North Dakota Medicaid Income Limits 2026: HHS Chart

North Dakota is one of 41 jurisdictions that expanded Medicaid, and to compare it with other states, see our national Medicaid income limits guide.

North Dakota Medicaid Income Limits by Household Size (Effective April 1, 2026)

North Dakota publishes 7 monthly income charts for its main family and adult groups, and every one of them carries the same effective date: April 1, 2026. The HHS charts already include the 5% income disregard where it applies, so the dollar figure on the chart is the actual cutoff.

Source: North Dakota HHS, Medicaid Eligibility (opens in a new tab), income levels effective April 1, 2026. HHS prints the pregnancy and parent charts only through a household of four plus a per-person add-on; the figures marked are Grantsights calculations that add HHS's own per-person amount. HHS labels the parent chart 41% of poverty, but its dollar amounts work out to about 39% of the 2026 guideline ($517 divided by $1,330).*

The Medicaid Expansion page also gives the yearly version of the adult limit: $22,025 for one person, $29,864 for two, $37,702 for three, $45,540 for four, $53,379 for five, $61,217 for six, $69,056 for seven and $76,894 for eight, plus $7,839 for each additional person, with rates effective April 1, 2026.

Medicaid.gov's older numbers for North Dakota

The federal eligibility levels table on Medicaid.gov (opens in a new tab) still reflects state decisions as of December 1, 2023, and it lists North Dakota at 170% for children of all ages, 170% for pregnancy, 43% for parents (a dollar standard converted to a percentage), "N/A" for separate CHIP and 133% for the Expansion adult group. The federal table leaves out the 5% disregard and hasn't caught up with how HHS now splits children's coverage, so use the HHS charts above for an application in 2026.

How North Dakota Counts Your Income

5% of the poverty line is the disregard built into the Expansion, children's, CHIP and pregnancy charts, and it's why North Dakota's adult limit reads 138% instead of the 133% written in federal law. For a household of three, that disregard is worth about $114 a month.

Most children, parents, pregnant women and Expansion adults are judged under MAGI rules (Modified Adjusted Gross Income), which follow federal income tax concepts:

• Gross monthly income counts. HHS asks for proof of monthly income before taxes, such as pay stubs, a tax return if you're self-employed, pensions and disability payments.
• Tax households decide household size. Parents and the children they claim are counted together, and a pregnant woman counts each unborn child. HHS's own example: a pregnant woman who lives alone is a household of two.
• No asset test for MAGI groups. HHS's eligibility page says proof of assets is only needed for people who are blind, disabled or 65 and older.
• Children keep coverage for up to 12 months. Once approved, a child stays covered for up to a year as long as the family lives in North Dakota, even if income goes up.

People who qualify because of age, blindness or disability are judged under the older SSI-style rules, which count assets and use different deductions. The federal poverty guidelines guide explains where the dollar figures come from.

ND Medicaid for Seniors and People With Disabilities

The Aged, Blind and Disabled group in North Dakota uses 90% of the poverty level, which is $1,197 a month for one person on the April 1, 2026 chart, and it's one of several groups for people 65 and older or with a disability:

Source: North Dakota HHS, Medicaid Eligibility (opens in a new tab). The ABD, Workers with Disabilities and Children with Disabilities levels are effective April 1, 2026; the SSI amount is effective January 1, 2026.

For the 3- and 4-person ABD households, HHS lists $2,049 and $2,475. The value of a home, one car, household furnishings, irrevocable burial plans and personal items don't count toward the asset limit. Workers with Disabilities pays a premium equal to 5% of gross countable income plus a one-time $100 enrollment fee; HHS's example is a worker earning $1,000 who pays $50 a month. Native Americans don't pay the fee or premiums. The Children with Disabilities buy-in also charges 5% of the family's gross countable income.

Long-term care: nursing homes and home care

$3,000 is the countable asset limit for one person who needs long-term care in North Dakota, or $6,000 for a couple, and HHS's eligibility page doesn't list a separate income cap for this coverage. Instead, the applicant must fit a Medicaid coverage group, be 65 or older, blind, disabled or medically frail, and need help with daily tasks. Income over the coverage group's level is paid toward care as a client share.

From the HHS Spousal Impoverishment fact sheet (opens in a new tab) (updated July 2025):

• The spouse receiving care keeps $115 a month for personal needs.
• Income above $115 can be given to the spouse at home if that spouse's own gross income is under $2,644 a month.
• The spouse at home can generally keep up to half of the couple's countable assets, within federal minimum and maximum amounts that change each year. HHS doesn't print those amounts on the fact sheet; ask for an asset assessment.
• Gifts of assets can trigger a penalty period during which Medicaid won't pay for long-term care.

