Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official ND HHS and Medicaid.gov guidelines | Last Updated: May 2026
In 2026, North Dakota Medicaid covers adults earning up to $22,025 a year. Children and families may qualify at higher income levels.
This guide shows every program, every income limit, and exactly how to apply.
Quick Summary:
- Medicaid pays for doctor visits, hospital stays, prescriptions, mental health care, and more
- Adults, children, pregnant women, seniors, and people with disabilities may qualify
- Income limits range from 41% FPL for parents to 225% FPL for workers with disabilities
- North Dakota has expanded Medicaid under the ACA — most low-income adults are covered
- Apply online, by phone, or in person at applyforhelp.nd.gov
What Is Medicaid?
Medicaid is a free or low-cost health insurance program. It is run by states and funded jointly by the state and federal government. North Dakota calls its program Medicaid and manages it through the North Dakota Department of Health and Human Services (ND HHS).
Medicaid is not the same as Medicare. Medicare is for people age 65+ who paid into Social Security. Medicaid is based on your income and household size — not your age or work history.
North Dakota expanded Medicaid in 2014 under the Affordable Care Act (ACA). That means most low-income adults between ages 19 and 64 can now qualify — even without children.
Who Qualifies for Medicaid in North Dakota 2026?
North Dakota Medicaid covers several groups of people. Your eligibility depends on your age, income, household size, and sometimes your disability or pregnancy status. Most applicants must be North Dakota residents and U.S. citizens or qualified immigrants.
To learn how North Dakota compares to other states, see our full guide on Medicaid Eligibility in 2026.
Medicaid Expansion Adults (Ages 19–64)
This is the largest group. Adults ages 19 to 64 who are not on Medicare may qualify. Your income must be at or below 138% of the Federal Poverty Level (FPL). There is no asset test — your savings do not count.
Children (Birth–Age 18)
Children have their own income limits. Younger children (birth–age 5) qualify at 152% FPL. Older children (ages 6–18) qualify at 138% FPL. Children who earn too much for Medicaid may still qualify for CHIP.
Pregnant Women
Pregnant women qualify at 175% FPL. The unborn child counts as a household member. Coverage continues for 12 months after the baby is born.
Seniors and People with Disabilities (Aged, Blind, Disabled)
Adults 65 and older, blind individuals, and people with qualifying disabilities may qualify at 90% FPL. This group has an asset limit of $3,000 for a single person. Medicare recipients in this group may also qualify for extra help through Medicare Savings Programs.
Parents and Caretaker Relatives
Parents and caretakers (such as grandparents or aunts and uncles) who care for a child under 18 may qualify at 41% FPL. This is a low limit. Most adults in this group will qualify instead through Medicaid Expansion.
Workers with Disabilities
Adults ages 16 to 65 who have a disability and are working may “buy in” to Medicaid. The income limit is 225% FPL. A small monthly premium of 5% of gross income applies.
Who Qualifies — At a Glance
| Coverage Group | Income Limit (FPL) | Asset Test? |
|---|---|---|
| Adults 19–64 (Expansion) | 138% | No |
| Children Birth–Age 5 | 152% | No |
| Children Ages 6–18 | 138% | No |
| CHIP (Children) | 205% | No |
| Pregnant Women | 175% | No |
| Aged, Blind, Disabled | 90% | Yes ($3,000) |
| Parents / Caretakers | 41% | No |
| Workers with Disabilities | 225% | Yes ($3,000) |
Source: ND HHS – Medicaid Eligibility
North Dakota Medicaid Income Limits 2026
All income limits below are effective April 1, 2026 – March 31, 2027. North Dakota updates its limits each April 1 using the latest Federal Poverty Level (FPL) guidelines. Income is based on Modified Adjusted Gross Income (MAGI) for most groups.
For a full comparison of income limits across the country, see Medicaid Income Limits by State in 2026.
Medicaid Expansion Adults (138% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 | $1,836 | $22,025 |
| 2 | $2,489 | $29,864 |
| 3 | $3,142 | $37,702 |
| 4 | $3,795 | $45,540 |
| 5 | $4,449 | $53,379 |
| 6 | $5,102 | $61,217 |
| 7 | $5,755 | $69,056 |
| 8 | $6,408 | $76,894 |
| Each additional person | +$654/mo | +$7,839/yr |
Source: ND HHS – Medicaid Expansion
Coverage for Expansion adults is managed by Blue Cross Blue Shield of North Dakota (BCBSND). Adults eligible for Medicare or SSI do not qualify for Medicaid Expansion. There is no asset test for this group.
Children’s Medicaid Income Limits (By Age Group)
| Household Size | Children Birth–Age 5 (152% FPL) | Children Age 6–18 (138% FPL) |
|---|---|---|
| 1 | $2,022/mo | $1,836/mo |
| 2 | $2,742/mo | $2,489/mo |
| 3 | $3,461/mo | $3,142/mo |
| 4 | $4,180/mo | $3,795/mo |
| 5 | $4,900/mo | $4,449/mo |
| 6 | $5,619/mo | $5,102/mo |
| 7 | $6,339/mo | $5,755/mo |
| 8 | $7,058/mo | $6,408/mo |
| Each additional person | +$720/mo | +$654/mo |
Source: ND HHS – Medicaid Eligibility
Children who qualify stay enrolled for 12 months as long as they live in North Dakota. After that, they go through annual renewal.
