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Medicaid Expansion

Access to the expanded Medicaid Program for North Dakotans

Beginning in January 2014, North Dakota is expanding access to Medicaid to cover more individuals.

Why Medicaid Expansion?

Expansion of Medicaid gives more individuals the opportunity to have affordable coverage, preventive services and greater economic security in the event of accidents or illness. We are building on the success of Medicaid to make health care coverage more accessible for North Dakotans.

Do You Qualify?

The expanded Medicaid program will be available to individuals under age 65 with household incomes up to 138% of the federal poverty level (FPL). Individuals eligible for Medicare or Supplemental Security Income (SSI) are not eligible for coverage under Medicaid expansion. If your household’s annual income is equal to or lower than the figures below, you will probably qualify for Medicaid.

1-person
2-people
3-people
4-people
5-people
6-people
7-people
8-people
$15,856
$21,404
$26,951
$32,499
$38,047
$43,594
$49,142
$54,689
For households with more than 8 people, add $5,548 for each additional person.

How to Apply for the Medicaid Expansion

Go to http://apply.dhs.nd.gov to apply for Medicaid coverage. On this site, you will be able to complete a Fillable PDF Form, save it to your computer, and upload it on the website. The online application form is the same as the paper application that is available through the department and at county social service offices. The state will process applications and notify applicants.

In addition to the online fillable application form, individuals can apply for Medicaid by submitting paper applications by mail, by telephone (855) 794-7308 or ND Relay TTY 1-800-366-6888 for people with hearing impairments), or in-person at a county social service office.

If an individual does not qualify for Medicaid, the individual can explore whether he or she may qualify federal health insurance marketplace coverage at www.healthcare.gov. NOTE: The open enrollment period for the federal Health Insurance Marketplace ended March 31, 2014. Some people with special life-changing circumstances may still be able to apply.

Medicaid Expansion Coverage

Member Services include:

    • Benefits
    • Claims
    • How to find a provider
    • How to file a complaint
    • How to order ID cards
    • Email memberservices@sanfordhealth.org, or call (855) 305-5060 / TTY (877) 652-1844

Pharmacy and Prescription Drug Coverage:

  • What drugs are covered?

Email um@sanfordhealth.org, or call (800) 805-7938 - Select option 1

Medical Management:

  • How do I get prior-approval of health care services?

Email um@sanfordhealth.org, or call (800) 805-7938 - Select option 2

The Health Insurance Marketplace

Starting in 2014, most Americans will be required to have health insurance. If individuals do not qualify for Medicaid, they will be able to research and buy health insurance through the federal government’s Health Insurance Marketplace at www.healthcare.gov or by calling the federal help line at 1-800-318-2596 ( TTY Users Call: 1-855-889-4325) during open enrollment periods. The online federal Marketplace has information about private health insurance choices and tax subsidies.

Resources

Medicaid Expansion Brochure (1.29 MB pdf)

Medicaid Expansion - Frequently Asked Questions (Updated 1/3/2014) (39kb pdf)

General Information Flyer (116kb pdf)

Information Flyer for American Indians (244kb pdf)

Training PowerPoint Handout - General Audience (updated 12/13/2013) (1.04Mb pdf)

Training PowerPoint Handout - Native American Audience (updated 12/13/2013) (622kb pdf)

Poster - general population (1249kb pdf)

Poster - American Indian audience (1077kb pdf)

30 Second Television Public Service Announcement (Posted 1/2/2014) (27Mb .MOV) - May be a short delay before this plays

30 Second Radio Public Service Announcement (Posted 1/2/2014) (501kb MP3)

60 Second Television Public Service Announcement (Posted 1/2/2014) (50Mb .MOV) - May be a short delay before this plays

60 Second Radio Public Service Announcement (Posted 1/2/2014) (944kb MP3)

Drop-in Newsletter Article 1 (Posted 1/7/2014)

Fact Sheet: Affordable Care Act Project Overview (109kb pdf)

Center for Consumer Information and Insurance Oversight (CCIIO) - State Planning and Establishment Grant Information

For Questions about the Medicaid Expansion, Contact:

Medical Service Division
North Dakota Department of Human Services
600 East Boulevard Avenue, Dept. 325
Bismarck, ND 58505-0250
Call: (701) 328-2321
Toll-free: (877)-543-7669
ND Relay TTY 800-366-6888
E-mail: dhsmed@nd.gov

 

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