North Dakota Health and Human Services mission is to provide quality, efficient, and effective human services, which improve the lives of people.
What is North Dakota Medicaid?
Medicaid is a federal and state partnership program that makes coverage available for basic health services for qualified families with children, women who are pregnant, and the elderly or disabled. Medicaid is overseen at the federal level by the Centers for Medicare and Medicaid Services (CMS) within the United States Department of Health and Human Services (HHS). In North Dakota, Medicaid is administered by the North Dakota Department of Human Services. Medicaid was federally authorized in 1965; North Dakota implemented Medicaid in 1966.
How does someone become eligible for Medicaid?
A person can meet income guidelines and be under age 21, a woman who is pregnant, those that have breast or cervical cancer, are blind or disabled, are age 65 and older, or individuals who are a member of a family with children.
Eligibility is also based on income and, in some situations, assets. Not all assets a person owns are counted. Some assets that are not counted include: the home the applicant lives in, one car or other vehicle for personal use, personal belongings, burial plans or property that produced earned income such as a farm.
What is the North Dakota Children's Health Insurance Program (CHIP)?
The Children's Health Insurance Program (CHIP) is a state and federal partnership that provides coverage for children in families with qualifying income. CHIP was federally authorized in 1997; North Dakota adopted CHIP on Oct. 1, 1999.
How does someone become eligible for CHIP?
Eligible children cannot have health insurance coverage (Indian Health Services is not considered health insurance coverage), must be 18 years of age or younger and live with families with qualifying incomes.
How can an individual apply for Medicaid or CHIP services?
How do Medicaid and CHIP work with Indian Health Services?
Native Americans who are eligible for health care through the Indian Health Services (IHS) are also entitled to Medicaid and CHIP coverage if they meet the categorical and financial eligibility requirements for the North Dakota Medicaid and CHIP programs. In cases in which a recipient is eligible for both Medicaid and IHS services, and a service (such as hospital care) is covered both by Medicaid and by the IHS, the Medicaid program is required to pay for the service. When a Medicaid recipient receives a service provided by the IHS that is not included as a Medicaid service, IHS has the responsibility to pay.
Centers for Medicare and Medicaid Services (CMS)
Approved North Dakota State Plan Amendments (SPA)
- Tribal Consultation State Plan Amendment (Approved February 2012)
- Tribal Consultation Letters
- DHS Tribal Consultation Meetings
North Dakota Medicaid Information
- Home and Community-Based Services
- The Coordinated Services Program
- Health Coverage for Children
- State Plan Amendments
- Information on North Dakota's Health Tracks - also known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program.
- Asset Information for Medicaid and CHIP Eligibility
IHS/Tribal 638 Encounter Rates
Current IHS/Tribal 638 Encounter Rates - Reimbursement to IHS/Tribal 638 facilities will be on a daily encounter basis and based on the approved all-inclusive rates published each year in the Federal Register by the U.S. Department of Health and Human Services.
IHS/Tribal 638 Care Coordination
- SHO #16-002 Federal Funding for Services "Received Through" an IHS-Tribal Facility (124kb pdf)
- ND Care Coordination Agreement Template (128kb pdf)
- ND HHS -Tribal Entity Agreement for Tribal Health Fund (15kb Word Doc)
- ND HHS - Tribal 638-IHS Care Coordination Billing Guidelines (193kb pdf)
- ND HHS – Tribal Care Coordination Presentation (May 18, 2023)
- Tribal Care Coordination Guidance
- Tribal Care Coordination FAQ
Medical Services Contacts
Medical Services Division
North Dakota Health and Human Services
600 E. Boulevard Ave., Dept. 325
Bismarck, ND 58505-0250