For the SSI side of this, see our SSI income limits guide and SSI benefits guide.

North Dakota CHIP Income Limits (Formerly Healthy Steps)

North Dakota's Children's Health Insurance Program covers uninsured children with family income up to 205% of poverty, or $56,006 a year for a family of three, according to the HHS CHIP program page, with income levels effective April 1, 2026 that include the 5% disregard:

Source: North Dakota HHS, Children's Health Insurance Program (opens in a new tab). For more than 10 people, add $971 a month or $11,644 a year per person.

Three things to know about North Dakota CHIP:

1. It's for uninsured children only. A child can't have other creditable health insurance, which is different from children's Medicaid.
2. The benefits match Medicaid. HHS says that although CHIP and ND Medicaid are different coverage groups, "the insurance coverage is the same," including well-child visits, dental and vision.
3. The old name was Healthy Steps. A September 12, 2019 Department of Human Services report to legislators (opens in a new tab) said 2,158 children were in Healthy Steps in August 2019 and that Senate Bill 2106 let the department move CHIP from managed care to a Medicaid "look-alike" fee-for-service arrangement. Current HHS pages just call it CHIP.

North Dakota Medicaid Expansion and the 2027 Changes

North Dakota started Medicaid Expansion on January 1, 2014, according to KFF's Medicaid expansion tracker (opens in a new tab), a non-government compilation that counts 41 jurisdictions with expansion and 10 without as of October 2026. Expansion covers adults 19 through 64 up to 138% of poverty who aren't eligible for Medicare or SSI, and HHS's Expansion page names Blue Cross Blue Shield of North Dakota as the plan members call with questions about services.

One trade-off sits in the fine print: HHS says Expansion "does not provide dental or vision care." The parent and caretaker group does. Expansion members with complex medical or behavioral health conditions can ask for medically frail status, which gives broader coverage, by filling out HHS's Medically Frail Questionnaire.

The federal reconciliation law signed July 4, 2025 brings these changes, per the HHS Stay Enrolled page (opens in a new tab), which dates the first one October 1, 2026:

Who doesn't have to meet the work rule: pregnant women and people who were pregnant in the last 12 months, parents and caregivers of children 13 and under or of someone with a disability, people with special health needs that affect daily living, people in substance or alcohol use disorder treatment, people released from incarceration within 90 days, former foster youth under 26, Native Americans and Alaska Natives, and veterans with a total disability rating. HHS also says earning at least $580 a month (80 hours at the federal minimum wage) meets the requirement, and people already meeting SNAP or TANF work rules won't need to do more.

HHS adds that North Dakota "is not cutting benefits or services" for people who remain eligible. The income charts earlier in this guide stay the same under all of these changes.

Worked Examples: North Dakota Households in 2026

For example, a family of three in North Dakota earning $3,300 a month, a single mom in Grand Forks with a 3-year-old and a 10-year-old and no private insurance, gets this result under the April 1, 2026 charts:

1. The 3-year-old: the ages 0 to 5 limit for three is $3,461, so she qualifies for ND Medicaid.
2. The 10-year-old: the ages 6 to 18 limit is $3,142. Specifically, he's $158 over that line. Because he's uninsured, he moves to CHIP, which goes up to $4,668.
3. Mom: she's over both the $871 parent limit and the $3,142 Expansion limit. At about 145% of poverty ($3,300 divided by $2,277), she can buy a Marketplace plan with a premium tax credit. HHS also offers a client share option to parents with high medical bills, figured from income above the $2,049 level for a family of three.

A 30-year-old in Fargo working 32 hours a week at $13 an hour earns about $1,800 a month, under the $1,836 Expansion limit for one. Starting January 1, 2027, she'll renew every six months, and her roughly 138 work hours a month clear the 80-hour rule.

One widower in Bismarck, 79, with $1,150 a month in Social Security and $2,400 in savings, is under the $1,197 ABD limit and the $3,000 asset limit, so he qualifies for full ND Medicaid. He's also under the $1,330 QMB line, which can pay his Medicare premiums, deductibles and coinsurance if his assets fit the low-income subsidy limits.

