North Dakota Medicaid income limits come in two sets, and the first thing to get right is which set applies to you. If you are under 65 and not disabled, you are measured on the MAGI test: the adult limit is 138% of the federal poverty level, and no assets are counted at all. If you are 65 or older, blind, or disabled, you are measured on the aged, blind, and disabled test, which runs on a 209(b) framework that lets a single applicant keep $3,000 in countable assets, above the $2,000 federal SSI resource standard.,,

That extra room matters, and so does what comes next. If your income runs over the line on the long-term-care side, North Dakota doesn't shut the door: it lets you spend the excess down on care.

Which North Dakota Medicaid income limit applies to you: MAGI or long-term care?

North Dakota runs two different income tests. Which one measures you depends on the door you come through, not on how much you earn.

  • The MAGI test covers most people: adults under 65 who are not disabled, parents and caretaker relatives, pregnant women, and children. It uses Modified Adjusted Gross Income, sets each limit as a percentage of the federal poverty level (FPL), and counts no assets at all.
  • The SSI-related aged, blind, and disabled (ABD) test covers people 65 or older and people who are blind or disabled. Federal law expressly excepts this track from the no-asset-test rule, which is why a resource limit exists here and nowhere on the MAGI side.,

If you are under 65, not blind or disabled, and not asking for long-term care, the MAGI table below is your answer, and the aged, blind, and disabled rules in the rest of this guide are not.

North Dakota's 2026 MAGI income limits by coverage group

Coverage group 2026 income limit
Adults, Medicaid Expansion (ages 19 through 64, not in another group) 138% FPL
Parents and caretaker relatives 41% FPL
Pregnant women 175% FPL
Children, birth through age 5 152% FPL
Children, age 6 through 18 138% FPL
Children's Health Insurance Program (CHIP), birth through age 18 205% FPL

North Dakota Health and Human Services sets these limits as percentages of FPL, and the levels above took effect April 1, 2026. To convert them: HHS publishes the 2026 guidelines as annual income, $15,960/year for one person in the 48 contiguous states and DC and $21,640/year for two. Divided by twelve those are about $1,330/month and $1,803/month.

No assets are counted on the MAGI side. North Dakota HHS asks for proof of assets only from people who are blind, disabled, or 65 and older, so none of the groups in the table above has an asset test. That follows federal law, which bars a state from applying any resource test to the MAGI groups. So the $3,000 countable-asset limit below has no counterpart here: an adult or parent who qualifies through MAGI can hold savings without it touching their eligibility.

Adults under 65: the Medicaid Expansion group at 138% FPL

North Dakota has adopted the ACA Medicaid expansion. Adults ages 19 through 64 who don't qualify for another Medicaid coverage group qualify through the adult Medicaid Expansion group at 138% FPL. For one person in 2026 that works out to roughly $1,835/month, 138% of the $15,960/year one-person poverty guideline.,

That 138% is the effective ceiling, not the statutory one. The Affordable Care Act writes the new adult group at 133% FPL, and a MAGI income disregard of 5 percentage points of FPL sits on top of it, which is where 138% comes from. North Dakota's published 138% already folds that disregard in, so it is the number to compare your income against.

The group has hard edges written into the statute. It covers individuals under 65 years of age, not pregnant, and not entitled to or enrolled in Medicare.

Turning 65 can end Medicaid eligibility even if your income never changes

Those edges create the trap this guide exists to name. On the 65th birthday, the expansion pathway closes and the same person is assessed on the SSI-related ABD track instead. Two things change at once:

  • The income yardstick drops. It is no longer 138% FPL, roughly $1,835/month for one person. North Dakota's aged, blind, and disabled income level is $1,197/month for one person, and above it you qualify only through spend-down; its categorically needy level is lower still, the SSI eligibility level (the 2026 SSI Federal Benefit Rate is $994/month).,
  • A resource test appears. The MAGI groups are barred from applying one; the ABD track is expressly excepted from that bar. The default standard is the SSI resource limit of $2,000 for an individual.

So a 64-year-old covered at $1,600/month with modest savings can be over both tests at 65 without a dollar of income changing. Age alone is not the only trigger: the expansion group also excludes anyone entitled to or enrolled in Medicare, so someone under 65 who reaches Medicare through disability leaves the 138% group the same way.

North Dakota softens the landing. Its long-term-care resource limit is $3,000 rather than the $2,000 SSI default, and its medically needy spend-down means income above the standard does not disqualify you outright., Confirm which standard applies to your situation with your county Human Service Zone before the birthday, not after.

