Yes — North Dakota Medicaid is the primary way most families in North Dakota pay for a long nursing-home stay. Medicare only covers short, skilled rehabilitation stays, and private long-term-care insurance is uncommon, so when a stay becomes long-term, Medicaid is usually where families turn. But North Dakota Medicaid is means-tested, and the rules blend federal law with North Dakota-specific details. This is the map, not legal advice — confirm every current figure with the North Dakota Department of Health and Human Services.
Does North Dakota Medicaid cover nursing-home care?
North Dakota Medicaid covers medically necessary nursing-facility care for people who meet both a financial test and a functional (level-of-care) test — meaning the person genuinely needs the level of help a nursing home provides. A separate nurse assessment usually confirms that need. Once approved, the resident contributes most of their monthly income toward the cost (the "patient pay amount" or "share of cost"), and Medicaid covers the rest at facilities that accept it.
Income and asset limits in North Dakota (2026)
North Dakota does not use the $2,000 asset limit that applies in most states.
- Asset limit: $3,000 for a single applicant.
- No fixed income cap. Income is measured against the cost of the nursing home rather than a set ceiling, so a pension that disqualifies someone in a cap state may not disqualify them here.
- Personal Needs Allowance: $115 per month — what the resident keeps once income goes toward care.
These figures are reset annually, so confirm the current ones with the North Dakota Department of Health and Human Services. Crucially, many things are exempt and do not count: the primary home (up to a state equity limit, if the applicant or a spouse intends to return or lives there), one vehicle, household goods and personal belongings, and certain prepaid burial arrangements. Families often assume they own "too much" to qualify when, after exemptions, they are much closer than they think.
The five-year look-back
When you apply, Medicaid reviews asset transfers made in the 60 months beforehand. Gifting money or property — or selling it for less than fair value — to qualify faster can trigger a penalty period during which Medicaid will not pay. This is the single most common and most expensive mistake families make. Before moving, retitling, or gifting anything, it is worth a conversation with an elder-law attorney or an accredited Medicaid planner, especially for larger estates.
Protecting a spouse
If one spouse needs care and the other stays at home, federal spousal-impoverishment rules protect the at-home spouse. The Community Spouse Resource Allowance (CSRA) lets them keep a protected share of the couple’s combined assets, and the Minimum Monthly Maintenance Needs Allowance (MMMNA) can shift income to them if theirs is low. No one should have to "go broke" to get a spouse the care they need — these protections exist precisely to prevent that.
Sorting out eligibility is a job for a caseworker or elder-law attorney — but finding a quality facility that accepts Medicaid while that’s underway is where we can help; See how Curalune Care Help works
Estate recovery
After a Medicaid recipient dies, states are required to seek repayment from the estate for long-term-care costs paid — the North Dakota Medicaid Estate Recovery Program. In practice this most often affects the home. There are exceptions and hardship waivers (for a surviving spouse, a disabled child, or a caregiver child who lived in the home), so this is another area to raise with the North Dakota Department of Health and Human Services or an attorney rather than assume the worst.
Staying home instead: the Aged and Disabled (HCBS) waiver
Nursing-home Medicaid is not the only option. North Dakota also offers home- and community-based services through the Aged and Disabled (HCBS) waiver, which can fund in-home aides, adult day care and assisted-living support for people who qualify for a nursing-home level of care but want to stay in the community. Waiver slots can be limited, so it is worth asking about waitlists early.
Ready-to-send message
Hello,
we’re starting a North Dakota Medicaid long-term-care application for a parent entering a nursing home in North Dakota.
Want a clear shortlist before you start calling?
If you don't know which nursing homes to contact first, Curalune Care Help can prepare an ordered shortlist of 3 to 5 suitable options — with contacts, useful links and a ready-to-send message you can put to all of them at once.
The service helps you organise the search. $89, one-off. If you don't receive at least 3 homes matching the area and criteria you gave us, we refund you in full. It does not replace the home's own assessment and does not guarantee admission, price or bed availability.
Important limit
Curalune offers practical help with the search and orientation. Admission, pricing, bed availability and the final assessment always rest with the nursing homes and the competent authorities (your state Medicaid agency, the state survey agency and Medicare).