North Dakota Medicaid: Income Limits, Eligibility and How to Apply
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Medicaid in North Dakota is run by the North Dakota Health and Human Services. North Dakota adopted the Affordable Care Act expansion in 2014, so an adult under 65 qualifies on income alone at or below 138% of the poverty guideline: $1,835 a month for one person in 2026. Children are covered through CHIP, and the application is at www.applyforhelp.nd.gov or 800-755-2604. Every figure below is dated 2026-09-23.
| Program | North Dakota Medicaid; ND Medicaid Expansion |
|---|---|
| Children | CHIP |
| Agency | North Dakota Health and Human Services |
| Apply | www.applyforhelp.nd.gov · 800-755-2604 |
| Expansion | Yes, since 2014 |
| Adult income limit, 2026 | $22,025 a year for one person; $45,540 for four |
| Work requirement | federal deadline January 1, 2027 |
Who qualifies in North Dakota
Adults 19 to 64 not on Medicare qualify at or below 138% of poverty (133% plus a 5% disregard), on household modified adjusted gross income, with no asset test. The 2026 figures:
| Household size | Annual income at 138% | Monthly | 100% of poverty (marketplace floor) |
|---|---|---|---|
| 1 | $22,025 | $1,835 | $15,960 |
| 2 | $29,863 | $2,489 | $21,640 |
| 3 | $37,702 | $3,142 | $27,320 |
| 4 | $45,540 | $3,795 | $33,000 |
| 5 | $53,378 | $4,448 | $38,680 |
Computed from the 2026 HHS poverty guidelines (January 15, 2026).
Children (CHIP), pregnant women, parents, seniors and people with disabilities use other limits that North Dakota sets above the federal minimums.
How North Dakota compares
North Dakota expanded on the first day it could, January 1, 2014, with the original group of states. On the work requirement it is not among the early starters (Arkansas, Iowa, Montana, Nebraska), so members have until January 1, 2027. North Dakota uses the plain "Medicaid" name, so the card and letters say what they are.
How to apply for North Dakota Medicaid
- Apply online at www.applyforhelp.nd.gov, or call 800-755-2604. HealthCare.gov also takes Medicaid applications and forwards them to North Dakota. There is no enrollment period; any day works.
- Report this month's income.
A North Dakota Medicaid case also qualifies you for a free phone (North Dakota carriers, paperwork) and shares documents with North Dakota SNAP.
What changes in North Dakota
North Dakota has not announced a start date for the federal work requirement, so it takes effect on the federal deadline, January 1, 2027. Six-month renewals for expansion adults begin with renewals scheduled on or after January 1, 2027. The nationwide changes are on the hub with CMS sources.
North Dakota specifics
- Expansion members are served through a single managed care contract while traditional Medicaid is fee-for-service.
- Offices serve Fargo, Bismarck, Grand Forks and every county; hospitals and health centers also employ enrollment assisters.
Whether North Dakota Medicaid pays for dental or weight-loss drugs is North Dakota's choice; see does Medicaid cover.
Common questions
What is the Medicaid income limit in North Dakota for 2026?
$22,025 a year for one adult, $29,863 for two and $45,540 for four (138% of the 2026 poverty guideline); children go higher through CHIP.
Does North Dakota have a Medicaid work requirement?
From January 1, 2027, the federal deadline; North Dakota has not set an earlier date. It applies to expansion adults 19 to 64 at 80 hours a month, with exemptions listed on the hub.
Sources
- North Dakota Medicaid: state program page
- HHS: 2026 poverty guidelines
- HealthCare.gov: Medicaid expansion and you (138%)
- Federal Register: community engagement interim final rule (June 3, 2026)
- CMS: 2025 law section-by-section overview
Gov-Grants.org is an independent guide, not a carrier and not a government agency. We never charge fees, and every fact above links to its source with the date we checked it. Program details change; confirm on the official site before applying.