Parents and caretaker relatives: 41% FPL

North Dakota covers parents and caretaker relatives at 41% FPL. For a two-person household, where 100% FPL is $21,640/year in 2026, or about $1,803/month divided by twelve, that is roughly $740/month.

This group matters to eldercare readers mainly for one household: a grandparent raising a grandchild. Whether a relative meets North Dakota's definition of a caretaker relative is your county Human Service Zone's call, so ask them rather than assuming.

The number is far lower than the others because of how federal law built the group. Children have a federal floor of 133% FPL. Parents and caretaker relatives are pegged instead to the state's old cash-welfare standard: the federal minimum is its AFDC income standard in effect on May 1, 1988, converted to a MAGI equivalent. A state may set its own standard above that floor, up to a federal ceiling, and the published state standard is the number to check. North Dakota's is 41% FPL.

In a state that never adopted the expansion, that state-set standard is what decides whether a working parent qualifies. North Dakota is not one of them: a parent under 65 whose income runs above 41% FPL can still qualify through the expansion group up to 138% FPL. The 41% standard binds mainly on someone the expansion group shuts out: a caretaker who is 65 or older, or who is enrolled in Medicare.

Children and CHIP

North Dakota covers children at 152% FPL from birth through age 5 and at 138% FPL from age 6 through 18, both above the general federal floor of 133% FPL., Above those levels, the state runs a separate Children's Health Insurance Program (CHIP) covering children birth through age 18 up to 205% FPL. Pregnant women qualify at 175% FPL, with the unborn child counted as a family member when household size is figured. None of these groups face an asset test.

Why North Dakota's $3,000 asset limit is different

The federal SSI resource standard for a single aged or disabled applicant is $2,000. North Dakota is one of eight section 209(b) states, which use at least one eligibility criterion more restrictive than SSI's and must let applicants spend down excess income on medical bills. On assets, though, North Dakota's limit is the more generous one. Under North Dakota Administrative Code 75-02-02.1-26, a single nursing-home or waiver applicant may hold $3,000 in countable assets, and a couple $6,000.

Two details people get wrong:

The couple figure is $6,000, not double-and-then-some. When only one spouse needs care, the far larger spousal-impoverishment allowance below is what protects the at-home spouse; the $6,000 applies when both members of a couple are applying.

"Countable" is the word doing the work. North Dakota, like every state, exempts a long list of assets from the count: your home (subject to an equity cap), one vehicle, household goods and personal effects, and irrevocable burial plans. So the $3,000 applies to things like bank accounts, a second vehicle, and investments, not the roof over your head.

A note on the home, because it works differently from everything else here. North Dakota excludes the home you live in, but excess equity is a bar, not a countable resource: if your equity interest exceeds $752,000 for an application filed on or after January 1, 2026 (it was $730,000 in 2025), you are not eligible for skilled nursing, swing-bed, or home and community-based services, however small your bank balance, though you may still qualify for other Medicaid benefits. A reverse mortgage or home equity loan can be used to bring the equity down. The bar does not apply if your spouse, a child under 21, or a blind or disabled child of any age lawfully lives in the home, and the limit is re-indexed each year (N.D.A.C. 75-02-02.1-28) to the Consumer Price Index for all urban consumers.

How the North Dakota Medicaid income limits work: spend-down

Here is where being a 209(b) state shapes everything. North Dakota is a medically needy program, so being over the income standard does not disqualify you. It publishes an aged, blind, and disabled monthly income level of $1,197 for a household of one and $1,623 for two, set at 90% of the federal poverty level and effective April 1, 2026. If your income runs above that and you have a medical need, you can still get coverage with a spend-down, which ND HHS calls a client share: the excess is applied to your incurred medical and care costs (a prescription, a clinic visit, a share of facility charges) before Medicaid pays.

That matters most when you set it against the alternative. In income-cap states, an applicant over the cap generally needs a Qualified Income Trust, also called a Miller Trust, and federal law confines that trust to states that do not cover nursing-facility care through a medically needy pathway. North Dakota has no such cliff: federal rules require a 209(b) state to let applicants deduct incurred medical expenses from income to reach the eligibility level. A high income means a larger spend-down here, not an automatic denial.

