In the Peace Garden State, where vast prairies meet the Badlands and winters test endurance from Bismarck to Fargo, healthcare access can feel as remote as a snowbound ranch. If you’re a family in Grand Forks covering kids’ check-ups amid rising costs or a senior in Minot managing chronic care on a fixed pension, the North Dakota Medicaid application offers essential support through programs like Basic Care for long-term needs and Expanded Medicaid for adults.
In 2025, Medicaid serves over 150,000 North Dakotans, managed by the Department of Health and Human Services (HHS). With the “One Big Beautiful Bill” (signed July 4, 2025) ushering in $1 trillion in federal cuts through 2034, including work requirements and frequent eligibility checks, launching your North Dakota Medicaid application now is a prairie-smart strategy.
This detailed guide covers eligibility, income limits, required documents, and the full process—tailored for North Dakota’s rural clinics, oil patch economies, and tribal partnerships like the Basic Care Waiver. Ready to take control? Start by estimating your benefits with the Medicaid Eligibility Calculator.
Eligibility for the North Dakota Medicaid Application
Before diving into the North Dakota Medicaid application, let’s clarify who qualifies. Medicaid isn’t just for the unemployed—it’s for working parents in Williston, college students in Grand Forks, and retirees in Dickinson whose income fits state-federal guidelines. North Dakota, an expansion state, covers adults up to 138% FPL, with robust options for children, pregnant women, and disabled individuals.
Core Eligibility Factors
- Household Composition: Your household includes everyone who lives with you, claimed on taxes, or sharing finances—spouses, kids, and dependents.
- Income Thresholds: Varies by program. For Expanded Medicaid (adults), up to 138% FPL ($21,597/year for one). Children up to 203% FPL ($33,996/year for one). Pregnant women up to 162% FPL ($27,261/year). Seniors/disabled for long-term care up to $2,901/month. See Income for Medicaid Eligibility for details.
- Asset Rules: $2,000 for singles ($3,000 for couples) in most programs; exempt home equity under $713,000, one car, and personal items. No asset limit for children/pregnant women in Basic Medicaid.
- Citizenship and Residency: U.S. citizens or qualified non-citizens living in North Dakota.
- Medical Need: For waivers like Basic Care or Elderly & Disabled, require nursing home level of care.
North Dakota’s expansions (as of July 2025) include the Basic Care program for home-based long-term care. The OBBBA adds work requirements (80 hours/month for adults 19–64 starting 2027) and 6-month eligibility checks from December 2026. Overlap with SNAP? Curious about costs? See Is Medicaid Free?.
North Dakota Medicaid Income Limits for 2025: Know Your Numbers
North Dakota’s Medicaid income limits vary by program and adjust annually (effective April 1, 2025). As an expansion state, adult coverage reaches 138% FPL.
Key Income Limits (Annual, Contiguous U.S.)
| Program/Group | Household Size 1 | Household Size 4 | Notes |
|---|---|---|---|
| Expanded Adults | $21,597 (138% FPL) | $43,194 (138% FPL) | Ages 19–64; no asset test. |
| Children | $33,996 (203% FPL) | $67,992 (203% FPL) | Up to age 18; CHIP for higher. |
| Pregnant Women | $27,261 (162% FPL) | $54,522 (162% FPL) | Prenatal/postpartum up to 12 months. |
| Parents/Caretakers | $15,650 (100% FPL) | $31,300 (100% FPL) | Low thresholds; family coverage. |
| Seniors/Disabled (Regular) | $11,604 (74% FPL) | $23,208 (74% FPL) | SSI-linked; $967/month single. |
| Nursing Home/Long-Term Care | $34,812 (300% SSI, $2,901/month single) | $69,624 (300% SSI, $5,802/month couple) | Income cap; spend-down available. |
Quick Math Tip: Use Modified Adjusted Gross Income (MAGI) for most; SSI methodology for seniors/disabled. Asset limit $2,000 single/$3,000 couple (exempt home under $713,000 equity). For SNAP overlap, see SNAP Benefits by State.
Essential Documents for Your North Dakota Medicaid Application
Streamline your North Dakota Medicaid application with these must-haves:
- Identification: Driver’s license, state ID, birth certificate, or Social Security card.
- Income Verification: Pay stubs (30 days), W-2s, tax returns, SSI/unemployment letters.
- Residency Proof: Utility bill, lease, or mail with North Dakota address.
- Household Info: Names, ages, relationships, SSNs for all members.
- Medical Proof: Doctor’s letter for disability/elderly waiver; pregnancy verification.
- Assets: Bank statements, property deeds for long-term care.
Digital uploads preferred; originals for in-person.
