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North Dakota · checked September 2026
How North Dakota helps pay for long-term care, who to call when you need help or something's wrong, and how to check a facility before you sign.
The first question
Yes, for the care. Medicaid Waiver for Home and Community-Based Services (Aged and Disabled) helps pay for care in assisted living. Rent and meals are usually still paid by the resident, often from Social Security.
North Dakota's Medicaid rules for long-term care, and the programs that pay for care outside a nursing home.
$1,197
2026
North Dakota has no income cap and no Miller trust. It uses a medically needy (spend-down) approach: the medically needy income level is $1,197/month for one person (effective April 1, 2026). Income above that goes toward the cost of care. A nursing home resident keeps a $115/month personal needs allowance.
Ask the state Medicaid office
$3,000 for a one-person unit. $6,000 for a couple. Confirm the current limits with the state Medicaid office before relying on them.
We couldn't confirm whether this state uses a Miller trust or a spend-down. Ask the Medicaid office or an elder law attorney.
Apply for North Dakota Medicaid
North Dakota Department of Health and Human Services
North Dakota Medicaid program for people who need nursing-home-level care but want to stay at home or in a residential setting. It can pay for adult residential services in assisted living or basic care, and a spouse can be paid through Family Personal Care. It pays for care, not rent and meals.
North Dakota has a care level called basic care. For people who need help with daily activities and qualify, Medicaid personal care plus the Basic Care Assistance Program pays licensed basic care facilities a daily rate that includes room and board. Call the Aging and Disability Resource Link to get a case manager, and ask about the age and asset rules.
State-funded in-home help for people who need help with daily activities but are not on Medicaid, with a sliding fee based on income. Ask about the current asset limit when you apply. Does not pay for assisted living or basic care.
In-home help for Medicaid-eligible people with very low income (SSI level) who need help with household tasks or supervision but are not severely impaired in personal care. No service fees. Does not pay for assisted living or basic care.
PACE provides all medical and long-term care for people 55+ who need nursing-home-level care but can live in the community. Programs in North Dakota:
Free, and on your side. Start with the aging office if you don't know where to begin.
The state's aging office and its local agencies explain your options, screen for programs and help with applications.
A free, independent advocate for residents of long-term care facilities. Call about any problem with care, rights, billing or a discharge.
You don't need proof to report. If someone is in immediate danger, call 911.
Business hours (Mon-Fri 8 a.m.-5 p.m.); call 911 if someone is in immediate danger
Unbiased Medicare help from counselors who don't sell anything: plans, bills, appeals, and programs that lower costs.
Help spotting and reporting Medicare fraud, billing errors and scams.
In North Dakota, assisted living is licensed as: Assisted Living Facility; also Basic Care Facility (a licensed care level with 24-hour supervision and personal care). Read inspection reports before you sign anything.
Confirm a community's license here, and ask the agency how to see its inspection reports.
File a complaint
Medicare rates every nursing home on staffing, inspections and quality, with full inspection reports.
State veterans homes are often far cheaper than private care for eligible veterans and, in many states, their spouses.
North Dakota Department of Veterans Affairs
Free legal help for older adults on issues like benefits, housing, powers of attorney and elder abuse.
Can a family member be paid to provide care? Yes, in some programs.
Yes. Through Family Home Care (SPED and ExSPED), a relative can be paid to care for someone at home, and through Family Personal Care (Medicaid waiver), a spouse can be paid. The caregiver must enroll as a Qualified Service Provider.
Free help for people caring for someone 60+ who needs help with 2 or more daily activities, or anyone caring for a person with dementia: counseling, training, support groups and respite care so the caregiver can take a break.
State-funded program run with the Alzheimer's Association since 2010. Offers free care consultations, education and support groups for families, with regional offices in Bismarck, Fargo, Grand Forks, Minot and Jamestown.
Yes, for the care part. In North Dakota, Medicaid Waiver for Home and Community-Based Services (Aged and Disabled) can pay for care in assisted living. Rent and meals are generally paid by the resident.
The North Dakota Long-Term Care Ombudsman Program: 1-855-462-5465 ext. 3 (or 701-328-4617). It's free and independent.
Researched from 31 sources, official pages first. Last checked .