What North Dakota HHS Doesn't Tell You About These Limits

Grantsights analysis of the 12 income charts on the HHS Medicaid Eligibility page found 5 points the charts don't spell out:

1. The parent limit is about 28% of the Expansion limit, but it carries better benefits. For a family of three, the parent and caretaker line is $871 a month and the Expansion line is $3,142, about 3.6 times higher. A parent under $871 gets dental and vision through the parent group; a parent between $871 and $3,142 lands in Expansion, which HHS says doesn't cover dental or vision.
2. The 41% label doesn't match the dollars. HHS calls the parent chart 41% of poverty, yet $517 for one person is about 39% of the 2026 guideline and $871 for three is about 38%. Go by the dollar figure.
3. Turning 6 lowers a child's limit. In a family of three, a child's Medicaid line drops from $3,461 to $3,142 on the sixth birthday, a $319 difference. If the family is between those numbers and uninsured, the child should move to CHIP rather than lose coverage.
4. Being over the limit isn't always a denial. HHS offers coverage with a client share to children through age 20, pregnant women, parents and caretakers, and people who are 65, blind or disabled who have medical bills above that amount. The client share fact sheet (opens in a new tab) describes it as working "like a monthly deductible."
5. Expansion adults face the most change. Six-month renewals, a one-month backdating limit and the work rule all hit the Expansion group in January 2027, while children, pregnant women and seniors stay on 12-month renewals.

Common Mistakes and Red Flags

A common mistake is assuming a 19- to 64-year-old parent is stuck with the $871 parent line. Avoid giving up there. Any adult who's over the parent limit but under 138% of poverty, and isn't on Medicare or SSI, can qualify through Expansion instead.

Other North Dakota errors that cost people coverage:

• Using take-home pay. The HHS charts are gross monthly income. Payroll taxes and health premiums only come off when HHS figures a client share.
• Skipping CHIP because a child had insurance last year. CHIP needs the child to be uninsured now. If an employer plan ended, apply.
• Counting a house or car against a senior. The ABD asset limit leaves out the home, one car, furnishings and irrevocable burial plans.
• Underestimating how fast the appeal window closes. North Dakota gives 30 days from the mailing date of the notice, which is shorter than many states.
• Missing a six-month renewal in 2027. Expansion members who ignore the mid-year renewal can lose coverage even if their income hasn't changed.

Red flags for scams: applying for ND Medicaid is free. Anyone who charges a fee to fill out the application, promises approval, or asks for your Medicaid ID or bank details by text isn't HHS. Real help comes from the HHS Customer Support Center at 866-614-6005, a human service zone office, or the ND Navigators at 1-833-545-9448 for Marketplace questions.

How to Apply for North Dakota Medicaid and How Long It Takes

North Dakota decides most Medicaid applications within 45 days of receiving a signed paper or online application, according to the HHS Application for Assistance guide (Guidebook PDF (opens in a new tab)). If you've applied for Social Security disability, it can take up to 90 days for Social Security to decide, and the Medicaid decision comes after that.

1. Apply online through the self-service portal linked from the HHS Ways to Apply page (opens in a new tab), or apply by phone, mail or in person.
2. Pick the right paper form. Use SFN 1909 if you're under 65, not disabled and want health coverage only; SFN 405 if you also want food, cash or child care help; and SFN 958 if you're aged, blind or disabled.
3. Call for help: the Customer Support Center is open 8 a.m. to 5 p.m. Central, Monday through Friday, at 866-614-6005 or 701-328-1000, with free translation. You can also email applyforhelp@nd.gov or visit a human service zone office.
4. Have proof ready: monthly income, identity (birth certificate, ID, passport or green card) and, for ABD applicants only, bank and investment statements.
5. Ask about past months. Medicaid can pay for care up to 3 months before the application month through December 31, 2026. From January 1, 2027, that drops to 1 month for Expansion and 2 months for other groups.

After approval, Medicaid ID cards arrive about 4 to 6 weeks after the approval notice, and changes must be reported within 10 days.

What to Do If You're Denied

You have 30 days from the date HHS mails the notice of action to request a hearing, according to the HHS File an Appeal page (opens in a new tab). You can appeal verbally by phone or in writing by email, fax or mail, and you can also submit online.

• The form is optional. SFN 162, Request for Hearing, helps but isn't required; give your name, contact details and the decision you're appealing.
• Where to send it: Appeals Supervisor, Legal Advisory Unit, North Dakota HHS, 600 E. Boulevard Ave., Dept. 325, Bismarck, ND 58505-0250; toll-free 800-472-2622, fax 701-328-2173, email dhslau@nd.gov.
• Check the household size first. A missed unborn child or a wrong tax household is the easiest error to fix.
• Reapply after a change. A pregnancy, a job loss or a new household member can change the answer without an appeal.

If You're Over the North Dakota Medicaid Limit

$15,960 to $63,840 a year is the 2026 income range where one person generally qualifies for Marketplace premium tax credits, and for most adults over 138% of poverty it's the best bet. Other options:

• Marketplace coverage: North Dakota uses HealthCare.gov (opens in a new tab). The ND Navigators at Minot State University help for free at 1-833-545-9448.
• Medicare Savings Programs: if you have Medicare and are under $1,796 a month for one person, QI-1 can pay your Part B premium.
• Community health centers: HHS points people to Federally Qualified Health Centers, which charge on a sliding fee scale.
• WIC and food help: pregnant women and children under 5 may qualify for WIC up to 185% of poverty; see our WIC income limits guide and SNAP income limits guide.
• Heating help: see our LIHEAP income limits guide.
• Older North Dakotans and people with disabilities: our help for seniors programs guide and disability grants for individuals guide cover help beyond Medicaid.
• Neighboring states: compare our Montana Medicaid income limits guide and South Dakota Medicaid income limits guide.

