North Dakota Healthcare Assistance for Single Mothers: Medicaid, CHIP & More [2025]

Last updated: September 2025

This is your no‑fluff, step‑by‑step North Dakota guide to free or low‑cost health coverage for you and your kids. Every number and rule below comes from official state or federal sources, linked throughout.

Quick Help Box

• Apply online now (fastest): Use North Dakota’s Self‑Service Portal and choose Medicaid/CHIP. If you’re in a rush, upload photos of documents now and add better scans later. Apply for Help – NDHHS Self‑Service Portal. For live help call 866‑614‑6005 (TTY 711). (hhs.nd.gov)
• Pregnant? You can qualify for Medicaid at higher income limits and get 12 months of coverage after the pregnancy ends. Tell ND Medicaid as soon as you’re pregnant to lock this in. Postpartum coverage: what it includes. Call 866‑614‑6005. (hhs.nd.gov)
• Kids under 19 may qualify for free coverage through Medicaid or CHIP even if your income is too high for adult Medicaid. Use the income tables below. You’ll also get Health Tracks (EPSDT) well‑child visits, dental, vision and more. (hhs.nd.gov)
• Don’t have a car for appointments? Ask for a Medicaid ride. Request at least 3 days before the visit by contacting the Customer Support Center (866‑614‑6005; email subject “Medicaid Travel”). (hhs.nd.gov)
• Denied, delayed, or stuck? Ask for a free appeal within 30 days of your notice. You can file by phone, online, or mail. (hhs.nd.gov)
• Marketplace insurance (HealthCare.gov): If you don’t qualify for Medicaid, compare plans with federal tax credits. Call 800‑318‑2596 (TTY 855‑889‑4325) or visit HealthCare.gov. Open Enrollment for 2026 runs Nov 1, 2025 – Jan 15, 2026 in North Dakota. Note: The “low‑income year‑round” SEP is paused Aug 25, 2025 – Dec 31, 2026. (healthcare.gov, healthinsurance.org, federalregister.gov)

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Quick Reference Cheat Sheet (ND, 2025)

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Who qualifies: 2025 income rules (most common groups)

Start here: if your monthly income for your family size fits the chart below, apply right away. Amounts include the standard 5% disregard where NDHHS shows it that way.

Source pages show full size-by-size tables. Use ND’s official charts if your household is bigger than shown here. (hhs.nd.gov)

Full CHIP income chart (monthly and annual) is here: North Dakota CHIP income levels (effective Apr 1, 2025). (hhs.nd.gov)

For general 2025 Federal Poverty Guidelines (to estimate eligibility or compare programs), see HHS/ASPE. Example: 100% FPL for a family of four is $32,150/year. (aspe.hhs.gov)

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How to apply fast (with fewer headaches)

Action items (do these first):

• Apply online through the Self‑Service Portal. It’s mobile‑friendly and lets you upload photos from your phone. Apply for Help – NDHHS. Or request a paper application by mail: 866‑614‑6005 (TTY 711). (hhs.nd.gov)
• If you only need health coverage, use the “Application for Health Care Coverage and Help Paying Costs” (SFN 1909). If you also want SNAP, TANF or child care help, use “Application for Assistance” (SFN 405). Submit online, by email, fax, mail, or at your local Human Service Zone office. (hhs.nd.gov)
• Keep these contacts handy: ND Customer Support Center 866‑614‑6005; email applyforhelp@nd.gov; fax 701‑328‑1006. Find your local Human Service Zone office from the state directory. (hhs.nd.gov)

What documents to gather (you can submit what you have and add more if asked):

• Proof of identity and ND residency (e.g., driver’s license, lease, utility bill)
• Social Security numbers for those applying (not required for Emergency Medicaid)
• Proof of pregnancy (if pregnant)
• Recent income (pay stubs, award letters, self‑employment info)
• Health insurance info if anyone has coverage

These examples are straight from ND’s Application for Assistance Guidebook; use it as your checklist. (hhs.nd.gov)

Timelines and follow‑up:

• Processing varies. If the state needs more info, respond by the deadline in your notice; you can check case status in the portal or call 866‑614‑6005. If your case isn’t handled with “reasonable promptness,” you can file a free appeal (see Appeals section). (hhs.nd.gov)

What to do if this doesn’t work (Plan B):

