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.

This guide covers both tests for 2026: North Dakota's MAGI limits by coverage group, the 65th-birthday transition between the two, and then the long-term-care rules for seniors and people who are blind or disabled, from the $3,000 asset limit through what a spouse who stays home is protected from.

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. It is the test behind every other figure in this guide: the $3,000 asset limit, the medically needy spend-down, the $118 a month a nursing-facility resident keeps. 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 not applying for nursing-facility care, the MAGI table below is your answer, and the long-term-care 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) 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: in 2026, 100% FPL for one person is $15,960/year, about $1,330/month, in the 48 contiguous states and DC; for two people it is $21,640/year, about $1,803/month.

No assets are counted on the MAGI side. North Dakota counts no assets for children, families with children, or pregnant women, and applies an asset test only to the aged, blind, and disabled groups. 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 qualify through the adult Medicaid Expansion group at 138% FPL. For one person in 2026 that works out to roughly $1,835/month, which is 138% of the $15,960/year poverty guideline for one person in the 48 contiguous states and DC (Alaska and Hawaii run on separate, higher guidelines).,

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, but the SSI Federal Benefit Rate, which is $994/month for an individual in 2026.,
  • 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 about $1,803/month in 2026, 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. Parents and caretaker relatives are federally mandatory, but unlike children (mandatory to 133% FPL) and the new adult group (effectively 138% FPL), the mandatory floor is only the state's old cash-welfare standard: the AFDC income standard the state had in effect before 1996, converted to a MAGI equivalent, which is typically far below the poverty level. That floor is a federal minimum and a state may set its own standard above it. North Dakota's 41% sits far below the poverty line, in the range that frozen floor tends to produce.

In states that never adopted the expansion that leaves a working parent over the limit at a very low income with no other adult pathway. North Dakota is not one of them: a parent under 65 whose income runs above 41% FPL is still covered by 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 federal mandatory 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 set at least one eligibility criterion of their own rather than following SSI, and on assets North Dakota's is the more generous. 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 prepaid burial arrangements. 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 at all, however small your bank balance. 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. Whatever your monthly income runs above that becomes your spend-down amount, which ND HHS calls your client share: once you've incurred that much in medical or care costs in a given month (a prescription, a clinic visit, a share of facility charges), Medicaid covers the rest of that month.

That matters most when you set it against the alternative. In strict income-cap states, an applicant even one dollar over the limit is locked out unless they route the excess through a Qualified Income Trust, also called a Miller Trust. 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. If your income is high, you spend down; you are never simply "too rich" for long-term-care Medicaid here.

For a nursing-facility resident, the income test plays out as recipient liability: the resident contributes their income toward the cost of care, keeping only the protected allowances described next, and Medicaid pays the balance of the bill.

North Dakota nursing home Medicaid: what a resident keeps

When North Dakota Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of care. What stays with them is money for their own small expenses like clothing, a haircut, or a phone, and North Dakota deducts it first under its post-eligibility rules as the nursing care income level: $118 a month, effective July 1, 2026. That is nearly four times the $30 a month federal personal-needs floor. Most states call this money the Personal Needs Allowance, and House Bill 1485 directs North Dakota to review its own under that name every year for inflation, but the figure the state publishes for nursing-facility residents is the nursing care income level. It moves 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. And because North Dakota uses spend-down rather than an income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care. 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, 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, up to $162,660 (federal maximum); minimum $32,532 The most in countable assets the at-home spouse may keep, on top of the applicant's own limit.
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.

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets while the other spouse receives Medicaid-funded care. 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. North Dakota also reaches joint-tenancy property, and on the surviving spouse's death 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. Federal law requires every state to run an undue-hardship waiver procedure. 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), but financial eligibility is determined locally by your county Human Service Zone. ND HHS sets policy; your local zone office takes and decides your application. You can apply online, in person, or by phone.

North Dakota Self Service Portal Apply online for Medicaid and other assistance programs together. apply.nd.gov
ND HHS Customer Support Center Get help applying, or ask for a paper application by mail; your county Human Service Zone office also takes applications in person and decides eligibility locally. 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 prepaid burial 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 ages 19 through 64, it is 138% of the federal poverty level through the Medicaid Expansion group, which is roughly $1,835/month for one person in 2026, with no asset test. Parents and caretaker relatives are covered at 41% FPL, pregnant women at 175% FPL, and children at 152% FPL (birth through 5) or 138% FPL (ages 6 through 18), with separate CHIP up to 205% FPL.

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

The Medicaid Expansion group covers only people under 65 who are not enrolled in Medicare, so it closes on your 65th birthday. You are then assessed on the aged, blind, and disabled track, where the income yardstick becomes the SSI Federal Benefit Rate of $994/month rather than 138% FPL, and a resource test appears that never applied to you before. Nothing about your income has to change for both tests to go against you.

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. 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 keeps half the couple's countable assets, at least $32,532 and at most $162,660 (the Community Spouse Resource Allowance). 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 re-set each July 1. The rest of the resident's monthly income goes toward the cost of care, after deductions for a community spouse and certain health-insurance premiums.

Where do I apply for North Dakota Medicaid?

Apply online at apply.nd.gov, in person at your county Human Service Zone office, or with help from the ND HHS Customer Support Center at 1-866-614-6005. North Dakota HHS sets policy, but your local Human Service Zone takes and decides the application.

Learn More

MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the 2026 figures and your state's exact limits. MedicaidNorth Dakota Medicaid Estate RecoveryNorth Dakota Medicaid estate recovery reaches beyond probate to joint property and a spouse's estate. See who is subject, who's protected, and how to respond. 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 explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting. MedicaidThe Medicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, state figures from $30 to $200, 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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Brevy Care Team

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