North Dakota Medicaid

Last verified: June 2026

What is North Dakota Medicaid?

North Dakota Medicaid is administered by the Medical Services Division of North Dakota Health and Human Services (HHS), based in Bismarck. North Dakota expanded Medicaid under the ACA effective January 1, 2014 — among the earlier expansion states. Approximately 130,000 North Dakotans are enrolled, representing roughly 17% of the state's population.

The program runs on a fee-for-service model. There is no statewide managed care organization requirement — enrolled members can see any North Dakota Medicaid-enrolled provider directly. HHS contracts with providers and pays claims directly.

North Dakota presents access challenges common to rural states: a geographically dispersed population, limited specialist availability in western counties, and a significant American Indian and Alaska Native population served through the Indian Health Service (IHS) and tribal health programs. IHS facilities are authorized Medicaid providers, and North Dakota Medicaid coordinates with tribal governments on coverage.

Who qualifies for North Dakota Medicaid?

North Dakota covers multiple eligibility groups with different income and asset requirements. Most groups are MAGI-based (no asset test). The aged, blind, and disabled group has a $3,000 asset limit for a single person. Income levels were updated April 1, 2026 by ND HHS.

• Adults ages 19–64 (Medicaid Expansion): at or below 138% FPL — approximately $1,836/month for a single person (April 2026)
• Children birth through age 5: at or below 152% FPL — approximately $2,022/month for household of 1
• Children ages 6–18: at or below 138% FPL
• Pregnant women: at or below 175% FPL — approximately $2,328/month for household of 1
• Parents and caretaker relatives: at or below 41% FPL (income limits vary by household size)
• Aged, blind, or disabled individuals: at or below 90% FPL — $1,197/month for 1; $3,000 asset limit for single individuals
• Workers with disabilities: up to 225% FPL with monthly premium
• SSI recipients: automatically eligible

Source: ND HHS Medicaid Eligibility page (hhs.nd.gov/healthcare/medicaid/eligibility); income levels effective April 1, 2026. Verify current figures at hhs.nd.gov or by calling 1-800-755-2604.

One important limit for expansion adults: no dental or vision

North Dakota HHS explicitly states that the adult Medicaid Expansion group (ages 19–64 who qualify at 138% FPL) does not include dental or vision coverage. This is different from some other coverage groups in North Dakota Medicaid, which do cover dental and vision. Adults who qualify through the disability-based or parent/caretaker pathways may have access to dental and vision benefits that expansion adults do not.

For dental care, expansion adults generally need to find a community health center (FQHC), which receives federal grant funding and provides sliding-scale services regardless of coverage status. North Dakota's FQHC locations are available through the HRSA Find a Health Center tool at findahealthcenter.hrsa.gov.

How North Dakota Medicaid is structured

North Dakota uses five 1915(c) HCBS waivers to serve populations who need more than standard Medicaid but want to avoid institutional care. These cover adults with physical disabilities (Home and Community-Based Services waiver), children and adults with intellectual and developmental disabilities (IDD/DD waiver), children with autism spectrum disorder (Autism waiver), children with medically fragile conditions, and children in hospice.

North Dakota also funds the Basic Care Assistance Program (BCAP) — a state-funded (not federal Medicaid) residential care benefit for people who need some assistance with daily living but do not meet the nursing facility level of care standard required for Medicaid long-term care. This fills a gap that exists in most other states.

North Dakota Medicaid topics

What does North Dakota Medicaid cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the North Dakota Medicaid website for the current state-specific benefit package.

How to apply

Most people can apply online through North Dakota's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). North Dakota must follow that federal timeline.