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Last updated: 20 September 2026
North Dakota Medicare Savings Programs can help people with limited income and assets pay Medicare costs. The three programs most older adults use are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). North Dakota policy also includes Qualified Disabled and Working Individual (QDWI), a narrower program for certain working people with disabilities.
Bottom Line
If Medicare premiums or cost-sharing are hard to afford, apply through North Dakota Health and Human Services even if your gross income looks a little above a chart. North Dakota uses countable income and allows certain deductions. QMB provides the strongest help because it can pay Medicare premiums and protect you from Medicare deductibles, coinsurance, and copayments for covered care. SLMB and QI mainly pay the Part B premium. The standard Part B premium is 2026 Part B premium of $202.90 a month.
Start Here
- Check the North Dakota Medicaid eligibility page and the income table below.
- Apply through the state Medicaid application page, or call the Customer Support Center at 1-866-614-6005.
- If you are unsure which program fits, use the GFS Medicare savings checker before you call.
| Program | What it can pay | 2026 income guide | 2026 resource limit | Important rule |
|---|---|---|---|---|
| QMB | Part B premium, Part A premium if owed, and Medicare cost-sharing for covered care | ND base level: $1,330 one person; $1,804 two people | $9,950 one person; $14,910 two people | Providers generally cannot bill you for Medicare-covered Part A or Part B cost-sharing. |
| SLMB | Part B premium | ND base level: $1,596 one person; $2,164 two people | $9,950 one person; $14,910 two people | May be approved for up to three prior months if you were eligible then. |
| QI | Part B premium | ND base level: $1,796 one person; $2,435 two people | $9,950 one person; $14,910 two people | You cannot receive QI and other Medicaid coverage for the same month. |
| QDWI | Part A premium | Medicare screening chart: $5,405 one person; $7,299 married couple | $4,000 one person; $6,000 married couple | Only for certain working disabled people under 65 who lost premium-free Part A. |
The North Dakota QMB, SLMB, and QI amounts above are the state’s April 2026 poverty-level figures. They are not always the same as your gross-income cutoff because the state applies allowable income deductions.
What Has Changed
- Asset rule change: Effective August 13, 2026, North Dakota removed its former nine-month asset exclusion for unspent retroactive Social Security Title II or Supplemental Security Income (SSI) lump-sum benefits. If you recently received a back payment and your bank balance is near the MSP resource limit, ask the state how it will count the money before assuming it remains excluded. The change appears in the state’s 2026 release log and current excluded-assets policy.
- Income-limit clarification: North Dakota’s April 2026 table uses poverty-level base figures, while Medicare’s national screening chart is $20 higher for QMB, SLMB, and QI. North Dakota separately allows a $20 disregard for many aged, blind, and disabled applicants, so the state table should not be treated as a simple gross-income cutoff.
- QDWI clarified: North Dakota’s public eligibility page highlights QMB, SLMB, and QI, but the current state policy manual also includes QDWI for a narrower group of working people with disabilities.
How North Dakota Counts Income
North Dakota’s official 2026 MSP table uses 100% of the federal poverty level for QMB, 120% for SLMB, and 135% for QI. The state’s current income-level policy lists $1,330 a month for one-person QMB, $1,596 for SLMB, and $1,796 for QI. For two people, it lists $1,804, $2,164, and $2,435.
Those are base countable-income levels, not a simple gross-income stop sign. North Dakota’s current income-deduction policy allows a $20 monthly disregard for many aged, blind, and disabled applicants. It also allows earned-income deductions in some cases. Medicare’s national 2026 screening chart shows QMB at $1,350 for one person, SLMB at $1,616, and QI at $1,816. Those figures are $20 above the North Dakota base levels, while North Dakota separately applies a $20 disregard for many aged, blind, and disabled applicants.
If you have wages, a pension, Social Security, veterans benefits, or other income, do not try to reproduce the state’s full calculation from one number. Apply if you are close. The state decides what is countable. For a broader explanation of the four programs, see the GFS Medicare Savings Programs guide.
Helpful tip: When you call, ask, “What income deductions were applied to my MSP case?” That question is more useful than asking only for the gross-income limit.
