North Dakota Medicaid Income Limits 2025: Qualification Requirements

North Dakota Medicaid Income Limits 2025: qualification requirements and income tables with FPL percentages for families, children, adults, seniors, and disabled individuals.

North Dakota Medicaid helps people see the doctor. It pays for checkups, medicine, and hospital visits. If you do not have much money, you can get this help for free or low cost.

In 2025, the rules changed a little bit. The state looks at your family size and your paycheck to see if you qualify.

⚡ Quick Answers: Do You Qualify?

Here are the monthly money limits for one person in North Dakota:

  • Children (0–18): $2,791 (Highest limit!)
  • Pregnant Women: $2,596 (Counts mom + baby)
  • Adults (19–64): $1,799 (For working adults)
  • Seniors (65+): $967 (Stricter rules)

Checking for a different state? This guide is for North Dakota. To see the numbers for the rest of the country, check our main guide on medicaid income limits by state.

❓ Simple Questions & Answers

  • Do I need kids to get help? No. Adults aged 19 to 64 can get Medicaid even without children.
  • Do they check my bank account?
    • For Families & Kids: No. They only look at your paycheck.
    • For Seniors (65+): Yes. They check your savings. You can usually have up to $3,000.
  • How do I apply? You can apply online right now. It is the fastest way to get covered.

How Medicaid Works in North Dakota (MAGI vs Non-MAGI)

MAGI Medicaid

MAGI-based Medicaid uses tax rules for most families. It covers children, pregnant women, parents, and expansion adults, no asset test needed.

For kids, limits reach 209% FPL; pregnant women get 194% FPL with 12 months postpartum coverage; parents/caretakers qualify at 41% FPL; adults 19-64 up to 138% FPL. It’s straightforward, based on your tax return.

Non-MAGI Medicaid

Non-MAGI applies to elderly (65+), SSI-related disabled, institutional care, and HCBS waivers. It checks monthly income and assets, with stricter rules.

Elderly/disabled general limit is $967 monthly for individuals ($1,450 couples), tied to SSI; long-term care allows up to $2,901 monthly (300% SSI) but with $3,000 asset cap for individuals ($6,000 couples).

2025 resource rules hold steady, no big changes, but verify for waivers like HCBS for home care.

2025 Income Limits Overview

Income limits update April 1 each year with FPL changes. North Dakota uses FPL percentages for MAGI groups and SSI rates for non-MAGI. Family size includes you, spouse, kids under 19, and +1 for pregnancy.

Tax household (MAGI) counts tax dependents; Medicaid household (non-MAGI) includes those sharing costs. For 2025, FPL starts at $1,305 monthly ($15,660 yearly) for one, +$459 ($5,508) per extra.

This keeps coverage fair, e.g., 138% for adults is $1,800 monthly for one. Check HHS for your fit.

Income Limits by Category

Children (0–18)

North Dakota covers children 0-18 up to 209% FPL through Medicaid and CHIP integration, focusing on preventive care like checkups and shots. It’s family-friendly, with no asset test.

Children 0–18 (209% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$2,791$33,492
2$3,773$45,276
3$4,756$57,072
4$5,738$68,856

Pregnant Women

Pregnant women qualify up to 194% FPL, counting the unborn baby as +1, with coverage extending 12 months postpartum for checkups and family planning. It’s designed to support healthy births.

Pregnant Women (194% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
2 (Mom + Baby)$2,596$31,152
3$3,507$42,084
4$4,418$53,016

Adults (19–64)

North Dakota expanded Medicaid, so adults 19-64 qualify up to 138% FPL, no kids required, covering basics like doctor visits and meds. It’s a key safety net for working folks.

Adult Expansion (138% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$1,799$21,588
2$2,432$29,184
3$3,065$36,780
4$3,698$44,376

Parents & Caretaker Relatives

Parents or caretakers qualify at 41% FPL if caring for a child under 19, tying to family needs with low thresholds for support.

Parents / Caretakers (41% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$535$6,420
2$723$8,676
3$911$10,932
4$1,099$13,188

Aged, Blind & Disabled (ABD Medicaid)

ABD Medicaid uses non-MAGI with SSI limits: $967 monthly for individuals ($1,450 couples), automatic for SSI recipients, no asset test for basic but $3,000/$6,000 for long-term care.

