Apply Online
Complete and submit an Application for Assistance for Medicaid (health care) coverage using our self-service portal.
On Paper
Complete the appropriate form below and return to a human service zone office. Find your local zone office. All applications are fillable .pdfs.
- If you are under age 65, not disabled, and you want Medicaid ONLY
- If you want to apply for Medicaid and also want to apply for help with food, cash assistance, or child care
- Application for Assistance form (SFN 405) and return it to a human service zone office.
- If you are aged, blind, or disabled, and you ONLY want Medicaid coverage, the Medicare Savings Programs, or coverage in a basic care facility
By Mail
Contact the Customer Support Center at (866) 614-6005 or 701-328-1000; 711 (TTY), or a human service zone office and request an application by mail.
Application Assistance
If you are needing our help with your ND Medicaid coverage, contact the Customer Support Center, Monday-Friday, 8 a.m. - 5 p.m. CT.
- Phone: 866-614-6005 or 701-328-1000
- TTY: 711
- Free translation is available
- Fax: 701-328-1006
- Mail: Customer Support Center
P.O. Box 5562
Bismarck, ND 58506 - Email: applyforhelp@nd.gov
- In person: Visit a human service zone office. Find a human service zone office near you.
Additional Information
For information about public assistance programs, view the Application for Assistance Guidebook - Which contains important information about programs and client rights.