QMB, SLMB, QI, and QDWI in North Dakota
Qualified Medicare Beneficiary (QMB)
QMB is the strongest Medicare Savings Program. North Dakota policy says QMB can cover the Part B premium, a Part A premium when one is owed, and Medicare cost-sharing for covered care. Medicare also explains that QMB members are protected from most provider billing for Medicare-covered deductibles, coinsurance, and copayments.
QMB can matter even if you also receive full Medicaid. North Dakota policy says Medicaid should not be automatically closed just because a person becomes eligible for QMB or SLMB. Medicaid may still pay for services Medicare does not cover.
Reality check: QMB does not erase charges for services that Medicare does not cover. Always ask what service and billing code caused the charge.
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB pays the Medicare Part B premium. It does not provide the same Medicare cost-sharing protection as QMB. North Dakota’s MSP benefits policy says SLMB eligibility may be established for as many as three calendar months before the application month if the person was eligible in those months.
Reality check: SLMB can lower your monthly premium cost, but you may still owe Medicare deductibles, coinsurance, and copayments.
Qualifying Individual (QI)
QI also pays the Part B premium. North Dakota says a person cannot receive QI and other Medicaid coverage for the same month. Medicare says QI must be renewed each year and states give priority to people who received QI the prior year.
If you may need broader Medicaid coverage for home care, long-term care, or other services, tell the eligibility worker. Do not choose QI without understanding how it interacts with Medicaid.
If assisted living may become part of the plan, the GFS North Dakota assisted living guide explains payment paths.
Reality check: QI is useful for premium help, but broader Medicaid may be more important for someone who needs ongoing care services.
Qualified Disabled and Working Individual (QDWI)
QDWI is a narrow program. It helps pay the Medicare Part A premium for some people under 65 who have a disability, are working, and lost premium-free Part A because they returned to work. North Dakota’s policy manual includes QDWI even though the public eligibility page mainly highlights QMB, SLMB, and QI.
Medicare’s 2026 MSP chart lists a screening income limit of $5,405 a month for one person and $7,299 for a married couple, with resource limits of $4,000 and $6,000. North Dakota policy applies QDWI using special SSI-style income and resource methods, so ask for a QDWI review rather than self-screening from gross wages alone.
Reality check: QDWI cases are uncommon. North Dakota policy notes that these cases may need special handling by Medicaid policy staff.
Assets and What May Not Count
For QMB, SLMB, and QI, North Dakota’s 2026 asset-limit policy sets the limit at $9,950 for a one-person unit and $14,910 for a two-person unit. These limits took effect January 1, 2026. QDWI uses a lower resource limit: $4,000 for one person and $6,000 for a married couple.
Not every asset counts. North Dakota’s current excluded-assets policy includes an occupied home, household goods and furniture, and one motor vehicle among the items that may be excluded. Other rules can be detailed, especially for jointly owned property, burial funds, annuities, and property that produces income.
Important August 2026 change: North Dakota repealed the former nine-month exclusion for unspent retroactive Social Security Title II or SSI lump-sum benefits. If you received a large back payment, do not assume it is protected for nine months under the current North Dakota Medicaid asset rules. Ask the Customer Support Center how the change applies to your MSP case.
If disability-related benefits, work, or complicated assets are part of your case, the GFS guide to North Dakota disability help can point you to other state resources.
How to Apply Without Wasting Time
North Dakota accepts Medicaid and MSP applications online, on paper, by mail, and through local human service zones. The state’s application page says an aged, blind, or disabled person who only wants Medicaid, Medicare Savings Programs, or basic care coverage can use the Health Care Application for the Elderly and Disabled, SFN 958.
| Route | Best for | What to do |
|---|---|---|
| Online | People comfortable using a portal | Start at the state application page and submit requested proof promptly. |
| Phone | Questions, application status, mailed forms | Call 1-866-614-6005 or 701-328-1000. TTY: 711. |
| Paper | Older or disabled applicants who prefer forms | Ask for SFN 958 if you only want Medicaid, MSP, or basic care coverage. |
| In person | People who need face-to-face help | Use the state human service zones directory. |
North Dakota’s Customer Support Center is open Monday through Friday, 8 a.m. to 5 p.m. Central Time. The state says free translation is available. If you use several state benefit systems, the GFS North Dakota portals guide can help you keep the websites straight.
