North Dakota Medicaid is a joint state and federal program that helps eligible residents access healthcare when private insurance is not affordable. Eligibility depends on factors such as income, household size, age, pregnancy status, or disability, especially under North Dakota’s Medicaid expansion.
Understanding how the program works can help you determine whether you qualify and avoid coverage gaps that disrupt medical care.
1. What Is North Dakota Medicaid?
North Dakota Medicaid is a public health coverage program funded by both the state and federal government. It is designed to help eligible residents access medical care when private insurance is unavailable or unaffordable. The program covers a wide range of essential health services, including doctor visits, hospital care, preventive services, prescriptions, and long-term care support for qualifying individuals.
North Dakota participates in Medicaid expansion, which allows more low-income adults to qualify based on income alone. This expansion plays a major role in extending coverage to working adults who may not qualify under traditional Medicaid rules but still fall within income limits.
2. Who Qualifies for North Dakota Medicaid?
Eligibility for North Dakota Medicaid depends on personal circumstances rather than a single universal rule. The program serves several core groups, each evaluated under specific criteria.
Main eligibility groups include:
- Adults ages 19–64: Low-income adults may qualify under Medicaid expansion if their income falls within the state’s limits.
- Children: Children from low-income households can qualify even if their parents do not meet adult eligibility rules.
- Pregnant women: Pregnancy-related coverage is available with higher income thresholds to support prenatal and postpartum care.
- Seniors and people with disabilities: Individuals age 65 or older, or those with qualifying disabilities, may qualify under different financial and medical rules.
How eligibility is determined:
- Income-based eligibility: Most adults, children, and pregnant women are evaluated primarily on household income and size.
- Category-based eligibility: Seniors and individuals with disabilities may qualify based on a combination of income, assets, and medical need, rather than income alone.
Understanding which category you fall into is the first step in determining whether North Dakota Medicaid can provide coverage for your situation.
>>> Read more: What Is Considered A Low Income Household? Federal Guidelines, Examples, And Benefits You May Qualify For
3. Income Guidelines for North Dakota Medicaid
To qualify for North Dakota Medicaid, your household income must fall within certain limits based on the Federal Poverty Level (FPL). For 2026, North Dakota continues to use the Modified Adjusted Gross Income (MAGI) to calculate eligibility for most adults and families.
According to the North Dakota Department of Health and Human Services (NDHHS, 2026), the income threshold for the North Dakota Medicaid expansion group is set at 138% of the FPL. Below are the estimated monthly income limits for 2026 based on household size:
| Household Size | Monthly Income Limit (138% FPL) | Annual Income Limit (Approx.) |
| 1 | $1,800 | $21,597 |
| 2 | $2,433 | $29,187 |
| 3 | $3,065 | $36,777 |
| 4 | $3,698 | $44,367 |
| 5 | $4,330 | $51,957 |
| 6 | $4,963 | $59,547 |
- Children (CHIP/Medicaid): Families often qualify with higher incomes, as children are eligible up to 205% of the FPL ($66,010 annually for a family of four).
- Pregnant Individuals: Eligibility is typically set at 162% of the FPL to ensure comprehensive prenatal and postpartum care.
- Seniors (Aged, Blind, Disabled): For those aged 65+ or with disabilities, the limit is closer to 100% of the FPL, which is approximately $1,174 per month for an individual.
4. What Does North Dakota Medicaid Cover?
Medicaid North Dakota provides comprehensive health coverage designed to support both routine care and serious medical needs. Covered services generally include:
- Primary care visits, preventive screenings, and wellness services
- Hospital care, emergency services, and inpatient treatment
- Prescription medications approved under Medicaid guidelines
- Mental health and substance use treatment
- Maternity and postpartum care
- Pediatric services, including well-child visits and immunizations
- Long-term care services for eligible seniors and individuals with disabilities
Coverage details can vary by eligibility group, and some services may require prior authorization. Children and pregnant women often receive broader coverage, while long-term care services follow additional financial and medical criteria.
For the most accurate and up-to-date coverage details, eligibility rules, and application guidance, residents are encouraged to consult resources provided by the North Dakota Department of Health and Human Services, which administers the Medicaid program statewide.
