North Dakota Medicaid Office

North Dakota Medicaid office (Medical Services Division)

North Dakota Medicaid splits its public-facing contact lines into two distinct centers, each with its own phone number, address, and email. The Medical Services Division (the agency that runs the program) handles policy, provider questions, and program governance. The Customer Support Center (the consumer intake hub) handles applications, renewals, case questions, and translation services. Members typically call the Customer Support Center; providers and policy questions go to Medical Services.

Two contact centers, two roles

Eligibility changes coming in 2026

HHS has posted a notice on every Medicaid-program page: starting in 2026, some people's Medicaid eligibility will change. The Stay Enrolled webpage at hhs.nd.gov/stayenrolled lists what's changing, when, and what affected members need to do. Members are urged to keep their contact information up to date so HHS can reach them with personal renewal notices.

How to engage with policy

ND Medicaid maintains a Medicaid Medical Advisory Committee (MMAC) of members, providers, advocates, legislators, and health care associations that reviews and recommends changes to ND Medicaid's policy, state plan, and waivers. Members can suggest coverage changes by filling out the SFN 905 (Service, Technology, or Procedure Assessment) form and emailing it to dhsmed@nd.gov. Suspected Medicaid fraud is reported to medicaidfraud@nd.gov.

Who qualifies for North Dakota Medicaid?

North Dakota publishes its FPL anchors per category in dollar terms with an explicit effective date. The state expanded Medicaid in 2014 and runs the expansion through a single contracted MCO (Blue Cross Blue Shield of North Dakota) — every other coverage group runs fee-for-service through ND Medicaid directly. Most of ND's category thresholds are higher than the federal default: children birth–5 at 152% FPL (federal default is 142%), pregnant women at 175% FPL.

Children and pregnancy categories

Adult and disability categories

What counts (and doesn't) toward the ABD asset test

For the ABD category, ND excludes the value of the home, one car, home furnishings, irrevocable burial plans, and other personal items from countable assets. Pay stubs and tax returns prove income; checking and savings statements prove assets. Coverage groups whose members are over the age of 55 may be subject to Medicaid Estate Recovery — typically the long-term care categories on the ABD side.

Children's Disability Buy-In has unusual rules

The Children with Disabilities Buy-In category is one of ND's most distinctive features. Families above the regular Medicaid income line can buy in if their child has a disability per SSA's definition, paying a monthly premium equal to 5% of family income. There is no asset limit — families can own a home, multiple cars, and other assets. Private insurance can coexist with this coverage; if a parent's employer offers medical coverage for the child and pays at least half the premium, the child must be enrolled in the employer plan.

North Dakota Medicaid income limits (effective April 1, 2026)

North Dakota publishes its Medicaid income limits both monthly (children, pregnancy, and ABD categories) and annually (Medicaid Expansion). Both sets are effective April 1, 2026 in the figures below. The federal poverty level updates each January, so HHS republishes its tables in spring; the percentage anchors are stable from year to year.

Children and pregnancy — monthly gross income (effective April 1, 2026)

Note: the unborn child counts as a family member when sizing up a pregnancy-category household.

Adults, blind, and disabled (ABD) — monthly gross income

ABD also applies an asset test: $3,000 for a single person, $6,000 for a couple, plus $25 per additional household member. Home, one car, home furnishings, irrevocable burial plans, and other personal items are not counted.

Medicaid Expansion — annual gross income (effective April 1, 2026, 138% FPL)

Individuals eligible for Medicare or SSI are not eligible for Medicaid Expansion — they fall into the ABD track instead. Medicaid Expansion members can apply by paper (Form SFN 1909), by phone at (866) 614-6005 or 711 (TTY), by mail, or in person at a Human Service Zone office.

How to apply for North Dakota Medicaid

North Dakota runs a single Self-Service Portal at applyforhelp.nd.gov that submits an application or manages a case for four different HHS programs — Medicaid, SNAP (food), LIHEAP (home energy), and CCAP/TANF (family). One log-in, one identity verification, one set of documents. Most households apply online; paper and in-person remain available through county Human Service Zone offices.

Four ways to apply

• Online via Self-Service Portal — apply or manage your case at dhsbenefits.dhs.nd.gov/SSPPortal. The "Am I Eligible?" screener at the same site answers a few questions and tells you which HHS programs you might qualify for.
• By phone — call the Customer Support Center at (866) 614-6005 or local (701) 328-1000, TTY 711.
• On paper — print and complete the Application for Assistance (SFN 405; also available in Spanish), then return to your local Human Service Zone office. For the Medicaid Expansion category specifically, use SFN 1909.
• In person — visit your county's Human Service Zone office. The HHS website publishes a county-by-county locator.

Important recent notices

• CCAP waitlist — Child Care Assistance Program applications submitted on or after December 1, 2025 are being placed on a waitlist.
• SNAP eligibility changes — beginning November 2025, some people's SNAP eligibility is changing.
• Medicaid eligibility changes — beginning in 2026, some people's Medicaid eligibility will change. The Stay Enrolled page tracks specifics.

Out-of-state inquiries

People applying from outside North Dakota (for example, providers verifying coverage for a member who recently moved) can email applyforhelp@nd.gov with subject "Out of State Inquiry" plus the requestor's name and title. HHS replies by encrypted email; allow up to 5 business days.

Federal decision deadlines

Federal Medicaid rules give HHS up to 45 days to decide a non-disability application and up to 90 days for applications based on disability. Coverage can be retroactive up to three months before the application month when the applicant had qualifying medical bills during that window.

What North Dakota Medicaid covers

ND Medicaid runs as two delivery models in one program. Medicaid Expansion (the adult 19–64 group) is delivered by Blue Cross Blue Shield of North Dakota (BCBSND) under a single managed care contract — unusual: most states with managed care use multiple MCOs to provide member choice. Every other coverage group (children, ABD, pregnant women, foster youth, ABD-Long Term Care) runs as fee-for-service ND Medicaid, where the state pays providers directly without an MCO intermediary. The split matters most when picking providers: BCBSND has its own provider directory.

Medicaid Expansion (delivered by BCBSND)

• BCBSND Member Services — Toll-Free (833) 777-5779, TTY 711 or (800) 366-6888.
• BCBSND Medicaid Expansion member site — medicaid.bcbsnd.com.
• Find a Doctor — bcbsnd.com/members/find-a-doctor.

Fee-for-service ND Medicaid (everyone else)

Children, ABD, pregnant women, foster youth, and ABD-Long Term Care members use the HHS Provider Directory (linked from the Medicaid hub) to find any ND Medicaid-enrolled provider. There is no plan network — any participating provider can see any fee-for-service member.

What's covered

ND Medicaid covers the federal mandatory benefits plus a substantial set of state options:

• Routine doctor and specialist visits
• Inpatient and outpatient hospital care, including surgery and emergency
• Prescription drugs
• Lab work, X-rays, and diagnostic testing
• Pregnancy care, including prenatal, delivery, and 12 months postpartum
• Mental health, substance use disorder treatment, and behavioral health services
• Wellness visits for children (Health Tracks well-child checks) including dental and vision
• Special Health Services for children with special health care needs
• Women's Way Program (breast and cervical health screening)
• HCBS Medicaid Waivers for members who qualify for long-term services

Getting started after approval

After your application is approved, you'll receive a notice with an identification number for each member of your household. Medicaid ID cards arrive 4 to 6 weeks after that notice. Carry the card at every appointment and show it at every pharmacy visit. Free language translation and free sign language interpretation are available — DPA covers sign language interpreter services for your Medicaid-related appointments.

Other state Medicaid pages