CHIP Income Limits (205% FPL)
CHIP covers uninsured children who earn too much for Medicaid. North Dakota runs a Medicaid-expansion CHIP (M-CHIP) — there is no separate standalone CHIP program.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 | $2,727 | $32,718 |
| 2 | $3,697 | $44,362 |
| 3 | $4,668 | $56,006 |
| 4 | $5,638 | $67,650 |
| 5 | $6,608 | $79,294 |
| 6 | $7,579 | $90,938 |
| 7 | $8,549 | $102,582 |
| 8 | $9,519 | $114,226 |
| Each additional person | +$971/mo | +$11,644/yr |
Source: ND HHS – CHIP
The child must be uninsured to qualify for CHIP. Children with access to employer insurance do not qualify.
Pregnant Women Income Limits (175% FPL)
The unborn child counts as a household member when calculating your household size.
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $2,328 |
| 2 | $3,156 |
| 3 | $3,985 |
| 4 | $4,813 |
| Each additional person | +$829/mo |
Source: ND HHS – Medicaid Eligibility
Women who earn over the limit may still qualify through a client share or spend-down pathway if they have high medical costs.
Aged, Blind, and Disabled Income Limits (90% FPL)
This group also has an asset limit of $3,000 for an individual and $6,000 for a couple. Your home, one vehicle, and household items are generally exempt.
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,197 |
| 2 | $1,623 |
| 3 | $2,049 |
| 4 | $2,475 |
| Each additional person | +$426/mo |
Source: ND HHS – Medicaid Eligibility
Parents and Caretaker Relatives (41% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $517 |
| 2 | $694 |
| 3 | $871 |
| 4 | $1,048 |
| Each additional person | +$178/mo |
Source: ND HHS – Medicaid Eligibility
Most parents who exceed this limit will qualify through Medicaid Expansion at 138% FPL instead.
Workers with Disabilities Buy-In (225% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $2,993 |
| 2 | $4,058 |
| 3 | $5,123 |
| 4 | $6,188 |
| Each additional person | +$1,065/mo |
Source: ND HHS – Medicaid Eligibility
You pay a monthly premium equal to 5% of your gross countable income. You must have a qualifying disability and be actively employed.
Medicare Savings Programs (MSPs)
These programs help Medicare enrollees pay for Part B premiums and cost-sharing. Eligibility is based on income only.
| Program | What It Helps With | Single Monthly Limit | Couple Monthly Limit |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part A & B premiums, deductibles, co-pays | $1,330 | $1,804 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | $1,596 | $2,164 |
| QI1 (Qualifying Individual) | Part B premium only | $1,796 | $2,435 |
Source: ND HHS – Medicaid Eligibility
Long-Term Care / Nursing Home Medicaid
This program covers seniors who need nursing home or home-based long-term care. The rules are more complex than standard Medicaid. A single applicant may keep just $3,000 in assets. A married applicant’s spouse may keep up to $162,660 (the Community Spouse Resource Allowance).
| Program | Income Limit | Asset Limit (Single) | Spouse Asset Limit |
|---|---|---|---|
| Nursing Home Medicaid | No set cap* | $3,000 | $162,660 |
| Home & Community-Based Services (HCBS) Waiver | $1,197/mo | $3,000 | $162,660 |
| Aged/Blind/Disabled Medicaid | $1,197/mo | $3,000 | $6,000 |
*Nearly all income goes toward nursing home costs. You keep a Personal Needs Allowance of $115/month.
Key facts for Long-Term Care Medicaid in 2026:
- Home equity limit: $752,000
- Community Spouse Monthly Maintenance Needs Allowance: $2,644/month
- Look-back period: 60 months (5 years) for asset transfers
- Personal Needs Allowance: $115/month
Source: Medicaid Planning Assistance – North Dakota 2026
What Does Medicaid Cover in North Dakota?
North Dakota Medicaid covers a wide range of health services. Most services are free or have very small co-pays for enrolled members. Coverage is broad and designed to keep you healthy.
Core Medical Benefits
- Doctor and specialist visits
- Emergency room care and hospital stays
- Prescription drugs
- Lab tests and X-rays
- Preventive care (checkups, vaccines, screenings)
- Mental health and substance use treatment
- Family planning services
Additional Benefits
- Dental care (adult dental is covered under North Dakota Medicaid Expansion)
- Vision care and eyeglasses
- Hearing aids
- Medical transportation to appointments
- Home health care services
- Long-term care and nursing facility care
- Durable medical equipment (wheelchairs, walkers, etc.)
Children’s Benefits (EPSDT)
Children on Medicaid receive Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. This includes well-child visits, developmental screenings, dental, vision, and hearing care. These services are provided at no cost to the child.
