How to Apply for North Dakota Medicaid Benefits

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.