Phone script — first application
“I have Medicare and I want to apply for every Medicare Savings Program I may qualify for. Please check QMB, SLMB, and QI, and tell me which documents you still need.”
Phone script — QDWI
“I am working, I have a disability, and I lost premium-free Medicare Part A after returning to work. Please check whether I can be reviewed for QDWI.”
Documents to Gather
Do not delay an application just because one document is missing. Apply, then ask what proof is still needed. North Dakota’s eligibility page says applicants age 65 or older, blind, or disabled may need proof of assets as well as income.
| Proof | Examples | Why it helps |
|---|---|---|
| Medicare | Medicare card, Social Security notice | Shows Part A and Part B status. |
| Income | Social Security letter, pension statement, pay stubs | Lets the state calculate countable monthly income. |
| Resources | Bank statements, CDs, investments, retirement accounts | Used for the MSP resource test. |
| Identity and status | Government ID, birth record, immigration document if applicable | Confirms identity and required status. |
| Problem bills | Provider bill, Medicare Summary Notice | Useful when fixing a QMB billing problem. |
Approval, Prior Months, and Extra Help
North Dakota Medicaid policy says eligibility decisions generally should be made within 45 days, or within 90 days when a disability determination is pending, except in unusual circumstances. If your case has been sitting longer, call and ask whether the state is waiting for proof. The policy is explained in the state’s decision-and-notice rules.
Coverage timing is not identical for every MSP. North Dakota policy says SLMB and QI may be approved for as many as three calendar months before the application month if you were eligible during those months. QDWI may also be retroactive for up to three months. QMB cost-sharing follows a different start rule, so do not assume a QMB approval will erase older Medicare cost-sharing bills.
People who qualify for an MSP also get Extra Help with Medicare Part D prescription costs. Medicare’s 2026 Extra Help page says the plan premium and deductible can be $0, with covered prescriptions costing up to $5.10 for each generic drug and $12.65 for each brand-name drug at participating pharmacies. For more detail, see the GFS guide to Extra Help in 2026.
If You Have QMB and Get a Bill
Federal law gives QMB members strong billing protection. The Centers for Medicare & Medicaid Services says Medicare providers and suppliers cannot bill QMB members for Medicare Part A or Part B deductibles, coinsurance, or copayments for Medicare-covered items and services. The CMS QMB billing page also says QMB members have no legal obligation to pay that Medicare cost-sharing.
First call the provider’s billing office. Ask them to verify your QMB status and correct the claim. If the bill is not fixed, call Medicare at 1-800-MEDICARE and North Dakota’s free State Health Insurance Assistance Program (SHIP) at 1-888-575-6611. The GFS QMB billing guide has a step-by-step checklist.
Phone script — QMB bill
“I am enrolled in QMB. Please verify my QMB status and remove Medicare deductibles, coinsurance, or copayments for covered services. Please pause collections while you review the bill.”
Reality Checks and Common Mistakes
- Do not self-deny from gross income. North Dakota uses countable income and allowed deductions.
- Do not use QI without checking Medicaid. QI cannot overlap with other Medicaid coverage for the same months.
- Do not assume all prior bills will be covered. QMB timing differs from SLMB, QI, and QDWI retroactive rules.
- Do not ignore asset changes. The August 2026 lump-sum rule can matter if a large retroactive Social Security or SSI payment remains in your account.
- Do not send originals unless asked. Keep copies of applications, statements, notices, and uploaded documents.
- Do not pay a QMB cost-sharing bill automatically. Ask the billing office to verify QMB first.
Denied, Delayed, or Overwhelmed
Read the notice first. Look for the reason, the date it was mailed, the program that was tested, and any missing proof. North Dakota policy says a Medicaid appeal must be filed no later than 30 days from the mail date on the notice of action. The state allows appeal requests by telephone, internet, mail, in person, or other commonly available means.
The state’s appeal policy gives the 30-day rule. North Dakota’s Medicaid handbook also lists the Appeals Supervisor at 1-800-472-2622 or 701-328-2311. If your denial seems to be caused by missing proof, ask whether you can supply the proof before filing a new application.