How to Apply for Medicaid in North Dakota: Step by Step
HHS targets 30–45 day processing (45 days expedited for children/pregnant). Here’s the roadmap:
Step 1: Pre-Screen Your Odds
Test waters at hhs.nd.gov/healthcare/medicaid/eligibility or the Medicaid Eligibility Calculator.
Step 2: Pick Your Path
- Online (Recommended): hhs.nd.gov/applyforhelp. Sign up, fill digitally, upload—routed to your Human Service Zone.
- Mail/Fax: Download from hhs.nd.gov/forms. Send to your local Human Service Zone (list at hhs.nd.gov/regional-offices).
- In-Person: Visit a Human Service Zone office for guided help.
- Phone: Call 1-833-545-9448 (Navigator) or 701-328-2310.
Elderly/disabled? Use Form HP-207 for waivers.
Step 3: Fill and Submit
Detail household, income, assets, medical needs. Sign it—e-sign or print.
Step 4: Interview Time
Phone or in-person within 30–45 days to chat details. Have docs ready.
Step 5: Decision Awaits
- Approved: Medicaid card mails 7–30 days; provider setup.
- Denied: Appeal notice—challenge in 90 days (coverage during for some).
- Expedited: 45-day fast lane for kids/pregnant.
Step 6: Activate and Track
Annual renewals; changes in 10 days. Track via hhs.nd.gov/mybenefits.
Pro Tips for a Seamless North Dakota Medicaid Application
- Basic Care Focus: Home-based waiver for seniors—include functional assessment.
- Tribal Partnerships: Standing Rock Sioux Tribe offers streamlined apps.
- Help Hotlines: ND Legal Services (1-800-634-5263) or county zones.
- OBBBA Heads-Up: Work expansions 2027—document hours if applicable.
- Renewals: Use HHS reminders—delays happen, appeals fix retroactively.
Frequently Asked Questions About the North Dakota Medicaid Application
How do I qualify for expedited Medicaid benefits in North Dakota?
To qualify for expedited Medicaid benefits in North Dakota, pregnant women and children under 21 get priority processing within 45 days, while emergencies (like labor or acute illness) can fast-track to 10 days. For the North Dakota Medicaid application, submit via hhs.nd.gov/applyforhelp with proof like a doctor’s note for pregnancy or hospital records for urgent needs. This is crucial in rural areas like the Red River Valley, where access lags—Human Service Zones can assist with same-day intake.
What is the maximum Medicaid income limit in North Dakota for children?
The maximum Medicaid income limit in North Dakota for children is 203% of the Federal Poverty Level (FPL)—$33,996 annually ($2,833/month) for a single-parent household or $67,992 ($5,666/month) for a family of four in 2025. This covers kids up to age 18 with no asset test, making the North Dakota Medicaid application family-friendly. Include immunization records for faster approval, and it’s a lifeline for working parents in Fargo suburbs.
Can pregnant women apply for Medicaid in North Dakota without income proof?
Pregnant women in North Dakota can apply for Medicaid with presumptive eligibility, covering prenatal care immediately upon application—even without full income proof—up to 162% FPL ($27,261/year for one). The North Dakota Medicaid application via hhs.nd.gov allows provisional approval based on self-attestation, with verification later. This ensures timely services in high-risk areas like the Bakken oil fields, where clinics partner with Human Service Zones for walk-in support.
Does North Dakota Medicaid cover long-term care for seniors?
North Dakota Medicaid covers long-term care for seniors through the Basic Care Waiver, with income up to $2,901/month ($34,812/year) for singles and assets under $2,000. The North Dakota Medicaid application requires a nursing home level of care assessment via Form HP-207—apply through your Human Service Zone for home-based services like in-home aides, avoiding institutionalization. It’s vital for rural elders in the Turtle Mountains, where transportation to facilities is tough.
How often do I need to renew North Dakota Medicaid coverage?
North Dakota Medicaid renewal is annual for most programs, but the “One Big Beautiful Bill” mandates 6-month checks for expansion adults starting December 2026, requiring updated income proof via hhs.nd.gov. For children and pregnant women, it’s yearly—set reminders to avoid gaps. The North Dakota Medicaid application process includes auto-renewal notices, but respond within 30 days to keep coverage seamless, especially post-flood in the Red River Valley.
Final Thoughts: Take the First Step Today
The North Dakota Medicaid application is your accessible route to healthcare stability—eligibility varies by program (up to 138% FPL for adults), docs like ID/pay stubs, and apply via hhs.nd.gov/applyforhelp or Human Service Zones. With OBBBA cuts on the horizon, seize the moment.
Plug your numbers into the Medicaid Eligibility Calculator for a quick estimate, dive deeper on Income for Medicaid Eligibility, or learn Is Medicaid Free?. Reach HHS at 1-833-545-9448 or hhs.nd.gov. Protect your health, North Dakota—you deserve it.