If the household also needs help with groceries, rent or the power bill, Grantsights' free eligibility checker points to official programs worth a look. It doesn't decide Medicaid eligibility or file an application; North Dakota HHS makes that decision.

When These Limits Change Next

North Dakota's poverty-based charts change once a year on April 1, after HHS ASPE publishes new guidelines in January, and every chart in this guide carries the April 1, 2026 effective date. Expect new charts around April 1, 2027. The 2026 guideline is $15,960 for one person and $33,000 for four, plus $5,680 per additional person, according to HHS ASPE's 2026 poverty guidelines (opens in a new tab).

SSI-linked numbers change each January 1. SSA's SSI federal payment amounts page (opens in a new tab) lists $1,029 for one person and $1,544 for a couple in 2027, up from $994 and $1,491 in 2026, after a 3.6% cost-of-living increase.

FAQ: North Dakota Medicaid Income Limits

What is the income limit for Medicaid in North Dakota in 2026?

For adults 19 to 64 under Medicaid Expansion, it's $1,836 a month for one person and $3,142 for a household of three, or $22,025 and $37,702 a year, on charts effective April 1, 2026. Children, pregnant women, parents and people who are 65, blind or disabled each have their own limit.

What is the North Dakota CHIP income limit?

205% of poverty, including the 5% disregard: $4,668 a month for a family of three and $5,638 for four, effective April 1, 2026. The child must be uninsured.

What is the income limit for pregnant women on ND Medicaid?

175% of poverty, or $3,156 a month for a household of two and $3,985 for three. The unborn baby counts in the household, and coverage lasts 12 months after the pregnancy ends.

What are the Medicaid income and asset limits for seniors in North Dakota?

$1,197 a month for one person and $1,623 for two under the ABD group, with a $3,000 asset limit for one person or $6,000 for a couple. A home, one car and burial plans don't count.

Does North Dakota have a nursing home income cap?

The HHS eligibility page doesn't list one. Applicants must fit a coverage group and have under $3,000 in countable assets, and income above the group's level goes toward care as a client share. A resident keeps $115 a month for personal needs.

When do North Dakota Medicaid work requirements start?

January 1, 2027, for Medicaid Expansion adults who aren't exempt: 80 hours a month of work, volunteering, school or training, or at least $580 a month in earnings.

How long do I have to appeal a North Dakota Medicaid decision?

30 days from the date the notice of action is mailed, by phone, email, fax, mail or online.

When do North Dakota Medicaid income limits change?

Each April 1 for poverty-based charts and each January 1 for SSI-linked amounts. The 2027 SSI amount is $1,029 for one person.

Sources

1. North Dakota HHS: Medicaid Eligibility (opens in a new tab) - income charts effective April 1, 2026; ABD, MSP, SSI, long-term care and client share rules
2. North Dakota HHS: Medicaid Expansion (opens in a new tab) - yearly 138% limits, rates effective April 1, 2026
3. North Dakota HHS: Children's Health Insurance Program (opens in a new tab) - 205% chart effective April 1, 2026
4. North Dakota HHS: Stay Enrolled (opens in a new tab) - noncitizen, retroactive coverage, renewal, work requirement and cost-sharing dates
5. North Dakota HHS: Ways to Apply (opens in a new tab)
6. North Dakota HHS: File an Appeal (opens in a new tab)
7. North Dakota HHS: Spousal Impoverishment fact sheet (opens in a new tab), updated July 2025
8. North Dakota HHS: Medicaid Client Share fact sheet (opens in a new tab), updated October 2024
9. North Dakota HHS: Application for Assistance Guidebook (opens in a new tab) - 45-day decisions, 3-month backdating, appeal rights
10. North Dakota DHS: CHIP report to the Human Services Committee (opens in a new tab), September 12, 2019 - Healthy Steps enrollment and SB 2106
11. Medicaid.gov eligibility levels table (December 2023 data), used here for North Dakota (opens in a new tab), as of December 1, 2023
12. KFF: Status of State Medicaid Expansion Decisions (opens in a new tab) (non-government compilation), October 2026
13. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
14. SSA: SSI Federal Payment Amounts (opens in a new tab) - 2026 and 2027 amounts
15. HealthCare.gov: Medicaid expansion and you (opens in a new tab)