North Dakota Medicaid Plans

North Dakota Medicaid, managed by the North Dakota Department of Health and Human Services (NDHHS), provides medical coverage to low-income individuals and families, children, pregnant women, people with disabilities, and seniors. Unlike many states, North Dakota does not operate a full managed care model. Instead, it uses a **Primary Care Case Management (PCCM)** approach with a limited number of care coordination vendors and a traditional fee-for-service structure. Medicaid expansion for adults up to 138% FPL is included and administered through Sanford Health Plan.

Available Medicaid Plans

Plan Name	Member Services	Coverage Type
Sanford Health Plan – Medicaid Expansion	800‑752‑5863	Adults (Expansion Group)
North Dakota Medicaid PCCM	844‑854‑4825	Traditional Medicaid (Fee-for-Service)

Enrollment & Eligibility

• Apply online via Apply.dhs.nd.gov or call 800‑755‑2604.
• Eligibility is based on income, age, disability status, and household size.
• Children may also qualify under the **Healthy Steps** CHIP program.

Provider Resources

• North Dakota Medicaid Home
• Medicaid Expansion Information
• Legacy Medicaid Program Info

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Common Questions

Does North Dakota use managed care?

No, North Dakota uses a fee-for-service Medicaid model with limited PCCM oversight. Managed care is not used statewide.

What is Medicaid Expansion in ND?

Medicaid Expansion covers low-income adults up to 138% FPL and is administered through Sanford Health Plan.

How do I apply for coverage?

Visit apply.dhs.nd.gov or contact your local county social services office.

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