WHAT IS THE MEDICAID PROGRAM?

This program pays for your 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.

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 EXEMPT?

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.

WHAT RESOURCES ARE EXCLUDED?

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 $5,000 burial fund and a burial plot for each family member.

The value of a life estate. NOTE* The county may impute income from your life estate interest.

WHERE DO I APPLY FOR HELP?

Contact your local County Social Service Office for an application. You have a right to make an application and to receive a written decision.

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 Medicare Savings Programs (see brochure #515).

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

March 2006
Published by Legal Services of North Dakota in conjunction with Department of Aging Services -Title III.