North Dakota nursing home Medicaid: what a resident keeps

When North Dakota Medicaid pays for nursing-facility care, the resident contributes most of their monthly income toward the cost of care. The first thing North Dakota deducts under its post-eligibility rules is money for the resident's own small expenses like clothing, a haircut, or a phone, called the nursing care income level: $118 a month, effective July 1, 2026. Other deductions follow, such as amounts for a spouse at home, insurance premiums, and uncovered medical costs, so not everything above $118 goes to the facility. The $118 is nearly four times the $30 a month federal personal-needs floor. Most states call this the Personal Needs Allowance, and House Bill 1485 has North Dakota review its own every year for inflation, but the figure the state publishes for nursing-facility residents is the nursing care income level. It is expected to move each July 1, so confirm the current amount with your county Human Service Zone.

The same $3,000 asset limit applies to nursing-home applicants. For the national picture on how the PNA is set and calculated, see our explainer on the Medicaid personal needs allowance.

The five-year look-back

North Dakota reviews asset transfers made in the 60 months before a long-term-care application., Giving away money or property for less than fair market value during that window, such as gifting a grandchild a down payment or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a blind or permanently and totally disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review before you move a dollar. For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left without enough to live on. North Dakota's own rule (N.D.A.C. 75-02-02.1-24) sets the asset side as a half-share bounded by the federal floor and ceiling, which a fair hearing or court order can raise, and sets the income side at the federal minimum.,

Protection 2026 Amount What it does
Community Spouse Resource Allowance (CSRA) Half the couple's countable assets, counted as of the start of the first continuous stay; minimum $32,532, standard maximum $162,660 The countable assets the at-home spouse keeps, on top of the applicant's own limit; a fair hearing or court order can set more.
Monthly Maintenance Needs Allowance (MMNA) $2,705.00/month, the federal minimum North Dakota elects; more only on a court or hearing officer's order The monthly income the at-home spouse is brought up to; income can be shifted from the applicant to reach it.

The community spouse's asset share normally tops out at $162,660, but a court order, or a fair hearing showing the share yields too little income to reach the $2,705.00 allowance once the institutionalized spouse's income is counted first, can raise it., On the income side, treat the $4,066.50 federal maximum you will see quoted in national guides with care, because North Dakota does not use it: N.D.A.C. 75-02-02.1-24(1)(e) defines the community spouse's allowance as the minimum federal law permits, so $2,705.00 is the figure to budget on unless a court or hearing officer orders more.,

After death: estate recovery

North Dakota's Medicaid estate-recovery program reaches further than a generic explainer implies. Under N.D. Cent. Code 50-24.1-07 the state holds a preferred claim for the total medical assistance paid on behalf of a recipient who was 55 or older when they received it, not only the long-term-care portion. The protections for a surviving spouse, or a surviving child under 21 or of any age who is blind or permanently and totally disabled, are a deferral rather than a cancellation: the claim need not be paid and interest does not accrue while they apply, but a timely-filed claim is not disallowed, and no statute of limitations runs against it. The claim also arises on the surviving spouse's death, when all assets in that spouse's estate are presumed to be assets the recipient had an interest in, so moving the house into the well spouse's name is not a way out. Joint tenancy is less settled: the statute only requires surviving joint tenants to be reported to the department, so confirm with ND HHS or a lawyer how far the claim reaches. Federal law requires every state to run an undue-hardship waiver procedure; North Dakota's statute doesn't spell out its own, so ask ND HHS for it. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in North Dakota

North Dakota Medicaid is administered by North Dakota Health and Human Services (ND HHS), and eligibility is processed through your county Human Service Zone. You can apply online through the ND HHS self-service portal, or return a paper application to a Human Service Zone office; SFN 958 is the form for applicants who are aged, blind, or disabled. To get a paper application by mail or help applying, call the ND HHS Customer Support Center.

ND HHS Self-Service Portal Apply for Medicaid online. dhsbenefits.dhs.nd.gov/SSPPortal/public/?userType=client
ND HHS Customer Support Center Get help applying, or ask for a paper application by mail; you can return a paper application to your county Human Service Zone office. TTY users dial 711. 1-866-614-6005
North Dakota Health and Human Services Sets Medicaid policy; find your local Human Service Zone office. www.hhs.nd.gov/healthcare/medicaid

Long-term-care applicants also go through a level-of-care screening to confirm they need nursing-facility-level services. Apply even if you think you're over the limit. Between the $3,000 asset rule and the medically needy spend-down, many people who assume they're disqualified are not.