• Call the ND Navigators for free application help: 800‑233‑1737 or 833‑545‑9448. They’ll walk you through MAGI income rules, document uploads, and notices. (hhs.nd.gov)

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Medicaid for pregnant North Dakotans (including 12‑month postpartum)

Start here:

• Apply immediately and report your pregnancy. Income limits are higher during pregnancy (see table above). Coverage lasts 12 months after the pregnancy ends even if your income changes. (hhs.nd.gov)

What the postpartum year covers:

• Regular checkups, behavioral health, family planning, dental, vision and more—full ND Medicaid benefits. (hhs.nd.gov)

Practical tips:

• If you’re close to delivery and uninsured, submit an application and call the Customer Support Center (866‑614‑6005) to flag urgent processing. Use your approval letter at the hospital. (hhs.nd.gov)
• If you’re over the pregnancy income limit but facing big medical bills, ask about “coverage with a client share” (a monthly deductible‑like option). (hhs.nd.gov)

Plan B if you’re denied:

• Call Women’s Way for free breast/cervical screenings and navigation; if diagnosed, you may qualify for Medicaid treatment coverage under the Breast & Cervical Cancer program. Women’s Way phone 800‑449‑6636 or 701‑328‑4536. (hhs.nd.gov)

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Children’s coverage: Medicaid, Health Tracks, dental and vision

Why this matters:

• Kids in ND get robust benefits through Medicaid or CHIP: well‑child visits, vaccines, dental (including orthodontics when medically necessary), vision exams and glasses, hearing checks, therapies, and more. (hhs.nd.gov)

Eligibility (2025):

• Children 0–5: up to 152% FPL; ages 6–18: up to 138% FPL (see income table above). Continuous eligibility for up to 12 months. (hhs.nd.gov)

CHIP in North Dakota (for kids above Medicaid limits):

• ND sets CHIP up to 205% FPL (effective Apr 1, 2025). Coverage is the same as Medicaid for kids (no separate copays; ND moved CHIP kids onto Medicaid benefits effective 2020). Use the official CHIP chart to check your family size. (hhs.nd.gov, nd.gov)

Dental and vision specifics:

• Dental: two exams/cleanings per year; fillings; x‑rays; medically necessary orthodontics (7–20). Vision: one exam and one pair of glasses per 12 months; replacements with prior approval when medically necessary. Find dentists via InsureKidsNow. (hhs.nd.gov)

Health Tracks (EPSDT):

• Follow the checkup schedule at 1, 2, 4, 6, 9, 12, 15, 18, 24, 30 months, and yearly ages 3–20. Public health or your clinic can deliver these. (hhs.nd.gov)

Plan B:

• If your child is over income but has high medical needs, ND offers “Children with Disabilities” Medicaid (up to 250% FPL) with a family premium equal to 5% of gross income. See ND’s official income chart and premium rules. (hhs.nd.gov)

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Adults: Medicaid Expansion (19–64), medically frail option, and what’s covered

First step:

• If you’re 19–64 and not on Medicare, check Medicaid Expansion (up to 138% FPL; see income table). Expansion covers preventive visits, hospital care, behavioral health, and prescriptions. Administered by Blue Cross Blue Shield of ND for this group. (hhs.nd.gov)

Important limitations:

• Standard Expansion doesn’t include routine dental or vision for adults. If you have complex conditions, ask to be screened for “medically frail,” which can broaden coverage. (hhs.nd.gov)

Plan B:

• If you’re over income but have big medical bills, ask about “Medicaid with a client share” (monthly spenddown). ND posts the calculation rules and 90%‑FPL thresholds used in the formula. (hhs.nd.gov)

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Non‑emergency medical transportation (NEMT), telehealth, and out‑of‑state care

Get a ride:

• Request rides at least 3 business days ahead. Provide pick‑up, appointment time/address, and drop‑off. For urgent needs, ask the call center about exceptions. Contact 866‑614‑6005 (TTY 711), email applyforhelp@nd.gov (subject “Medicaid Travel”). (hhs.nd.gov)

Use telehealth when you can:

• ND Medicaid covers many telehealth services (behavioral health, therapy, diabetes care, some dental, and more). Ask your provider if a visit can be virtual. (hhs.nd.gov)

Going out of state:

• Emergencies are covered; for planned care, your provider may need prior authorization. Always carry your Medicaid card. (hhs.nd.gov)

