Complete Topic List

     

Medicaid For People In The Community

WHAT IS THE MEDICAID PROGRAM?


The Medicaid program began in North Dakota on January 01, 1966. The program’s purpose is to provide medical care and services to certain groups of people whose resources are insufficient to meet their medical needs.

The program looks at your income and resources to determine your eligibility.

You could be eligible from the first day of the month in which you apply. Retroactive eligibility may be established for as many as three calendar months preceding the month you apply. You must meet the eligibility criteria in each of these months.

WHO IS ELIGIBLE?

Persons who are age 65 or older, blind, or disabled. Members of families with dependent children, qualified pregnant women, or children; other individuals.

WHAT MEDICAL CARE IS PAID?

Inpatient and outpatient hospital costs. Services of doctors, dentists, optometrists and other licensed medical practitioners. Lab work, x-rays, eyeglasses, prescribed drugs and medicines. Also other medical-health services.

WHAT IS THE INCOME LEVEL?

It depends on your living situation, type of income and the group you qualify under. Not all income counts, and there are deductions.

If your income exceeds the limit after all the disregards, you can still qualify, but you would have to pay some of the costs. This is known as recipient liability (Further information regarding recipient liability can be found in brochure #514).

WHAT IS THE RESOURCE LIMIT?

The combined equity value of all property, not excluded or exempt, is $3,000 for a one-person unit and $6,000 for a two-person unit. Add $25 for each additional household member. Resources cannot exceed these limits.

WHAT RESOURCES ARE EXCLUDED?

  • Your home and all connecting land up to 160 acres if rural, or two acres if located in a city.
     
  • One motor vehicle, personal effects, wearing apparel, household goods and furniture.
     
  • Indian trust or restricted lands.
     
  • Indian per capita and judgment funds.
     
  • Property necessary to earn a livelihood, if actively engaged in using it to earn income (such as farming). You cannot rent or lease the property out.
     
  • Property which is up for sale, but not sold.
  • A $6,000 burial fund and a burial plot for each family member. ** Beginning August 1, 2019, the law has changed and will read: “A burial fund and burial fund is an irrevocable itemized funeral contract designated by the applicant or recipient to pay for their funeral. Interest or earnings retained in a funeral fund also may not be considered as an asset. Any funds not used for funeral or burial expense must be returned to the estate of the medical assistance recipient and is subject to recovery by the department from the medical assistance recipient's estate."

  • The value of a life estate.

    NOTE* The county may impute income from your life estate interest.
     
  • The value of mineral acres.

WHERE DO I APPLY FOR HELP?

Contact your local County Social Service Office for an application. All individuals wishing to make an application for Medicaid must be given the opportunity without delay.

HOW WILL I KNOW I AM ELIGIBLE?

The county must provide you with a decision in writing. This is usually 45 days (90 days in disability cases) from the date you returned the completed application. The decision will inform you if you are eligible. If you are not eligible, it must explain the reasons.

WHAT CAN I DO IF I AM DENIED?

You can appeal. This is a request for a hearing. The appeal must be in writing. The notice you receive tells you how to appeal, where to send the appeal, and the date by which you must appeal.

PLEASE NOTE:

This brochure covers the eligibility criteria for people who live in the community.

It does not include eligibility criteria for institutionalized individuals or the community spouse (see brochures #511, #512, #513). It does not include eligibility criteria for Home & Community Based Services. It also does not include eligibility criteria for the Medicare Savings Programs. (see brochure #515).

DISCLAIMER: This information is not legal advice. If you have a legal problem, you should talk to lawyer and ask for advice about your options.

May 2019

Published in conjunction with Department of Aging Services -Title III.
N.D.A.C 75-02
NDCC 510-05-70-30