Benefits for seniors in North Dakota

Medicaid for people 65 and over

North Dakota Medicaid covers people who are 65 or older, blind or disabled.

• If you get SSI: You can get Medicaid as part of the "categorically needy" group.
• If you do not get SSI: You can still qualify as "medically needy." The medically needy income level is $1,197 a month for one person and $1,623 for two. If your countable income is higher, you pay part of your medical costs each month first. North Dakota calls this your recipient liability. After that, Medicaid pays.
• Savings (assets): $3,000 for one person, $6,000 for a couple.
• What it covers: Doctor visits, hospital care, prescriptions and more. If you also have Medicare, Medicaid fills many of Medicare's gaps.

Long-term care. Medicaid can pay for nursing home care and for care at home through a waiver (see "Help staying at home"). In a nursing home, you keep $118 a month for personal needs, and most of the rest of your income goes toward your care. If your spouse stays at home, your spouse can keep part of your income so their own income reaches $2,705 a month. Your spouse can also keep part of your savings: at least $32,532 and up to $162,660.

Estate recovery. After a Medicaid member dies, the state seeks repayment from the estate if the member was 55 or older or lived permanently in a nursing home. Nothing is collected while a spouse, a child under 21, or a blind or disabled child is living. Medicare cost-sharing paid since January 1, 2010, is not collected. Questions: 701-328-2310 or 1-800-472-2622 (TTY 711).

Help paying Medicare costs

North Dakota's Medicare Savings Programs use the federal income limits:

• QMB (Qualified Medicare Beneficiary): Pays your Part A and Part B premiums, deductibles and coinsurance. Income up to $1,350 a month for one person, $1,824 for a couple.
• SLMB (Specified Low-Income Medicare Beneficiary): Pays your Part B premium. Income up to $1,616 a month for one person, $2,184 for a couple. It can cover up to three months before you apply.
• QI (Qualifying Individual): Pays your Part B premium. Income up to $1,816 a month for one person, $2,455 for a couple.
• Savings limit: $9,950 for one person, $14,910 for a couple.

The state's own chart shows limits about $20 lower because it takes off the $20 of income that is not counted. If you get any of these programs, you also get Extra Help with Medicare drug costs automatically. Apply the same way you apply for Medicaid.

Prescription drug help

North Dakota does not have a state drug program that pays part of your Medicare drug costs. Two places to start:

• Extra Help: The federal program that lowers Medicare Part D costs. Income can be up to 150% of the poverty level. Apply with Social Security.
• Prescription Connection: A free North Dakota Insurance Department service that helps residents with low income apply to drug company assistance programs. Call (888) 575-6611.

Extra state payment with SSI

North Dakota does not add a state payment to SSI. Social Security lists no optional state supplement for North Dakota. The federal SSI payment is $994 a month for one person in 2026. If you live in a licensed basic care facility, ask your Human Service Zone office about the Basic Care Assistance Program, which helps pay that cost.

Food help

North Dakota calls food help SNAP (Supplemental Nutrition Assistance Program).

• Medical costs count: If you are 60 or older or disabled, medical costs over $35 a month can raise your benefit. Instead of adding up receipts, you can choose a standard medical deduction of $175 a month.
• How to apply: Online through the Self-Service Portal, or fill out the Application for Assistance (SFN 405) and return it to your Human Service Zone office. The same form covers Medicaid.
• Farmers market coupons: North Dakota does not run a statewide Senior Farmers Market Nutrition Program. The Spirit Lake Tribe runs one for its area.
• Meals: For meals at senior centers or delivered to your home, call the Aging and Disability Resource LINK (see "Free help and counseling").

Help staying at home

• SPED (Service Payments for the Elderly and Disabled): A state program that pays for help at home, such as homemaker and chore services, respite care, personal care, case management and adult family foster care. You qualify based on your needs, income and assets. Your home and the first $50,000 of savings do not count. You may pay part of the cost on a sliding scale.
• Expanded SPED (Ex-SPED): For people 65 or older (or 18 and over and blind or disabled) who are on Medicaid and have income no higher than the SSI payment. It is for people who need help with tasks like meals, housework, medicines and laundry.
• Medicaid Waiver for Home and Community Based Services: For people 65 and over, and adults 18 to 64 with a physical disability, who need nursing home level care but want to stay at home. You must be on Medicaid. Services include personal care, homemaker, chore, respite, home-delivered meals, adult foster care and care coordination.
• PACE (Program of All-Inclusive Care for the Elderly): For people 55 and over who need nursing home level care and can live safely at home. PACE has sites in Bismarck, Dickinson, Fargo and Minot. Ask the state PACE office at 701-328-2838 or 1-800-755-2604 (TTY 711) whether you live in the service area.
• Get started: Call the Aging and Disability Resource LINK at 1-855-462-5465, or contact your Human Service Zone office.

Property tax and housing help

The first two programs are for people 65 or older, or with a permanent and total disability.

• Homestead Property Tax Credit (homeowners): Household income must be $70,000 or less for last year. There is no asset limit. If your income is $40,000 or less, the taxable value of your home is cut by 100%, up to $200,000 of value. Above that, it is cut by 50%, up to $100,000. Apply to your local assessor or county director of tax equalization by April 1.
• Renter's Refund: Same age and income rules ($70,000), no asset limit. If 20% of your yearly rent is more than 4% of your income, you get the difference back, up to $600 a year. Utilities do not count as rent. Mail your application to the Office of State Tax Commissioner by May 31.
• Primary Residence Credit (any age): Homeowners who live in their home can get up to $1,600 off their property tax. There is no age or income limit. Apply online at tax.nd.gov/prc from January 1 to April 1. Without internet, call 701-328-7988 or 1-877-649-0112.

Help with energy bills

North Dakota's Low Income Home Energy Assistance Program (LIHEAP) helps with heating costs, furnace cleaning, repair and replacement, and emergencies.

• Income: For the 2026-2027 program year, yearly income up to $41,356 for one person or $54,082 for two.
• When to apply: Any time. Applications are taken year-round, and emergency help is also available year-round. Do not wait for an emergency.
• How to apply: Online through the Self-Service Portal at hhs.nd.gov/applyforhelp, or fill out the Application for LIHEAP (SFN 529) and return it to your Human Service Zone office.

Free help and counseling

• Aging and Disability Resource LINK (ADRL): North Dakota's starting point for older adults and people with disabilities. It connects you to in-home help, meals and other services. Call 1-855-462-5465 (ND 711 for TTY), email [email protected], or visit ndcarechoice.hhs.nd.gov.
• SHIP (State Health Insurance Assistance Program): Free, unbiased Medicare counseling from the North Dakota Insurance Department. Counselors help with Medicare choices, Part D, bills, claims and appeals. Call (888) 575-6611.
• Human Service Zone offices: Each county is served by a Human Service Zone office that takes applications for Medicaid, SNAP, LIHEAP and SPED. Find yours at hhs.nd.gov/service-locations/human-service/zones.
• Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov.

How to apply

Check what you may qualify for