What to do if this doesn’t work:

• If you’re between coverage or need sliding‑fee care, use federally funded Community Health Centers (FQHCs). ND has 20+ sites serving anyone regardless of ability to pay. Use HRSA’s “Find a Health Center” tool. (hhs.nd.gov, bphc.hrsa.gov)

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Marketplace coverage (HealthCare.gov) if you don’t qualify for Medicaid

When to apply:

• Open Enrollment for 2026 coverage in North Dakota runs Nov 1, 2025 – Jan 15, 2026. Outside that window, you need a qualifying event (move, loss of other coverage, etc.). Coverage picked during a Special Enrollment now starts the first day of the next month after you choose a plan. Get help 24/7 at 800‑318‑2596 (TTY 855‑889‑4325). (healthinsurance.org, cms.gov, healthcare.gov)

2025–2026 policy changes that affect you:

• The “low‑income” year‑round Special Enrollment Period (≤150% FPL) is paused Aug 25, 2025 – Dec 31, 2026 on HealthCare.gov. Translation: if you miss Open Enrollment and don’t have another qualifying life event, you may have to wait until the next Open Enrollment. (federalregister.gov, cms.gov)

Costs and carriers in ND:

• ND’s Insurance Department approved 2025 average individual‑market premium changes: Blue Cross Blue Shield of ND +15.94%, Sanford +16.5%, Medica +4.6%. If you shop on HealthCare.gov, tax credits (enhanced under the Inflation Reduction Act) remain in effect through 2025. Compare plans before auto‑renewing. (insurance.nd.gov, congress.gov)

Plan B:

• If Marketplace premiums are still too high, re‑check Medicaid eligibility (income changes, pregnancy, or childcare costs can shift MAGI). Also call local hospitals’ financial assistance offices (see Charity Care section below).

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Charity care, free clinics, and hospital discounts (statewide examples)

• Altru Health System (Grand Forks region): Financial assistance and certified application counselors; call 701‑780‑1500 (assistance) or 701‑780‑5060 (Marketplace help). (altru.org)
• Essentia Health (eastern ND): 100% discount at up to 200% FPL under its policy; contact Patient Financial Services 800‑985‑4675. (essentiahealth.org)
• Sanford Health (many ND locations): Financial assistance up to 375% FPL; Patient Financial Services 877‑629‑2999. (sanfordhealth.org)
• Community Health Centers (FQHCs) statewide: sliding‑fee care for medical, dental, behavioral health. Use HRSA’s locator. (bphc.hrsa.gov)

What to do if this doesn’t work:

• Dial 211 to find low‑cost local clinics, counseling, or transportation help. For mental health or substance crises, call/text 988. (helpishere.nd.gov)

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Special programs many single mothers miss

• Children with Disabilities Medicaid (up to 250% FPL; family premium is 5% of gross income; no asset test; can coordinate with employer coverage). Check ND’s chart and rules (effective Apr 1, 2025). (hhs.nd.gov)
• Emergency Medicaid (for non‑citizens with urgent medical needs, including childbirth). No SSN or proof of status required; you must meet ND income rules and submit specific forms/medical records. Apply through NDHHS. (hhs.nd.gov)
• Women’s Way (breast/cervical screening program). If diagnosed, you may qualify for Medicaid treatment coverage under the Breast & Cervical Cancer Category. Call 800‑449‑6636 or 701‑328‑4536. (hhs.nd.gov)
• ND Medicaid rides (NEMT): request 3 days before the appointment; ask about lodging/meals for long trips when medically necessary. (hhs.nd.gov)

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Diverse communities: tailored help and rights in North Dakota

