How to Get North Dakota Medicaid Benefits 

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We have scoured the internet to provide you with all you need to know about the North Dakota Medicaid Benefits.

Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.

This post will teach you all you need to learn about Medicaid in North Dakota.

What is the North Dakota Medical Program?

North Dakota Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the North Dakota Medical Program?

North Dakota Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums, copayments, or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in North Dakota?

Phone

1-844-854-4825

Mailing Address

North Dakota Dept. of Human Services, Medicaid Eligibility, 600 E. Blvd. Ave., Bismarck, N.D. 58505.

Email: medicaidcc@nd.gov.

What are the Medicaid plans in North Dakota?

Primary Care Case Management (PCCM) Program

To receive primary care, crisis intervention, and referrals to additional programs under the state’s Primary Care Case Management (PCCM) Program, kids, pregnant women, parents, and other limited adults must select or be assigned to a primary care physician.

ExperienceHealthND program

Before it changed into the “Health Management Program” in 2011, the ExperienceHealthND program served the entire state.

Medicaid Expansion MCO

The state elected to employ a managed care delivery system to provide care for those who become newly eligible for Medicaid beginning in 2014 as a result of the expansion made possible by the Affordable Care Act (Medicaid Expansion MCO).

How do I apply for North Dakota Medicaid?

Call 1-844-854-4825 to enroll. 

Apply in person at the North Dakota Dept. of Human Services, Medicaid Eligibility

Online:  Download and print the application.

Mail: To 600 E. Blvd. Ave., Bismarck, N.D. 58505.

Email:  medicaidcc@nd.gov.

What is covered by North Dakota Medicaid?

North Dakota Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

Can I have both North Dakota Medicaid and Medicare?

You can sign up for Medicare and Medicaid if you are dually eligible. Medicaid can pay for services like long-term care that Medicare does not.

North Dakota Waiver

  • Medicaid Waiver HCBS;
  • Children’s Hospice;
  • Autism Spectrum Disorder Birth through Four;
  • Self-Directed Supports (ended 03/31/2011);
  • Traditional MR DD HCBS;
  • Technology Dependent Medicaid Waiver;
  • Medicaid Waiver for Fragile Children

Copayments?

They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by North Dakota Medicaid?

Medicaid is not required to pay for private nursing or home care services given by family members. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for North Dakota Medicaid?

In 2022, a single adult will pay $13,590, a family of four $27,750, and an eight-person family $46,630.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for North Dakota Medicaid, thanks to the asset spend down option. 

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
  • When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in North Dakota?

The best plan for you is the one that meets your demands and offers the most benefits in terms of health insurance and monetary help because it varies from person to person.

Where do I find the letter showing the reason(s) for denial or discontinuance from North Dakota Medicaid?

By signing into your account at Portal, you can see the progress of your North Dakota Medicaid application.


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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