5. How to Apply for Medicaid in North Dakota
North Dakota offers several ways to apply for Medicaid, depending on your situation and whether you prefer to apply online, on paper, or with assistance. Below is a clear breakdown of each option so you can choose what works best for you.
Apply Online (Fastest option)
You can complete and submit an Application for Assistance for Medicaid (health care) through North Dakota’s self-service online portal.
This option is recommended if you want quicker submission and confirmation.
- Available 24/7
- Allows you to submit required information electronically
- Ideal for applicants who are comfortable applying online
Apply on Paper (In Person or Drop-Off)
Paper applications can be completed and returned to your local Human Service Zone office. All forms are fillable PDFs.
Choose the form that matches your situation:
- Medicaid only (under age 65, not disabled): Application for Health Care Coverage and Help Paying Costs (SFN 1909).
- Medicaid plus food, cash assistance, or child care: Application for Assistance (SFN 405)
- Aged, blind, or disabled applicants (Medicaid only, Medicare Savings Programs, or basic care facility coverage): Health Care Application for the Elderly and Disabled (SFN 958).
Once completed, return the form to your local Human Service Zone office.
Apply by Mail
If you prefer to receive an application by mail, you can request one by contacting the Customer Support Center:
- Phone: (866) 614-6005 or (701) 328-1000
- TTY: 711
You may also request forms directly through your local Human Service Zone office.
Note: The Customer Support Center is currently transitioning to a new phone system, so response times may be slightly delayed.
Get Free Application Assistance
If you want help completing your application, ND Navigators offer free assistance either in person or virtually.
- Call: 800-233-1737
- ND Navigators are federally funded enrollment helpers and are not part of North Dakota Medicaid, but they can guide you through the process step by step.
6. Why Staying Connected Matters for North Dakota Medicaid Members
For many North Dakota Medicaid members, phone access quietly sits behind every step of the process. Renewal notices, follow-up questions, document requests, or clarification calls often happen by phone. Miss one call, and a simple issue can turn into a delayed approval or a temporary loss of coverage.
That risk increases when members are already juggling work schedules, childcare, or health appointments. Calls from caseworkers or messages tied to the North Dakota Medicaid phone number are not always repeated multiple times. If communication breaks, decisions can move forward without the member’s input.
Because staying connected is a necessity, the federal government established the Lifeline program to help low-income households afford communication services. Lifeline is not a service provider itself; rather, it is a federal program that provides subsidies to authorized service providers. If you are already enrolled in Medicaid North Dakota, you automatically meet the program-based criteria to participate.
Instead of navigating complex paperwork, you can use your Medicaid benefit letter to prove your eligibility through an approved provider. This program ensures that residents navigating the Medicaid North Dakota system always have a way to reach emergency services, employers, and doctors without additional financial burden.
AirTalk Wireless is an official Lifeline service provider dedicated to helping North Dakotans access these federal benefits. In addition to basic Lifeline service support, AirTalk Wireless expands the benefit by offering generous talk, text, and data plans, along with access to free or discounted smartphones through provider-specific promotions. This gives Medicaid members more flexibility and value beyond standard connectivity.
When you apply for a free phone with Medicaid through AirTalk Wireless, you can receive:
- A free/heavily discounted smartphone: We provide quality 4G/5G devices at no cost to eligible customers to ensure you have the hardware you need.
- Unlimited talk & text: Stay in touch with your care providers and family members without worrying about monthly bills or minute limits.
- High-speed data: Use your data to access the ND Health and Human Services portal, manage your medical records, or attend telehealth appointments.
- Easy enrollment: Use your existing Medicaid status to fast-track your application and get connected quickly.
IMPORTANT: The government does not subsidize devices. Lifeline programs cover basic service costs only. Free or discounted devices, upgrade plans, or top-ups are exclusive benefits provided by AirTalk Wireless as part of our promotional offers. Terms and conditions apply. Limited-time promotion—offers vary by state, stock availability, and eligibility.
Conclusion
North Dakota Medicaid provides essential health coverage, but staying enrolled depends on more than eligibility alone. Ongoing communication plays a major role in keeping benefits active and issues resolved.
When Medicaid members have consistent phone access, they are better positioned to respond on time, manage renewals smoothly, and maintain uninterrupted coverage throughout the year.