Aged, Blind & Disabled (SSI-Based)

GroupMonthly Income LimitAnnual Income Limit
Individual$967$11,604
Couple$1,450$17,400

Long-Term Care / Nursing Home

Long-term care allows up to 300% SSI ($2,901 monthly individual), with $3,000 asset limit ($6,000 couple), spousal protections up to $154,140 (2025 community spouse allowance).

Long-Term Care (300% SSI)

GroupMonthly Income LimitAnnual Income Limit
Individual$2,901$34,812
Couple$4,351$52,212

Medicare Savings Programs (QMB, SLMB, QI-1)

These pay Medicare premiums: QMB up to 100% FPL ($1,305 monthly individual); SLMB 120% ($1,566); QI-1 135% ($1,761). No asset test for most, but QMB has $9,660 individual ($14,970 couple).

QMB (100% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$1,305$15,660
2$1,763$21,156
3$2,221$26,652
4$2,680$32,160

SLMB (120% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$1,566$18,792
2$2,116$25,392
3$2,666$31,992
4$3,216$38,592

QI-1 (135% FPL)

Family SizeMonthly Income LimitAnnual Income Limit
1$1,761$21,132
2$2,380$28,560
3$2,999$35,988
4$3,617$43,404

Asset Limits (Non-MAGI Only)

2025 Asset Rules

Non-MAGI like elderly/disabled cap assets at $3,000 individual ($6,000 couple). Add $25 per extra member. Exempt: Home, one car, household goods, burial funds.

What North Dakota Counts as Income

Countable: Earnings, SSI, pensions, interest. Non-countable: Gifts, loans, Native payments, home equity. Tribal payments often exempt, check HHS.

How to Calculate Your Medicaid Household Income

Count tax dependents for MAGI; shared costs for non-MAGI. Include wages, subtract deductions like childcare. Example: Family of 3 with $3,000 monthly wages, deduct $200 for childcare, for $2,800 countable. Use the HHS calculator.

How to Apply for Medicaid in North Dakota

Apply online at hhs.nd.gov or call 1-844-854-4821. Paper forms via local Human Service Zone or mail. Processing 45 days; presumptive for pregnant fast. Shutdown added delays, but online’s quicker.

Required Documents to apply successfully are;

Income: Pay stubs, tax returns, W-2s. ID: Driver’s license, birth certificate. Residency: Utility bill. Pregnancy: Doctor note. Disability: SSA letter.

Common Reasons People Get Denied

Over income from unreported sources. Wrong docs or missing verification. Household miscount, like forgetting a spouse. Duplicate benefits like SSI without adjustment. Citizenship gaps, an emergency for the undocumented.

FAQ for Medicaid in North Dakota in 2025 

What is the highest income to qualify for Medicaid in North Dakota in 2025?

The highest is 209% FPL for children ($2,791 monthly for one), but adults expand at 138% ($1,799). Seniors/disabled stick to SSI $967 monthly, check your category with HHS.

Does North Dakota have Medicaid expansion?

Yes, adults 19-64 qualify up to 138% FPL without kids. It covers basics like doctor visits, apply if you work but earn low.

Do seniors need to meet asset limits?  

Yes for non-MAGI like elderly/disabled, $3,000 individual, $6,000 couple. Exempt home and car; MAGI seniors skip assets.

What is considered income in Medicaid?

Countable: Wages, SSI, pensions. Non-countable: Gifts, loans, Native payments. MAGI uses tax AGI; non-MAGI subtracts deductions.

Can adults without children get Medicaid?  

Yes, via expansion up to 138% FPL ($1,799 monthly for one). No kids needed, just income and residency.

How does “counting the baby” work for pregnant women?

Add one to household size for 194% FPL limit ($2,596 for mom + baby). Coverage lasts 12 months postpartum.

Does Medicaid cover dental/vision?

Kids get full dental/vision; adults emergencies only. Expansion adds basics, check your plan.

How often do income limits change?  

Yearly on April 1 with FPL updates. 2025 numbers hold through March 2026, recheck if life changes.

Final thoughts 

North Dakota Medicaid income limits keep care accessible, FPL guides most, with tables for quick checks. Remember, limits update yearly, so verify with HHS’s chart. If close, apply; navigators help free. Your health matters, take the step today.

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