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Medicaid Frequently Asked Questions

Q. Who can apply for programs or services?

A. Generally speaking, anyone may apply for assistance. Eligible applicants will ordinarily reside in North Dakota. For additional information, please refer to the program brochure(s).

Q. Where do I apply for programs and services?

A. To apply, contact your local County Social Service Office. For local contact information, click on the county closest to your home on the locator map. You may also view the Application for Assistance. Completing the application prior to visiting the County Social Service Office may help to shorten the eligibility determination process.

Q. Who do I contact if I have additional questions prior to applying for programs or services?

A. The County Social Service Office staff can assist you in the completion of the application and answer any questions you may have regarding the program.

Q. Who has access to my information if I apply for programs or services?

A. The Department of Human Services must follow federal and state laws on privacy. Only those whose job requires them to view your personal information in order to administer the programs, or process payments, have access to your information. Department of Human Services staff and County Social Service agency staff are bound by strict confidentiality rules that do not allow unauthorized disclosure of your personal information.

Q. Are other programs or services available?

A. The Department of Human Services provides a wide range of programs and services. You can return to the Financial Help page to review other programs that may be available to assist with your financial needs.

Q. How can I get coverage for medical expenses?

A. If you are a pregnant woman or a member of a family with children under age 21, and you ONLY want medical coverage, you can complete the "Application for Health Care Coverage." If you also want to apply for coverage in a basic care facility, assistance with child care expenses, food stamps, a TANF grant, for help with Medicare premiums, or if you are aged or disabled, there is an application form that will allow you to apply for any or all of these programs with a single application. You can get either application form from your local County Social Service office (in person or by mail).

Q. Will there be any cost to me for programs or services?

A. Some people are required to pay co-payments for services received, and some may also be required to pay a recipient liability. Individuals DO NOT have to pay co-payments if they are younger than age 21, or are pregnant, or need emergency services, or receive family planning services, or if Medicare pays for part of the service, or if they are living in a nursing facility, swing bed, intermediate care facility for the mentally retarded, the state hospital, or the Anne Carlsen School.

Q. How much are co-payments?

Q. What is recipient liability?

A. Recipient liability is the amount you are responsible to pay toward your medical expenses for the month. It is based on your monthly income, and is similar to the deductible amount in an insurance policy.

Q. Can I go to any medical doctor I choose?

A. Families with children will be required to choose a primary care physician who will be responsible for all of their health care and who will make referrals to specialty physicians if needed. Certain other recipients are not required to choose a primary care physician. If your primary care physician is not able to provide a service, a referral will be made to a doctor who can give you the care you need.

Q. What does Medicaid consider as income?

A. Income is any money received which is considered to be available to a person for current use, such as wages, child support, social security benefits, other retirement benefits, etc.

Q. Are there income and asset limits for Medicaid?

A. Eligibility is based on income and, in some cases, assets. Medicaid has several different coverages with different income and asset levels. Please contact your local county social service office for details.

Q. When does eligibility begin?

A. If you are approved for Medicaid, the Medicaid program may pay for health services provided to you up to three months before the month the county social service office receives your signed application.

Q. What is the difference between Medicare and Medicaid?

A. Medicare is the part A and B insurance coverage through the Social Security Administration. Medicaid is a state program that covers Medicaid expenses and may be in addition to Medicare.

Q. What if I don't agree with the county social service office's action?

A. You can request a fair hearing if you do not agree with a decision about Medicaid eligibility. To request a hearing, you can contact your local county social service office.

Q. Does the Medicaid program take people's property?

A. The Medicaid program does not put liens against property. Medicaid may use the estate recovery process on estates of people who were age 55 or older when they received Medicaid coverage. When those individuals die, Medicaid may recover the cost of benefits paid out, BUT ONLY IF there is NOT a surviving spouse, or a child who is younger than 21 or is blind or permanently and totally disabled.

 

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