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North Dakota

How to Apply for North Dakota Medicaid Benefits

North Dakota Medicaid · SFN 1909

Content verified 2026-07-17T00:00:00.000Z

Medicaid Asset Protection & Spend-Down MilestonesGoverned Protocol
160-Month Lookback Guard

All asset transfers and gifts within 5 years are audited under state lookback statutes.

2Exempt vs. Countable Assets

Primary home equity, one vehicle, and personal effects remain protected under community spouse allowances.

3Miller Trust / QIT Path

Excess income in income-cap states is redirected into a Qualified Income Trust to preserve qualification.

Program overview

North Dakota Medicaid is a state and federally funded program that helps pay for health care services for qualifying low-income adults, children, pregnant women, older adults and people with disabilities. North Dakota opted to accept federal funding to expand Medicaid under the Affordable Care Act, providing coverage to more working families and individuals.

To qualify for North Dakota Medicaid, adults are eligible with household incomes up to 138% of the federal poverty level, pregnant women with incomes up to 147% of poverty, and children are eligible for Medicaid or CHIP with household incomes up to 170% of poverty. Traditional Medicaid provides additional income-based coverage for pregnant women, the elderly, and people with disabilities, with eligibility including submitting in-depth income and asset information.

North Dakota Medicaid covers comprehensive health services including doctor visits, hospital care, prescription medications, preventive care, mental health services, and long-term care services. Children who qualify are eligible to receive all services covered by North Dakota Medicaid, with some services subject to prior authorization requirements and benefit limits. The program also includes specialized coverage options like Children with Disabilities Medicaid Coverage for families with disabled children under age 19.

When applying, you can apply online or by using a paper application. Medicaid enrollment is year-round; you do not need to wait for an open enrollment period to apply for Medicaid. Be prepared to provide comprehensive documentation about your household income, assets, and circumstances. When you fill out an application on the Marketplace, if it looks like you might qualify for North Dakota Medicaid, your application will be sent to ND Medicaid for further review by an eligibility worker, and within a few weeks, you may be sent a letter asking for additional information, or stating that you are approved or denied Medicaid coverage.

Main application form

Application for Health Coverage and Help Paying Costs

Form SFN 1909

Download form

Additional forms

  • Medicaid Application for the Elderly and Disabled · SFN 958

    For individuals aged, blind, or disabled applying for Medicaid coverage

    Download form →
  • Application for Assistance · SFN 405

    Multi-program application for Medicaid, TANF, SNAP, and child care assistance

Where to submit

Submit completed application to the Customer Support Center by email at applyforhelp@nd.gov, phone at 1.866.614.6005 or 701-328-1000, fax at 701.328.1006, or mail to Customer Support Center P.O. Box address or local Human Service Zone office.

Read guide

North Dakota Medicaid provides essential healthcare coverage for low-income families, seniors, and people with disabilities. With Medicaid expansion, adults earning up to 138% of the federal poverty level qualify, while children can qualify with family incomes up to 170% of poverty. You can apply year-round using form SFN 1909 online at hhs.nd.gov/applyforhelp or by paper application. Gather documents like Social Security cards, pay stubs, bank statements, and proof of citizenship. Submit your completed application to the Customer Support Center or local Human Service Zone office. For help, call 866-614-6005 or email applyforhelp@nd.gov. Don't wait - apply today to get the healthcare coverage you need.

Official resources

Related guides

Frequently Asked Questions

How do I apply for North Dakota Medicaid in North Dakota?

To apply for North Dakota Medicaid in North Dakota, complete Application for Health Coverage and Help Paying Costs (SFN 1909), then submit it to Submit completed application to the Customer Support Center by email at applyforhelp@nd.gov, phone at 1.866.614.6005 or 701-328-1000, fax at 701.328.1006, or mail to Customer Support Center P.O. Box address or local Human Service Zone office..

What documents do I need to apply for North Dakota Medicaid in North Dakota?

You typically need to provide: Social Security cards or numbers for all household members, Birth certificates for all household members, Proof of citizenship or legal immigration status, Photo identification for the applicant, Pay stubs and employment records (last 30 days), Bank statements and financial account information, Insurance policies and premium information, Medical bills and health insurance information, Proof of residence (utility bills, lease agreements), Tax returns and W-2 forms from previous year, Child support documentation (if applicable), Disability determination documents (if applicable).

Where do I submit my North Dakota Medicaid application in North Dakota?

Submit your completed North Dakota Medicaid application to Submit completed application to the Customer Support Center by email at applyforhelp@nd.gov, phone at 1.866.614.6005 or 701-328-1000, fax at 701.328.1006, or mail to Customer Support Center P.O. Box address or local Human Service Zone office..

What is the main application form for North Dakota Medicaid in North Dakota?

The primary application form is Application for Health Coverage and Help Paying Costs (SFN 1909). Download it from the official state website: https://www.nd.gov/eforms/doc/sfn01909.pdf

Where can I find official information about North Dakota Medicaid in North Dakota?

Official information and application resources are available at ND Health and Human Services — Medicaid: https://www.hhs.nd.gov/healthcare/medicaid

How we research and verify this information

Our team compiles this listing from public records and provider data, and reviews it against authoritative sources. Read our editorial standards and research methodology.

Editorial review by John Richie, Senior Care Research Editor.

The Care Decision Podcast · Episode 2 & Printable Cost Checklists

Real Care Cost Breakdown: Audio Guide & Printable Tour Checklists

Base rent is rarely the final monthly invoice. Stream Episode 2 (19 min) or click either reference card below to zoom, save, or print our tour pricing checklist and 3-bucket invoice funding blueprint.

The Care Decision podcast cover art

Episode 02 · 19:21 · Hosted by Maya & Daniel

What Does Memory Care Actually Cost?

Assisted living base rent ($5,900–$6,250/mo) vs. memory care ($6,500–$8,500+/mo), level-of-care add-ons, and tour questions.

Tour Pricing Checklist · Ep 2 Assisted Living vs. Memory Care Cost Breakdown (Ep 2)
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Funding Stack Blueprint · Ep 3 The 3-Bucket Invoice Split ($6,200/mo Gap · Ep 3)
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📝 Open Interactive 5-Question Facility Tour Worksheet & 24-Month Calculator (Printable) Expand ↓
Interactive Facility Tour Scorecard

5-Question Tour Worksheet & 24-Month Survival Calculator

Fill in the numbers quoted during your tour to calculate the 2-year total at the next care tier up, then print a 1-page scorecard.

Day-1 Monthly (Base + Meds)

$7,140/mo

Year-2 Monthly (Next Tier Up)

$8,390/mo

24-Month Total at Next Tier Up

$199,774

🧮 Open Interactive 3-Bucket Monthly Gap & Six-Doors Benefit Calculator (Ep 3 · Printable) Expand ↓
Interactive 3-Bucket Funding Stack · Ep 3

3-Bucket Monthly Gap & Six-Doors Benefit Stacker

Split the community quote into Room & Board (Bucket 1) and Personal Care/ADLs (Bucket 2) to see how Social Security, VA Aid & Attendance, LTC insurance, and state Medicaid HCBS waivers reduce your net monthly gap.

Net Monthly Family Gap (After Benefits)

$4,129/mo

Total Invoice: $6,200/mo · Covered: $2,071/mo

90-Day Elimination / Approval Bridge

$12,387

Home Care + Adult Day pacing ($3,120/mo) saves $9,240 over 90d

24-Month Net Family Out-of-Pocket

$99,096

Bucket 3 Clinical & Part D ($2,400 Rx cap) stays on Medicare

Card 1 / 1

Printable Family Reference Card

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