For details on how Medicaid pays providers, see our guide to the Medicaid Fee Schedule in 2026.
How to Apply for Medicaid in North Dakota
Applying is free and easier than most people expect. You can apply online, by phone, or in person. There is no wrong time to apply — you can apply any time of year.
Here are your options:
Step 1: Gather your documents. Have these ready: proof of identity (ID or passport), Social Security numbers for all household members, proof of income (pay stubs, tax return, or a letter from your employer), and proof of North Dakota residency (utility bill or lease).
Step 2: Choose how to apply.
- Online: Go to applyforhelp.nd.gov — available 24/7
- By phone: Call 1-866-614-6005 (toll-free) or 711 (TTY)
- In person: Visit your local ND HHS county office
Step 3: Complete the application. Answer all questions about your household, income, and any existing health coverage. Be honest and complete — missing information can slow down your application.
Step 4: Submit and wait for a decision. After submitting, you will get a confirmation. Most decisions are made within 45 days. Disability-based applications may take up to 90 days.
Step 5: Get your Medicaid card. If approved, you will receive a Medicaid card or enrollment letter in the mail. Your coverage may start on the first day of the month you applied.
What Happens After You Apply?
After you submit your application, ND HHS reviews your information. They may contact you if they need more documents or have questions. It is important to respond quickly to any requests — delays in your response can delay your decision.
Your Approval Timeline
| Step | Timeframe |
|---|---|
| Application submitted | Day 1 |
| ND HHS reviews your documents | 1–2 weeks |
| Decision made | Within 45 days (standard) / 90 days (disability) |
| Medicaid card mailed | Within 7–10 days of approval |
| Coverage starts | Usually the 1st of the month you applied |
If You Are Approved
You will get a letter explaining your coverage. Your Medicaid card will arrive by mail. You can then start using your coverage right away — just show your card at doctor visits, pharmacies, and hospitals.
If You Are Denied
You have the right to appeal. Your denial letter will explain why you were denied and how to request a fair hearing. You have 90 days from your denial date to appeal. You can also reapply at any time if your situation changes.
Annual Renewal
You must renew your Medicaid coverage every year. ND HHS will send you a renewal notice. If your income or household size changes during the year, report it right away so your coverage stays accurate.
2026 Work Requirement (Effective December 31, 2026)
Medicaid Expansion adults (ages 19–64) without disabilities will need to complete 80 hours per month of work, volunteering, or education to stay enrolled. This rule takes effect December 31, 2026. Pregnant women, enrolled tribal members, and foster youth are exempt. ND HHS has a “Stay Enrolled” page to help members prepare.
Frequently Asked Questions
Q: What are the Medicaid income limits in North Dakota for 2026?
A: It depends on your coverage group. Most adults qualify at 138% FPL — about $1,836 per month for a single person. Pregnant women qualify up to 175% FPL. Children may qualify up to 205% FPL through CHIP. Seniors and people with disabilities have separate, lower limits. All figures are effective April 1, 2026.
Q: Does Medicaid cover dental for adults in North Dakota?
A: Yes. North Dakota Medicaid Expansion covers dental care for adults. This includes routine checkups, cleanings, fillings, and extractions. Not all dental providers accept Medicaid, so call ahead before scheduling. Children on Medicaid also receive full dental coverage at no cost through EPSDT benefits.
Q: How long does Medicaid take to approve in North Dakota?
A: Most standard applications are decided within 45 days. If your application includes a disability-based claim, it may take up to 90 days. After approval, your Medicaid card typically arrives within 7 to 10 business days. You can check your application status by calling 1-866-614-6005.
Q: Can I get Medicaid if I am working in North Dakota?
A: Yes. Working does not disqualify you from Medicaid. Adults earning up to 138% FPL ($22,025/year for one person) can qualify through Medicaid Expansion. Adults with disabilities who work can qualify through the Workers with Disabilities Buy-In program at up to 225% FPL, with a small monthly premium.
Q: What assets are counted for Medicaid in North Dakota?
A: For Medicaid Expansion (adults 19–64), there is no asset test — your savings and property do not affect eligibility. For seniors and people with disabilities, the asset limit is $3,000 for a single person. Exempt assets include your primary home, one vehicle, household goods, and an irrevocable burial plan.
Q: What happens if my income goes over the Medicaid limit in North Dakota?
A: You may still have options. Pregnant women over the income limit may qualify through a spend-down pathway. Adults who lose Medicaid due to income increases may qualify for subsidized ACA marketplace plans through healthcare.gov. Contact ND HHS at 1-866-614-6005 or visit Medicaid.gov for more guidance.
Sources & Disclaimer
Sources:
- ND HHS – Medicaid Expansion
- ND HHS – Medicaid Eligibility
- ND HHS – CHIP
- Medicaid Planning Assistance – North Dakota 2026
- Medicaid.gov
- Healthcare.gov – Medicaid & CHIP Overview
Last Updated: May 2026
Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. Income limits and eligibility rules can change. For official eligibility determinations, contact the North Dakota Department of Health and Human Services or visit Medicaid.gov.
