North Dakota Long-Term Care
Everything Your Family Needs in One Place.
Navigating long-term care in North Dakota is complicated — Medicaid rules, care costs, and senior services all have their own language, and it's hard to know who to turn to or who you can trust. We've organized everything North Dakota families need into one free guide — including connections to vetted providers who can help ease the burden.
Built around your situation and North Dakota's specific programs and rules.
What North Dakota families need to know before making care decisions.
Long-term care in North Dakota features an extreme cost contrast — nursing home care averages $11,528/month (20% above the national average) while assisted living averages just $4,729/month (24% below). This gap, one of the widest in the country, makes assisted living and home care especially attractive alternatives.
North Dakota has no set income limit for Nursing Home Medicaid — nearly all income goes toward care costs, with a $115/month Personal Needs Allowance (one of the highest nationally). The state also exempts IRAs/401Ks in 'payout status' and offers an entitlement Personal Care Services program.
We've organized every North Dakota-specific resource, tool, and guide in one place so families can stop searching and start planning. Everything here is free.
$11,528/mo
Nursing Home — Semi-Private
No set limit (NH)
Medicaid Income Limit
103
Senior Service Resources
What long-term care actually costs in North Dakota.
North Dakota's care costs vary dramatically by type — nursing home care averages $11,528/month (20% above the national average), one of the highest rates in the region, while assisted living is remarkably affordable at $4,729/month (24% below). Home care aligns near the national rate at $6,483/month.
Adult day care in North Dakota is exceptionally expensive at $5,525/month — the highest in the region — reflecting extremely limited supply. Understanding these cost disparities is essential for planning.
Use the calculator below to explore North Dakota care costs in detail and project how they'll grow over time with a 3% annual inflation rate.
$12,304/mo
$11,528/mo
$4,729/mo
$5,900/mo
Estimated (AL × 1.25)
$6,483/mo
$34/hr (nat'l avg: $35/hr)
$5,525/mo
Source: CareScout 2025 Cost of Care Survey (updated March 2026)
Calculate Your North Dakota Costs
State-specific data · Inflation projection · Total estimate
Use the sliders below to adjust years, inflation, and projection period
Not sure how long you'll need care? Get full insights into when you may need care, what kind, and for how long — personalized to your health and finances.
Start Your Full Care Planning Assessment →Your Cost Estimate
Today's Monthly Cost
$12,304/mo
NH Private Room · North Dakota
Monthly Cost Today
$12,304/mo
3% inflation · 3 years of care
Don't rush to sell the home
Bridge loans, HELOCs, and reverse mortgages can fund care without selling.
Care costs rise 3–5% annually
Factor long-term inflation into all planning models.
Medicaid lookback is 5 years
Planning must begin well before care is needed to protect assets.
Source: CareScout 2025 Cost of Care Survey (updated March 2026)
* AK NH Private Room: A Place For Mom. ADC — DE: Genworth; DC: PayingForSeniorCare; ID: MedicaidLongTermCare.org; SD: Genworth; VT: VT Adult Services Div.; WV: CareCostIndex.com.
Understanding costs is the first step. Next, let's explore how North Dakota Medicaid can help cover them — and what financial planning options are available.
Understanding North Dakota Medicaid long-term care coverage — and whether your family qualifies.
North Dakota Medicaid is administered by the Department of Human Services. There is no set income limit for Nursing Home Medicaid — all income above a $115/month Personal Needs Allowance ($230/month for married couples both on Medicaid) must go toward care costs. The HCBS Waiver income limit is $1,174/month.
North Dakota exempts IRAs and 401Ks that are in 'payout status' (meaning Required Minimum Distributions are being taken) — a significant advantage for retirees. The Medicaid State Plan Personal Care Services (MSP-PC) program is an entitlement, not a waiver, meaning no waiting lists. Participants can choose their own Qualified Service Provider, including friends and select relatives.
Use the Medicaid tool below to check eligibility, understand North Dakota's specific rules, and explore planning strategies.
Income Limit — Single
No set limit — nearly all income must be paid towards care*
Income Limit — Married (one applying)
No set limit — nearly all income must be paid towards care*
Asset Limit — Single
$3,000
Asset Limit — Married (one applying)
$3,000 for applicant & $162,660 for non-applicant
Look-Back Period
60 months (5 years)
Estate Recovery
Yes — North Dakota seeks reimbursement after death
Medicaid programs available in North Dakota
Medicaid State Plan Personal Care Services (MSP-PC)
An entitlement program providing assistance with daily living activities including personal hygiene, mobility, shopping for essentials, meal preparation, and medication management. Program participants must receive care from a Qualified Service Provider (QSP), but can choose their QSP. Friends and select relatives can become a QSP and be hired to provide care.
Aged and Disabled Waiver
Also called the Medicaid Waiver for Home and Community Based Services. Provides assistance to seniors and adults with disabilities to promote independent living. Services may include personal care assistance, adult day care, home modifications, emergency response systems, meal delivery, and specialized medical equipment.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. Additional benefits, such as dental and eye care, may be available.
