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
- Description - HCBS Agency Direct Caregiver Workforce Retention Incentive
- Description - HCBS Agency Direct Caregiver Workforce Recruitment Incentive
- FAQ - HCBS Agency Direct Caregiver Retention and Recruitment 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
- 2024 ND Medicaid Quality Strategy Plan (Effective January 1, 2024)
- The summary of public comments received by North Dakota Health and Human Services and the responses are available here.
- CURRENT Medicaid Home and Community-Based Services Waiver (Effective April 1, 2023)
- North Dakota Plan for Implementation of ARPA of 2021 Section 9817 10% Enhanced Federal Medical Assistance Percentage (FMAP) for home and community-based services
- North Dakota's Medicaid Access Monitoring Plan 2019 (1.83MB pdf)
Other News
Medicaid Access Monitoring Plan (5 MB pdf) - submitted to the Centers for Medicare and Medicaid Services (CMS) on Oct. 1, 2016.
Link to Archived News and Information.
Public Notices
2023
- Medicaid State Plan Alternative Benefit Plan Updates (posted Nov. 14, 2023)
- ND Medicaid State Plan Changes for January 1, 2024
- ND Medicaid End of Primary Care Case Management Program for January 1, 2024
- ND Medicaid State Plan Changes for January 1, 2023
- ND Medicaid 1915(i) State Plan Amendment for April 1, 2023
- ND Medicaid State Plan Changes for July 1, 2023
- ND Medicaid State Plan Changes for October 1, 2023
- ND Medicaid State Plan Alternative Benefit Plan Updates for January 1, 2024
2022
- Aug. 16, 2022: Medicaid Rate and State Plan Changes for Sept. 1, 2022
- June 14, 2022: Medicaid Rate and State Plan Changes for July 1, 2022
- March 24, 2022: Medicaid Rate and State Plan Changes for April 1, 2022
2021
- Dec. 21, 2021: Medicaid Rate and State Plan Changes for Jan. 1, 2022
- Dec. 1, 2021: Public comment sought on the draft 1915(c) Medicaid Home and Community-Based Services waiver renewal application
- Nov. 30, 2021: Public comment sought on the draft 2022 Medicaid Expansion Quality Strategy Plan
- Sept. 23, 2021: North Dakota 1915(b) Waiver January 1, 2022
- June 23, 2021: North Dakota Medicaid Rate and State Plan Changes for July 1, 2021
- Feb. 23, 2021: Public comment sought on the draft 2021 Medicaid Expansion Quality Strategy Plan
- Jan. 27, 2021: Public comment sought on the five-year renewal of the Medicaid 1915(c) Children with Medically Fragile Needs Home and Community-Based Services (HCBS) Waiver
- Jan. 14, 2021: North Dakota Medicaid Rate and State Plan Changes for January 1, 2021
2020
- Sept. 18, 2020: Public comment sought on renewal of Medicaid 1915(c) Technology Dependent Waiver
- Sept. 16, 2020: North Dakota Medicaid Rate and State Plan Changes for October 1, 2020
- Aug. 28, 2020: North Dakota Medicaid Alternative Benefit Plan and 1915(b) Waiver Amendment Submission
- June 23, 2020: North Dakota Medicaid Rate and State Plan Changes for July 1, 2020
- April 2, 2020: North Dakota Medicaid disaster relief changes effective March 1, 2020
- March 23, 2020: North Dakota Medicaid program changes effective April 1, 2020
- Feb. 18, 2020: Draft Medicaid 1915(i) state plan amendment
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)
- Return completed application to the ND Dept. of Human Services, Medical Services Division, 600 E. Boulevard Avenue, Bismarck, ND 58505-0250, or to your local Human Service Zone Office.
- Questions? Call 1 (877) KIDSNOW (1 (877) 543-7669)
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).
- For IMPORTANT information about these programs and client rights, see the Application for Assistance Guidebook.
- Complete this Application for Assistance (SFN 405) if you prefer to print, complete, and return it manually to your county social service office.
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
- Children's Hospice Waiver Program (487kb pdf) (September 2019)
- Children with Medically Fragile Needs (Medicaid Waiver) (66 kb pdf) (March 2020)
- Health Tracks - preventative health care program for newborns to young adults through age 20 enrolled in Medicaid.
- Notice of Right to Claim Good Cause - This form is to be completed by Medicaid applicants who believe they have "good cause" not to cooperate with the state's effort to establish paternity or collect child support or medical support.
- Coordinated Services Program (453kb pdf) (October 2019)
Fact Sheets
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, 2024
Family Size | Monthly Income |
| 1 | $3,138 |
| 2 | $4,259 |
| 3 | $5,380 |
| 4 | $6,500 |
Add $1,121 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 Section 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 2024
- Medical Claims Processing for County Jail Inmates (77kb pdf) (December 2018)
- Long-Term Care Partnership Program and Medicaid (53kb pdf) (July 2008)
- Medicaid Asset Assessment - Protecting Assets for the Spouse Still Living in the Community (34kb pdf) (April 2024)
- Medicaid Burial Policy (September 2021)
- Medicaid Client Share (Recipient Liability) (359kb pdf) (September 2021)
- Medicaid Disqualifying Transfers of Assets and Income (369kb pdf) (September 2021)
- Medicaid Disqualifying Transfer Hardship Provisions (350kb pdf) (September 2021)
- NEW: Medicaid Estate Recovery (378kb pdf) (May 2021)
- Medicaid and Spousal Impoverishment Protection (389kb pdf) (July 2023)
- Medicaid State Plan Personal Care Services (MSP-PC) (808kb pdf) (July 2011)
- Medicaid Waivers for Home and Community-Based Services (808kb pdf) (July 2011)
- Medicare Savings Program - Helping qualified individuals with Medicare Part B premiums and other cost-sharing elements (382kb pdf) (April 2024)
- Service Payments for the Elderly and Disabled (SPED) Program (848kb pdf)
- State Long Term Care Subsidy Program - Provides funds for personal needs such as clothing, health and beauty supplies, snacks and related items. (369kb pdf) (March 2022)
- Program for All-inclusive Care for the Elderly (PACE) (66kb pdf) (December 2020)
- Qualified Service Providers (QSPs) (778kb pdf) (July 2011)
- Workers with Disabilities Medicaid Coverage (355kb pdf) (September 2021)
Provider Newsletters
For provider newsletters please visit our Medicaid Provider Information page.
Member Newsletters
Please visit our Medicaid Member News page to read member newsletters.
Reports
- Uniform Payment Schedule - Medicaid Expansion
- Medicaid Expansion Annual Technical Reports
- North Dakota Long-Term Care Interim Study Final Report - July 1, 2014 (1.62mb pdf)
Other Documents
Quarterly Budget Insight: This report includes caseload and expenditure data for selected programs within the N.D. Department of Human Services.