Medicaid is a program that provides health coverage to some low-income North Dakota residents. Medicaid covers families with children and pregnant women, medically needy individuals, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid. Non-citizens who do not have immigration documents cannot enroll in Medicaid.
- For certain categories of people, eligibility for Medicaid is based on the amount of your household income.
In North Dakota you may be eligible for Medicaid if you are a child, a parent of a child, or pregnant, and your family income meets the Medicaid income standards.
Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact your County Department of Social Services for more information.
Low income persons eligible for Medicaid in North Dakota*
Category - Income eligibility (as percent of federal poverty level)
Child up to 5 - 133% (monthly income of about $1,737 for family of 3)
Child 6-18 - 100%
Non-working parents - 40%
Working parents - 69%
Pregnant woman - 133%
Individual - 66%
Couple - 51%
* Eligibility information was compiled State Health Facts Online, the Henry J. Kaiser Family Foundation and may have changed since this guide was published. Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.
To get an idea of how your income compares to the federal poverty level,* use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2004:
Size of Family Unit Poverty Guideline (annual income)
1 $ 9,310
2 $ 12,490
3 $ 15,670
For larger families add $3,180 for each additional person
So, for example, using this guideline, 133% of the federal poverty level for a family of 3 would be an annual income of $20,841, or a monthly income of $1,737.
* Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.
- Parents who receive benefits under TANF (also known as Training, Employment, Education Management, or TEEM) should know that when you get a job and your TANF benefits would normally end, you generally can stay on Medicaid for a 12-month transitional period.
In addition, your children may qualify for Medicaid if your family’s income meets certain income standards.
- Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid.
Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage if you are elderly or you are still considered disabled and you continue to have medical need.
- People who have high medical expenses may also qualify for Medicaid. You may qualify as medically needy if you have high medical expenses that, when subtracted from your income, would make you eligible for Medicaid coverage. For example, people who have to pay a lot for prescription drugs, nursing home care, or other long term care services sometimes qualify as medically needy if their health insurance is limited or does not cover these services.
- Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid through the Medicare Savings Programs. Even though your income may be too high to qualify for Medicaid coverage, there may be other ways Medicaid can help you.
If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.
If your household income is above 100% but below 135% of the poverty level, Medicaid will pay for your monthly Medicare premiums only.
Contact your county social service office for more information about other eligibility requirements.
- There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact your county social service office. You can apply for Medicaid at county social service office or at certain sites, although very few throughout North Dakota.
To obtain the locations and telephone number of sites near you call Medicaid Services at the Department of Human Services.