Money Follows the Person
A federal program that helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — North Dakota
How the main LTC programs available in North Dakota compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $15–18/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in North Dakota | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
North Dakota Medicaid programs
HCBS
Family Personal Care
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in North Dakota
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in North DakotaHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: DHS · nd.gov/dhs/services/medicalserv
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in North Dakota
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in North Dakota. The process typically takes 45–90 days from application to first paycheck.
Apply in North Dakota: DHS · nd.gov/dhs/services/medicalserv
Medicaid Eligibility Screener — North Dakota
Answer 7 quick questions — we'll check the financial and care requirements for North Dakota and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Medicaid figures: 2026 federal/state guidelines
Beyond Medicaid, North Dakota has a network of senior services and programs that can help your family. Let's explore what's available in your county.
Community services and aging programs available to North Dakota seniors — most families never find all of them.
North Dakota's 8 Human Service Zones coordinate aging services across all counties — home-delivered meals, transportation, caregiver respite, benefits counseling, and home modifications. The Aging Services Division also operates the ND SHIP program for Medicare counseling.
North Dakota funds programs including Older Americans Act services, adult protective services, the Long-Term Care Ombudsman program, and Aging and Disability Resource Links (ADRL) as a single point of entry for care information.
Use the service finder below to discover which programs serve your North Dakota county — or browse the full directory for statewide and local listings.
Home-Delivered Meals & Nutrition
Programs like Meals on Wheels and congregate dining at senior centers — available to North Dakota seniors through local Area Agencies on Aging.
Transportation & Mobility
Non-emergency medical transport, volunteer driver programs, and reduced-fare transit for North Dakota seniors who no longer drive.
Caregiver Support & Respite
Respite care, support groups, training, and the National Family Caregiver Support Program — helping North Dakota caregivers avoid burnout.
Benefits Counseling & Legal Aid
Free SHIP (State Health Insurance Assistance Program) Medicare counseling, Medicaid application help, and legal assistance for elder law issues like guardianship and advance directives in North Dakota.
Select your county
This helps us find your local Area Agency on Aging
Links verified June 2026 · Always call to confirm current availability
In addition to government programs, North Dakota has a strong network of nonprofit organizations that can help — many offering free services most families never discover.
Nonprofit and community organizations helping North Dakota families — free help most families never find.
North Dakota has nonprofits serving seniors including the Alzheimer's Association Minnesota-North Dakota Chapter, Legal Services of North Dakota, and community action agencies. Many offer free benefits counseling, caregiver training, and emergency assistance.
Regional nonprofits provide specialized services including SHIP counseling, elder abuse prevention, and respite care. Your zip code determines which organizations serve your area.
Use the nonprofit finder below to search for organizations that match your family's specific needs.
Disease-Specific Support
Nonprofit organizations focused on Alzheimer's, Parkinson's, ALS, cancer, and other conditions that require long-term care. North Dakota chapters offer helplines, support groups, respite programs, and education to help families navigate diagnosis and care planning.
Legal Aid for Seniors
Free legal assistance with Medicaid applications, advance directives, power of attorney, guardianship, and elder abuse cases through North Dakota's legal aid societies.
Caregiver & Family Support
Nonprofit organizations providing caregiver training, respite coordination, support groups, and counseling for North Dakota families — because caregivers need care too.
Community Action & Emergency Aid
Community action agencies and charitable organizations offering emergency financial assistance, utility help, food pantries, and crisis intervention for North Dakota seniors.
Who needs help?
This helps us personalize your results
Don't hesitate to contact multiple organizations — many have overlapping services and can refer you to others. Every conversation gets you closer to the help your family needs.
Additional resources every North Dakota family should know about.
Medicare, Veterans benefits, caregiver compensation programs, and financial planning tools are available to every North Dakota family — and understanding them early can save thousands in long-term care costs.
Finding the right people to help your North Dakota family.
When it matters most, nothing replaces someone who truly understands your family. Care Connections will match your North Dakota family with vetted local professionals based on your zip code and your specific situation. No cold calls. No pressure. Just the right introduction at the right time.
Tell us what your family needs and we'll notify you the moment Care Connections is available in your North Dakota county.
Helps us match you with professionals in your county
We'll notify you when Care Connections is available
No spam. Just a heads up when it's ready for your area.
You've seen what North Dakota has to offer. Now see how it all fits your family's specific situation.
Every section above gives you one piece of your North Dakota picture — what care costs near you, whether Medicaid might help, what senior services and nonprofits are available, and what other programs your family might qualify for.
But each piece only tells part of the story.
The free personalized care snapshot puts all the pieces together — your health situation, your financial picture, your timeline, and the North Dakota-specific options available to your family. It takes about 8 questions and 1 minute.
Most families who complete the snapshot tell us it's the first time they've felt like they actually understood their situation. That's what it's designed to do.
Who needs help?
Tell us who you're planning care for.
The next questions will be about whoever you choose above — answer for them, not yourself (unless this is for you).
Everything your North Dakota family needs — in one place.
Free tools, North Dakota-specific resources, a personalized care snapshot, and connections to the right people. All organized for North Dakota families. All completely free.
Built around your situation and North Dakota's specific programs and rules.