North Dakota Long-Term Care Planning
North Dakota planning turns on the client-share pathway, equalized nursing-facility rates, the five-year transfer review, and careful deed-creditor analysis.
Begin with the North Dakota income path
North Dakota planning should begin with client share, not with a generic assumption that an applicant must use a Qualified Income Trust. HHS says its medically needy coverage is for people whose income is too high for Medicaid but whose medical expenses exceed client share, and its January 2026 policy describes recipient liability as a monthly deductible based on net income, deductions, and income levels. The income, deduction, and liability calculation should be completed before changing ownership of assets or purchasing a financial product (North Dakota HHS eligibility; ND Medicaid recipient-liability policy).
Resources still matter. The public HHS standard is less than $3,000 for a single long-term-care applicant and less than $6,000 for a couple, subject to exclusions and the special spousal rules. For an institutionalized or HCBS spouse, state law adopts the maximum federal Community Spouse Resource Allowance, while the administrative code permits the applicant spouse $3,000. An asset assessment should be requested before large purchases, retitling, or a spenddown (North Dakota HHS eligibility; North Dakota CSRA statute; North Dakota Administrative Code).
Want to know how this fits your family's plan?
Twelve questions. About four minutes. A shortlist of funding strategies ranked for your situation — not a generic list.