Medicaid Work Requirements in North Dakota

Check your situation in North Dakota

When it starts in North Dakota

• Late August – September 1, 2026: letters to Medicaid Expansion members.
• January 1, 2027: the requirement starts for new applicants.
• February 28, 2027: the first member reviews that include the requirement.

Who has to meet it

The rule applies to people ages 19 to 64 in the Medicaid adult expansion group, unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.

You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a total (100%) VA disability rating or TDIU, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.

How North Dakota checks and how to report

Months checked: HHS has not published a set number of months on its main page; your notice will list the months checked.

HHS checks data it already has. If it cannot verify you, you get a notice and have 30 days to send proof through the Self-Service Portal, by email to applyforhelp@nd.gov, by mail to P.O. Box 5562, Bismarck, ND 58506, or in person at a human service zone office.

Other things to know in North Dakota

• HHS says nearly half of expansion members qualify for an exclusion.
• Blue Cross Blue Shield of North Dakota administers Medicaid Expansion and handles contact updates.

Official tools and contacts

• Report and upload: Self-Service Portal
• HHS Customer Support Center (TTY 711): 1-866-614-6005
• BCBSND Medicaid Expansion: 1-833-777-5779
• ND HHS: StayCoveredND
• Agency: North Dakota Health and Human Services (HHS)

Federal protections that apply in North Dakota

• The state must check its own records before asking you for proof.
• If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
• You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
• If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.