• LGBTQ+ single mothers
  • Family planning clinics provide inclusive services regardless of insurance. Use the ND Family Planning Clinic Directory to find a site near you. NDHHS also offers free language/interpretation help via the Customer Support Center 866‑614‑6005 (TTY 711). (hhs.nd.gov)
• Single mothers with disabilities or raising a child with a disability
  • Explore “Children with Disabilities” Medicaid (up to 250% FPL, 5% family premium) and, for adults working with disabilities, the “Medicaid for Workers with Disabilities” option (check ND’s page for current income/premium updates). (hhs.nd.gov)
• Veteran single mothers
  • Apply for VA health care online or call VA Health Benefits at 877‑222‑8387; general VA info line 800‑698‑2411. You can use Medicaid/CHIP for your kids alongside VA benefits. (va.gov)
• Immigrant and refugee single moms
  • Using Medicaid/CHIP generally doesn’t count against you under the federal “public charge” rule (exceptions: long‑term institutional care at government expense; certain cash assistance). Review USCIS guidance for details. (uscis.gov)
• Tribal‑specific resources
  • Indian Health Service and Tribal facilities work with ND Medicaid. Find facilities via IHS and local Tribal health programs via the ND Tribal Nation Human Services Directory. (hhs.nd.gov)
• Rural single moms with limited access
  • Use CHCs (telehealth options), regional Human Service Centers for behavioral health, and ND DOT’s transit provider map listed on ND’s Health Tracks page. If your clinic is 50+ miles away, ask ND Medicaid about mileage/meals when medically necessary. (hhs.nd.gov)
• Single fathers
  • All rules above apply to single fathers. Children qualify based on household income and citizenship/immigration status, regardless of the parent’s gender. (hhs.nd.gov)
• Language access
  • Free interpreter services are available through ND Medicaid and the Customer Support Center. TTY users dial 711. (hhs.nd.gov)

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Common mistakes to avoid (real‑world)

• Waiting to report pregnancy. Don’t delay—12 months postpartum coverage starts with Medicaid during pregnancy. (hhs.nd.gov)
• Uploading unreadable documents. If the portal image is blurry, your case can stall. Resubmit clear photos or email/fax to the Customer Support Center.
• Skipping Human Service Zone mail. If ND asks for information and you miss the deadline, they can deny; then you’ll have to reapply or appeal.
• Assuming adult Medicaid covers dental/vision. It doesn’t under Expansion unless you’re medically frail. Kids and pregnant/postpartum members have broader benefits. (hhs.nd.gov)
• Missing rides. Request NEMT at least 3 days before your appointment; keep your phone on for driver confirmations. (hhs.nd.gov)

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Application checklist (print or screenshot)

• ID and proof you live in ND (license/state ID, lease, utility bill)
• Social Security numbers (not required for Emergency Medicaid)
• Proof of pregnancy (if applicable)
• Income for last 30–60 days (pay stubs, award letters, self‑employment details)
• Current health insurance info (if any)
• Any medical bills if asking for coverage with a client share (spenddown)

These are the exact types of documents ND lists in its official Guidebook. (hhs.nd.gov)

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Useful tables (scan quickly when time is tight)

A) Snapshot of 2025 ND Medicaid/CHIP income limits (monthly)

See NDHHS charts for larger households and full CHIP table. (hhs.nd.gov)

B) 2025 Federal Poverty Guidelines (selected)

Source: HHS/ASPE poverty guidelines (48 states & DC). (aspe.hhs.gov)

C) Key ND contacts you’ll actually use

D) Marketplace in ND: carriers and 2025 average rate changes

Source: North Dakota Insurance Department (Oct 22, 2024 announcement for 2025 plan year). Always compare net cost after tax credits. (insurance.nd.gov)

E) Practical timelines

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Real‑world examples (North Dakota)

• You’re pregnant with one child at home. Household of 3 counts the unborn, so family size is 4. If your monthly income is $4,689 or less, you likely qualify for pregnancy Medicaid; after delivery, you keep coverage for 12 months. (hhs.nd.gov)
• You work full‑time; your 8‑year‑old needs braces. Even if you’re over adult Medicaid limits, your child may qualify for Medicaid or CHIP. ND Medicaid can cover orthodontia when medically necessary. (hhs.nd.gov)
• You missed Open Enrollment and your income is under 150% FPL. In the past you could enroll any month, but the low‑income SEP is paused Aug 25, 2025 – Dec 31, 2026. Check Medicaid again or see if you have another qualifying life event. (federalregister.gov)

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What to do when things go wrong

• Denied or delayed? Call the Customer Support Center (866‑614‑6005) to clarify what’s missing, then file an appeal within 30 days if needed (online/phone/mail is OK). (hhs.nd.gov)
• Provider says they don’t take ND Medicaid? Use ND’s provider directory or ask for a referral. For dental/vision for kids, use InsureKidsNow to find enrolled dentists. (hhs.nd.gov)
• No ride? Re‑call for NEMT, ask about urgent exceptions, and save receipts when told to self‑transport. (hhs.nd.gov)

