North Dakota Medicaid & Elder Care
North Dakota's senior Medicaid landscape offers home and community-based services through its Aged and Disabled Waiver, alongside traditional nursing home coverage, with specific income and asset limits.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardNorth Dakota Monthly Costs
North Dakota senior care costs are approximately the same as the national average for nursing home care and slightly less for assisted living (2023 data).
Waiver Programs
Medicaid Waiver for Home and Community Based Services
Also called: Aged and Disabled Waiver, Medicaid Waiver
This waiver provides long-term services and supports for North Dakota residents aged 65 and older, or adults 18+ with disabilities, who require a nursing home level of care but prefer to receive services in their home or community. It covers various supports to prevent institutionalization, but does not pay for room and board.
- check_circle Adult Day Health Care
- check_circle Home Modifications
- check_circle Housekeeping Services
- check_circle Transportation
- check_circle Personal Care Assistance (Activities of Daily Living)
- check_circle Personal Emergency Response System
- check_circle Home Delivered Meals
- check_circle Respite Care
- check_circle Case Management
- check_circle Chore Services
- check_circle Environmental Modifications
- check_circle Homemaker Services
insights Program Snapshot
- Enrollment
- Approximately 850 authorized slots per year (2024 data)
- Functional criterion
- Nursing Facility Level of Care (NFLOC)
- Administered by
- Aging Services Division, North Dakota Department of Health and Human Services
- Self-direction
- Allows family personal care, including spouses, adult children, or adult grandchildren, to be paid caregivers if they enroll as Qualified Service Providers.
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $1,197 | $1,623 |
| Asset Limit | $3,000 | $6,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
North Dakota's Medicaid Estate Recovery Program seeks reimbursement for long-term care costs after a recipient's death, potentially placing a lien on the home, though recovery is delayed for surviving spouses or certain disabled children.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers made within 60 months of applying for Nursing Home Medicaid or HCBS Waivers can trigger penalties.
- warning Excess Income: Failing to utilize the Medically Needy Pathway to spend down income on medical expenses if it exceeds the limit.
- warning Joint Accounts: The full balance of joint bank accounts is often counted as the applicant's asset for eligibility purposes.
First Steps for Families
Locate your ADRC
Contact your local North Dakota Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $3,000.
Resource Contact
North Dakota Department of Health and Human Services
How to Apply for North Dakota Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification demonstrating a Nursing Facility Level of Care need.
Gather Financial Records
Collect 60 months of financial statements and other asset/income verification documents.
Address Income and Assets
If income or assets exceed limits, explore options like the Medically Needy Pathway or asset spend-down strategies.
Submit Application
Apply online, by mail, or in person at a North Dakota Human Service Zone office using the Health Care Application for the Elderly and Disabled form (SFN 958).
Attend Interviews and Assessments
Participate in required caseworker evaluations and functional assessments to determine eligibility.
Receive Determination and Benefits
Await the final eligibility determination and activation of Medicaid benefits.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Proof of other assets
Income Verification
- Social Security award letters
- Pension stubs
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments
- Proof of disability (if applicable)
- Birth certificate or other identity proof
Property/Residency
- Home deed
- Vehicle registration
- Proof of North Dakota residency
- Utility bills
Frequently Asked Questions About North Dakota Medicaid
Does North Dakota Medicaid pay for assisted living?
North Dakota's Medicaid Waiver for Home and Community Based Services, also known as the Aged and Disabled Waiver, can cover services provided in assisted living residences. However, it is important to note that this waiver will not pay for the room and board expenses associated with assisted living, only the care services.
What is the North Dakota Medicaid income limit for seniors in 2026?
For 2026, a single senior applying for North Dakota's Home and Community Based Services (HCBS) waiver or Aged, Blind, and Disabled (ABD) Medicaid can have a monthly income up to $1,197. For married couples, the combined monthly income limit is $1,623. These limits are effective from April 1, 2026, to March 31, 2027.
How long is the HCBS waiver waitlist in North Dakota?
North Dakota's Aged and Disabled Waiver is not an entitlement program, meaning there are a limited number of enrollment slots. As of 2024, there were approximately 850 slots available per year. Once these spots are filled, additional eligible applicants are placed on a waitlist. Specific wait times for 2026 are not published, but a waitlist does exist.
Will Medicaid take my parent's house in North Dakota?
North Dakota's Medicaid Estate Recovery Program (MERP) is legally mandated to seek reimbursement for long-term care costs paid by Medicaid after a recipient's death. This may involve placing a lien on the deceased's home or other assets. However, recovery is typically delayed if a surviving spouse or certain minor or disabled adult children continue to reside in the home.
Can I be paid to care for my parent through North Dakota Medicaid?
Yes, North Dakota's Medicaid Waiver for Home and Community Based Services (Aged and Disabled Waiver) includes a 'family personal care' option. This allows family members, such as spouses, adult children, or adult grandchildren, who live with the program participant to be paid for providing care. The caregiver must enroll as a Qualified Service Provider with the North Dakota Department of Health and Human Services.
Medicaid vs Medicare for long-term care in North Dakota?
Medicare primarily covers acute medical needs, hospital stays, and short-term skilled nursing facility care, but generally does not cover long-term care services like extended nursing home stays or ongoing personal care at home. North Dakota Medicaid, on the other hand, is a needs-based program that can cover these extensive long-term care costs for eligible seniors who meet financial and functional criteria.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE NORTH DAKOTA
Last updated: April 24, 2026. Sources: North Dakota Department of Health and Human Services, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.