North Dakota Medicaid and Children's Health Insurance Program
Tribal Health and Indian Health Services
The North Dakota Department of Human Services' mission is to provide quality, effecient, and effective human services, which improve the lives of people.
What is North Dakota Medicaid? Medicaid is a federal and state partnership program that makes coverage available for basic health services for qualified families with children, women who are pregnant, and the elderly or disabled. Medicaid is overseen at the federal level by the Centers for Medicare and Medicaid Services (CMS) within the United States Department of Health and Human Services (HHS). In North Dakota, Medicaid is administered in the North Dakota Department of Human Services. Medicaid was federally authorized in 1965; North Dakota implemented Medicaid in 1966.
How does someone become eligible for Medicaid? A person can meet income guidelines and be under age 21, a woman who is pregnant, those that have breast or cervical cancer, are blind or disabled, are age 65 and older, or individuals who are a member of a family with children.
Eligibility is also based on income and, in some situations, assets. Not all assets a person owns are counted. Some assets that are not counted include: the home the applicant lives in, one car or other vehicle for personal use, personal belongings, burial plans or property that produced earned income such as a farm.
What is the North Dakota Children's Health Insurance Program (CHIP)? The Children's Health Insurance Program (CHIP), also known as Healthy Steps, is a state and federal partnership that provides health insurance coverage for children in families who earn too much income to qualify for Medicaid, but cannot afford to purchase private health insurance coverage. CHIP was federally authorized in 1997; North Dakota adopted CHIP October 1, 1999.
How does someone become eligible for CHIP? Eligible children cannot have health insurance coverage (Indian Health Services is not considered health insurance coverage), must be 18 years of age or younger, does not qualify for the North Dakota Medicaid program, and live with families with qualifying incomes.
How can an individual apply for Medicaid or CHIP services? http://www.nd.gov/dhs/services/medicalserv/medicaid/apply.html
How does Medicaid and CHIP work with Indian Health Services? Native Americans who are eligible for health care through the Indian Health Services (IHS) are also entitled to Medicaid and CHIP coverage if they meet the categorical and financial eligibility requirements for the North Dakota Medicaid and CHIP programs. In cases in which a recipient is eligible for both Medicaid and IHS services, and a service (such as hospital care) is covered both by Medicaid and by the IHS, the Medicaid program is required to pay for the service. When a Medicaid recipient receives a service provided by the IHS that is not included as a Medicaid services, IHS has the responsibility to pay.
Centers for Medicare and Medicaid Services (CMS) Approved North Dakota State Plan Amendments (SPA):
North Dakota Medicaid Information:
Medicaid SPAs and Waivers Open for Consultation
IHS Encounter Rates
Current IHS Encounter Rates - Reimbursement to IHS facilities will be on a daily encounter basis and based on the approved all-inclusive rates published each year in the Federal Register by the U.S. Department of Health and Human Services.
Medical Services Division
North Dakota Department of Human Services
600 E Boulevard Ave Dept 325
Bismarck ND 58505-0250
Telephone: (701) 328-2321
Toll free: (800) 755-2604
ND Relay TTY: (800) 366-6888 or 711
Fax: (701) 328-1544