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Ten North Dakota‑specific FAQs

1. What’s the fastest way to apply?
   Online via the Self‑Service Portal. If you hit a snag, call 866‑614‑6005. (hhs.nd.gov)
2. I’m pregnant. What if my income goes up after delivery?
   You keep Medicaid for 12 months postpartum. Report changes, but your coverage stays. (hhs.nd.gov)
3. My teenager needs glasses. Is that covered?
   Yes—one exam and one pair of glasses every 12 months (repairs/replacements with prior approval if medically necessary). (hhs.nd.gov)
4. Does adult Medicaid Expansion include dental/vision?
   Not routine dental/vision. Ask about “medically frail” if you have complex conditions. (hhs.nd.gov)
5. Can I get a ride to appointments?
   Yes. Request at least 3 days before. Call 866‑614‑6005 (TTY 711). (hhs.nd.gov)
6. My income is a little too high for Medicaid, but my child has major medical costs. Any option?
   Check “Children with Disabilities” Medicaid (up to 250% FPL, 5% premium). (hhs.nd.gov)
7. If I don’t qualify for Medicaid, when can I get Marketplace coverage?
   During Open Enrollment (Nov 1 – Jan 15) or after a qualifying event. SEP coverage starts the first of the next month. (healthinsurance.org, cms.gov)
8. Is CHIP different from Medicaid for kids in ND?
   CHIP uses the same benefits as Medicaid here. Income goes up to 205% FPL. (hhs.nd.gov)
9. I’m worried about immigration rules. Will Medicaid/CHIP hurt my case?
   USCIS says non‑cash benefits like Medicaid/CHIP generally aren’t counted against you (exceptions: long‑term institutionalization). Review USCIS guidance or talk to a legal aid. (uscis.gov)
10. Who can help me in person?
    Call a Navigator at 800‑233‑1737 or 833‑545‑9448. You can also visit your Human Service Zone office. (hhs.nd.gov)

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If Marketplace costs look scary: real options to lower the bill

• Always check your net premium after tax credits. Enhanced tax credits are available through 2025; many families pay much less than the sticker price. (congress.gov)
• Compare plans each year; ND’s 2025 rates rose on average, but deductibles and networks differ—silver plans may unlock extra cost‑sharing help if your income qualifies. (insurance.nd.gov)
• Call HealthCare.gov (800‑318‑2596) for 24/7 help, or meet with a local Navigator. (healthcare.gov)

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Appeals, rights, and language access

• Appeal a denial or delay within 30 days of your notice. You can appeal by phone, online, mail, or fax. (hhs.nd.gov)
• Interpreter services are free. TTY users dial 711. (hhs.nd.gov)

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About This Guide

Compiled by the ASingleMother.org Editorial Team

This guide uses official sources from North Dakota Health and Human Services, CMS/HHS, and established nonprofits. It follows our Editorial Standards and is updated regularly, but it’s not a substitute for agency determinations. Individual eligibility outcomes cannot be guaranteed.

Last verified September 2025, next review April 2026.

Questions or corrections? Email info@asinglemother.org.

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Disclaimer

Program rules, income limits, premiums, and contact info change. Always verify with the agency or the official links in this guide before you act. Health care is sensitive—protect your data: only use official .gov sites, secure portals, or the phone numbers listed above. We do not ask for Social Security numbers or personal case details; never share those with anyone except the official NDHHS, HealthCare.gov, or your clinic/hospital.

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Sources (selected)

• ND Medicaid eligibility, income charts and program pages (effective Apr 1, 2025) and application methods. (hhs.nd.gov)
• Postpartum coverage (12 months) and benefits. (hhs.nd.gov)
• ND CHIP income table (effective Apr 1, 2025). (hhs.nd.gov)
• Health Tracks/EPSDT details; dental/vision specifics for kids. (hhs.nd.gov)
• Adult Medicaid Expansion limits and coverage notes (and BCBSND administration); medically frail; client share. (hhs.nd.gov)
• NEMT ride instructions/contact. (hhs.nd.gov)
• Appeals (30‑day window). (hhs.nd.gov)
• HealthCare.gov contact and SEP effective‑date alignment; Open Enrollment window for 2026

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