Our Customer Support Center is currently transitioning to a new phone system to better serve you. During this time you may experience slight delays in reaching us. We apologize for any inconvenience and appreciate your patience as we work to improve our services.
Apply Online
Complete and submit an Application for Assistance for Medicaid (health care) coverage using our self-service portal.
On Paper
Complete the appropriate form below and return to a human service zone office. Find your local zone office. All applications are fillable .pdfs.
- If you are under age 65, not disabled, and you want Medicaid ONLY
- Application for Health Care Coverage and Help Paying Costs form (SFN 1909)
- español SFN 1909
- If you want to apply for Medicaid and also want to apply for help with food, cash assistance, or child care
- Application for Assistance form (SFN 405) and return it to a human service zone office.
- If you are aged, blind, or disabled, and you ONLY want Medicaid coverage, the Medicare Savings Programs, or coverage in a basic care facility
- Health Care Application for the Elderly and Disabled form (SFN 958).
- español SFN 958
By Mail
Contact the Customer Support Center at (866) 614-6005 or 701-328-1000; 711 (TTY), or a human service zone office and request an application by mail.
Application Assistance
NOTE: For free application assistance in person or virtually, call a ND Navigator at 800-233-1737 or visit their website. ND Navigators are a federally-funded enrollment assistance grant program and are not part of North Dakota Medicaid.
Additional Information
For information about public assistance programs, view the Application for Assistance Guidebook - Which contains IMPORTANT information about programs and client rights.