Frequently Asked Questions

What is the North Dakota Medicaid asset limit in 2026?

$3,000 in countable assets for a single long-term-care applicant and $6,000 for a couple, set in state rule (N.D.A.C. 75-02-02.1-26). Because North Dakota is a 209(b) state, that single-person figure sits above the $2,000 federal SSI resource standard. The home, one vehicle, household goods, and irrevocable burial plans are exempt from the count, though home equity above $752,000 bars nursing-facility, swing-bed, and home and community-based coverage unless a spouse or a child under 21, blind, or disabled lives there.

What are the North Dakota Medicaid income limits for seniors?

Seniors 65 and older are measured on the aged, blind, and disabled test, not the MAGI test that covers younger adults. North Dakota publishes an ABD monthly income level of $1,197 for one person and $1,623 for two, at 90% of the federal poverty level, effective April 1, 2026. Being over it does not disqualify you: North Dakota uses a medically needy spend-down rather than a hard income cap, so you spend the excess down on medical and care costs each month to qualify. A nursing-facility resident instead contributes income toward the cost of care, keeping $118 a month.

What is the income limit for regular (non-nursing-home) North Dakota Medicaid?

For adults 19 through 64 who don't fit another group, 138% FPL through the Medicaid Expansion group, with no asset test. That is roughly $1,835/month for one person in 2026. Parents and caretaker relatives: 41% FPL. Pregnant women: 175%. Children: 152% (birth through 5) or 138% (ages 6 through 18), with separate CHIP up to 205%.

I qualified at 64 but lost Medicaid at 65. What happened?

The Medicaid Expansion group covers only people under 65 who are not entitled to or enrolled in Medicare, so it closes on your 65th birthday. On the aged, blind, and disabled track, the income level is $1,197/month for one person (the categorically needy level is the lower SSI level, tied to the $994/month 2026 Federal Benefit Rate), and a $3,000 resource test appears for the first time., Nothing about your income has to change for both tests to go against you, though spend-down can still get you covered.

Does North Dakota require a Miller Trust (Qualified Income Trust)?

North Dakota has no hard income ceiling for long-term-care Medicaid. As a 209(b) medically needy state it must let applicants deduct incurred medical expenses from income to reach the eligibility level, so an over-income applicant spends down instead of being locked out. A Qualified Income Trust is the device income-cap states use to get around a cliff North Dakota does not have, and federal law makes it unavailable as an eligibility route in a state that covers nursing-facility care through a medically needy pathway. If someone tells you that you need one here, ask your county Human Service Zone to point you to the rule before you pay for it.

How much can a spouse keep when the other goes into a nursing home?

For 2026, the at-home (community) spouse's share is half the couple's countable assets, at least $32,532 and normally no more than $162,660; a fair hearing or court order can set a higher amount. On income, North Dakota elects the federal minimum monthly maintenance needs allowance of $2,705.00 a month, raised only on a court or hearing officer's order. The $4,066.50 federal maximum quoted in national guides is not North Dakota's figure, so do not budget on it.,

What does a nursing-home resident on North Dakota Medicaid keep each month?

$118 a month, the nursing care income level North Dakota deducts first, effective July 1, 2026, and expected to change each July 1. The rest of the resident's monthly income goes toward the cost of care, after other allowed deductions such as amounts for a spouse at home, health and long-term-care insurance premiums, and uncovered medical expenses.

Where do I apply for North Dakota Medicaid?

Apply online through the ND HHS self-service portal, or return a paper application (SFN 958 for aged, blind, or disabled applicants) to your county Human Service Zone office. The ND HHS Customer Support Center at 1-866-614-6005 can mail you an application or help you apply.

Learn More

MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits for 2026 depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the figures and your state's limits. MedicaidNorth Dakota Medicaid Estate RecoveryNorth Dakota Medicaid estate recovery reaches beyond probate to a surviving spouse's estate. See who is subject, who's protected, and how to respond to a claim. MedicaidNorth Dakota Help Paying Senior Health-Insurance PremiumsNorth Dakota Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, what each program pays, Part D Extra Help, and how to apply through ND HHS. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidHow Medicaid Estate Recovery WorksMedicaid estate recovery can claim a home after death, but not while a spouse or a child under 21, blind or disabled survives. See your state's rules. MedicaidThe Medicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, what the states set, and how patient liability is calculated.

Find personalized help working through North Dakota Medicaid eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.