota through:
- Online at nd.gov/eforms/medicaid
- Phone: 1-844-854-4825 (ND Medicaid hotline)
- Download application and mail to: ND Dept of Health and Human Services, 600 E. Boulevard Ave, Dept 325, Bismarck, ND 58505
- In-person at local county social service office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in North Dakota from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
North Dakota-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI/QDWI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding). QDWI pays Part A premiums for working disabled individuals.
Learn MoreExpanded SPED Program
Medicaid buy-in for working individuals with disabilities. Allows earned income up to 250% of Federal Poverty Level while maintaining Medicaid coverage.
Learn MoreAging Services Division Programs
State aging agency providing case management, caregiver support, senior centers, and nutrition programs statewide.
Learn MoreNeed Help with North Dakota Medicaid?
Contact North Dakota Department of Health and Human Services - Medical Services Division for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-844-854-4825Application Helpline
1-844-854-4825