Phone script — denial
“I received an MSP denial. Please tell me which income, asset, or eligibility rule caused it, whether all MSP levels were checked, and the last day I can appeal this notice.”
Backup Options if MSP Is Not Enough
Medicare Savings Programs focus on Medicare costs. They do not solve every health or daily-living problem. If you need broader help, ask whether full Medicaid, home and community-based services, prescription help, or aging services fit your situation.
- Broader state help: Start with the GFS North Dakota senior guide.
- Local aging services: Use the GFS North Dakota AAA guide for meals, rides, caregiver help, and local support.
- Prescription costs: If drugs are the main problem, apply for Extra Help even if you are still waiting on an MSP decision.
- Dental costs: The GFS North Dakota dental guide covers dental assistance options for seniors.
North Dakota and Medicare Resources
- North Dakota Customer Support Center: 1-866-614-6005 or 701-328-1000; TTY 711. The state says free translation is available.
- North Dakota SHIP: 1-888-575-6611 for free, unbiased Medicare counseling. The Insurance Department’s Medicare assistance page says counselors help with bills, claims, appeals, paperwork, and coverage questions.
- Aging and Disability Resource Link: 1-855-462-5465; TTY 711. The official ADRL directory connects people to local aging, disability, housing, transportation, and care resources.
- Medicare: 1-800-MEDICARE for Medicare coverage, QMB billing, and general MSP questions.
Resumen en Español
En Dakota del Norte, QMB, SLMB y QI pueden ayudar con la prima de Medicare Parte B. QMB también puede ayudar con la prima de la Parte A y con deducibles, coseguro y copagos de servicios cubiertos por Medicare. QDWI es un programa limitado para algunas personas menores de 65 años con discapacidad que trabajan y perdieron la Parte A sin prima.
Los límites estatales de ingresos para 2026 usan ingreso contable, no siempre ingreso bruto. Dakota del Norte permite ciertas deducciones, incluido un descuento mensual de $20 para muchas personas mayores o con discapacidad. Si sus ingresos están cerca del límite, solicite y deje que el estado haga el cálculo.
Para solicitar ayuda, llame al 1-866-614-6005 o use la página estatal de Medicaid. Si recibe una factura de deducible, coseguro o copago después de entrar en QMB, pida al proveedor que revise su estado QMB. Si recibe una denegación, revise la fecha de envío de la carta; la regla estatal generalmente permite 30 días desde esa fecha para apelar.
Frequently Asked Questions
What are North Dakota’s 2026 QMB income limits?
North Dakota’s base QMB income level is $1,330 a month for one person and $1,804 for two people, effective April 1, 2026. The state also applies allowed income deductions, so gross income may be higher and still qualify.
Why does Medicare show a higher income limit?
Medicare’s national 2026 screening chart shows QMB at $1,350 for one person, SLMB at $1,616, and QI at $1,816. North Dakota lists the poverty-level base amounts $20 lower, then allows a $20 disregard for many aged, blind, and disabled applicants. Other deductions can also affect countable income.
What are the 2026 MSP asset limits?
For QMB, SLMB, and QI, North Dakota uses $9,950 for one person and $14,910 for a two-person unit in 2026. QDWI uses $4,000 for one person and $6,000 for a married couple.
Does an MSP also give me Extra Help?
Yes. Medicare says people who qualify for a Medicare Savings Program also get Extra Help with Medicare Part D prescription costs.
Can a provider bill me if I have QMB?
For Medicare-covered Part A and Part B items and services, federal law generally prohibits providers and suppliers from billing QMB members for Medicare deductibles, coinsurance, and copayments.
How long does North Dakota have to decide?
North Dakota Medicaid policy generally calls for a decision within 45 days, or within 90 days when disability is pending, except in unusual circumstances. Call the Customer Support Center if the state is waiting for proof.
How long do I have to appeal a denial?
North Dakota policy says a Medicaid appeal must be filed no later than 30 days from the mail date on the notice of action. Follow the deadline printed on your notice and ask the state immediately if the date is unclear.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note: This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections: Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer: This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 20 September 2026 · Next review: 20 January 2027
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