Medicaid Brochures 510-05-25-20

(Revised 4/1/05 ML #2962)

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  1. All applicants for Medicaid must be provided:

  1. A brochure entitled "Medicaid" (376kb pdf) (05-100-15) outlining the services available under the Medicaid Program;
  2. A brochure entitled "Your Civil Rights" (152kb pdf) (05-100-20); and
  3. A notice entitled "Notice of Privacy Practices" (18 kb pdf) (DN 900 which is available in E-Forms.)

  1. All households with individuals of childbearing age must be made aware of the opportunity they have to receive family planning services and must be given a brochure entitled "Family Planning-Choosing Your Family Size," or "Family Planning Program" (05-100-25).

  2. All households with individuals under the age of twenty-one must be made aware of the availability of "North Dakota Health Tracks" (early and periodic screening, diagnosis and treatment services) and be given the brochure entitled "ND Health Tracks" (05-100-30).

  3. All households with pregnant, breast feeding or postpartum women, or children under age five, must be made aware of the availability of the WIC (Women, Infants, and Children) Program, and must be provided a "WIC" outreach brochure (05-100-35).  

  4. Acknowledgment that the applicant received such information is contained on the application form.