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Medical Services Publications

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For additional information regarding the Medicaid program, you may choose from several options. A general overview is available via the following brochures and booklets.

HCBS Agency Direct Caregiver Workforce Recruitment/Retention Incentives

News and Information

North Dakota Marketplace Navigator Program

The ND Navigator project is a grant-funded program at the ND Center for Persons with Disabilities that helps people apply for health care coverage through the federal Health Insurance Marketplace or Medicaid/CHIP. Applicants do not need to have a disability to get help. Call 1-800-233-1737 for more information or visit their website.

For Public Information

Other News

Medicaid Access Monitoring Plan (5 MB pdf) - submitted to the Centers for Medicare and Medicaid Services (CMS) on Oct. 1, 2016.

LEARN MORE about North Dakota's Home and Community Based Services (HCBS) Settings Rule Statewide Transition Plan

Link to Archived News and Information.

Public Notices

2023

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Previous Years - Public Notices

2022

2021

2020

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Application

If you are under age 65, not disabled, and you want medical coverage ONLY, you may complete the Application for Health Care Coverage and Paying Costs (SFN 1909)

Health Care Application for the Elderly and Disabled - Used to determine if individuals who are elderly or who have disabilities quality for Medicaid, the Aid to the Blind Remedial Program, Basic Care Assistance Program, and/or Medicare Savings Programs

Online Application for Economic Assistance Programs - Used to apply online for Medicaid, Healthy Steps Children's Health Insurance Plan, Basic Care Assistance, Medicare Savings programs, and other assistance such as Child Care Assistance, Supplemental Nutrition Assistance Program (SNAP) (Food Stamps), and Temporary Assistance for Needy Families (TANF).

Booklets

Guide to N.D. Medicaid Primary Care Provider Program (Revised January 2023) (597kb pdf) - provides an overview of the primary care provider program for people who qualify for Medicaid under the children and families coverage group

Brochures

Fact Sheets

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Children with Disabilities Medicaid Coverage

Children with disabilities often have health care needs that may require services that exceed coverage from private health insurance. Children with Disabilities Medicaid Coverage allows families to “buy-into” the Medicaid program by paying a monthly premium based on the household’s income. 

Parents can apply online at www.applyforhelp.nd.gov or at a Human Service Zone office. 

To Qualify

  • A child must be under the age 19. If an eligible child turns 19 during a portion of a month, he or she could be covered through the end of that month.
  • The child must be disabled, which means he or she must meet the Social Security Administration's definition of disability.
  • The household’s total net countable income cannot be more than 250% of the Federal Poverty Level. 
  • There is no asset limit for this coverage. Children can qualify even if their family owns a home, more than one car or other assets.
  • If an employer of either parent offers medical coverage for the child, and the employer pays at least half of the premium, the child must be enrolled in the private health insurance plan.
  • A family can have private health care insurance and still qualify for the Children with Disabilities Medicaid Coverage. 

Effective April 1, 2023

Family Size 

Monthly Income 
1 $3,038
2 $4,109
3 $5,180
4 $6,250

Add $1,071 for each additional person.

Premiums

Families with a child who qualifies, pays a monthly premium equal to five percent of the household’s gross countable income. If the child is covered by other private health insurance, the Children with Disabilities premium will be reduced by the amount the family pays for the private health insurance premium.
 

Frequently Asked Questions

Q – Are children who are eligible under the Children with Disabilities Medicaid Coverage required to have a primary care provider?
A – No. Children who qualify for the coverage do not have to name a primary care provider.

Q – If a child qualifies for Children with Disabilities Medicaid Coverage, does the human service zone office make a referral to Child Support?
A – Yes. If one parent is out of the household, a referral is made to the department’s Child Support Division to establish paternity and to help secure health insurance and other supports for the child. 

Q – How much is the enrollment fee for a child who qualifies for the Children with Disabilities Medicaid Coverage?
A – There is no enrollment fee for this coverage.

Q – What is the earliest day my child can be covered under the Children with Disabilities Medicaid Coverage?
A – Coverage can start up to three months before the month the family applies for coverage. (Example: If the application is received in June, and the child is eligible, coverage could go back three months to March).

Q – What services are covered under the Children with Disabilities Medicaid Coverage?
A – Children who qualify are eligible to receive all services covered by North Dakota Medicaid. Some services are subject to prior authorization requirements and benefit limits. 

Q – Does the Children with Disabilities Medicaid Coverage have other out-of-pocket costs besides the premium?
A – No. The monthly premium is the only cost for covered services. Medicaid rules related to service authorizations and limits need to be followed to ensure there are no other out-of-pocket costs.


For more information, contact a human service zone office. 

Updated April 2023
 

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See additional fact sheets
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Provider Newsletters

For provider newsletters please visit our Medicaid Provider Information page.

Member Newsletters

Reports

Other Documents

Quarterly Budget Insight: This report includes caseload and expenditure data for selected programs within the N.D. Department of Human Services.