North Dakota Medicaid Long Term Care Eligibility for 2025

North Dakota Long Term Care

Services Offered in 2025:

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  • Adult Family Foster Care – Safe, supervised family living in a state-licensed setting.
  • Case Management – Needs assessment, care planning, provider referrals, and service monitoring.
  • Chore Service – Includes snow removal and heavy cleaning.
  • Emergency Response System – Telephone-based emergency response.
  • Environmental Modifications – Home modifications to enhance independence (e.g., safety rails).
  • Family Home Care – Reimburses a family caregiver residing with the client 24 hours per day.
  • Homemaker Services – Assistance with house cleaning, laundry, and meal preparation.
  • Respite Care – Temporary relief for full-time caregivers.

Eligibility for 2025:

1. Residency and Citizenship – Applicants must be North Dakota residents and U.S. citizens or have proper immigration status.

2. Age/Disability – Applicants must be 65 years or older, blind, or disabled and meet medical requirements consistent with the level of care requested. Care must be required for thirty (30) consecutive days.

3. Income Limitations – Applicants’ income must be less than the cost of care at the Medicaid rate. Medicaid-approved applicants must use part of their income to pay for care services, termed “recipient liability.” If single but not medically needy, monthly income must be ≤ $549. Medically needy applicants must have monthly income ≤ $853. Exempt income includes:

  • A personal needs allowance of $68/month.
  • Health insurance premiums and uncovered medical expenses.
  • Allowances for certain spousal or dependent family members.
  • A home maintenance allowance if returning home within six months and no one resides there.
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4. Asset Limitations – Medicaid divides assets into Exempt and Available. Non-exempt assets must be liquidated and applied toward care costs before eligibility. North Dakota enforces a 5-year look-back period for transfers below fair market value or gifts. Exempt transfers include:

  • Transfers to a spouse, blind/disabled child, or specific trusts for disabled individuals or the applicant’s benefit.
Exempt Assets in 2025 for an applicant in North Dakota include:
  • $3,000 or less in cash/non-exempt assets if single; $6,000 if married with both spouses requiring care.
  • One home (equity limit ≤ $788,000) if planning to return or if a spouse, child under 21, or disabled dependent resides there. Proceeds from the sale are countable.
  • One car, with no equity limit specified. If multiple cars, the most valuable is exempt.
  • An irrevocable funeral trust ≤ $1,500.
  • Self-employment property, such as tools or livestock.
  • Non-saleable property, household furnishings, clothing, and personal effects.
  • Indian trust/restricted lands, and per capita or judgment funds.
Spousal Rules for 2025:

Community Spouse Asset Allowance: A community spouse may retain up to $152,020 in non-exempt assets. If their assets are below $30,027, additional transfers from the institutionalized spouse are allowed.

Community Spouse Income Protection: A community spouse may retain income up to $3,898.50/month if their own income is < $2,389/month. Dependents may retain income up to $689/month.

North Dakota Long Term Care Insurance Partnership in 2025:

This partnership program protects assets dollar-for-dollar based on the policy’s maximum benefit. For instance, a policy paying $165,000 exempts $165,000 in assets. Spouses must purchase individual policies.

Further Reading: