North Dakota Medicaid State Plan Personal Care: North Dakota 2026 Guide
North Dakota’s Medicaid State Plan Personal Care (MSP-PC) pays for help with daily activities for Medicaid members who live at home or in certain residential settings. It is a regular Medicaid benefit, coordinated by case managers at the Human Service Zones under the North Dakota Department of Health and Human Services.
This guide covers who qualifies for Medicaid State Plan Personal Care, what help is included, how to start, and where it fits among North Dakota’s other long-term care options. For the full statewide rules on income, assets, spouses and the look-back, see our North Dakota Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What Medicaid State Plan Personal Care is
A case manager assesses the person’s needs and authorizes a number of units of personal care each month. North Dakota sets different service levels, with a higher level available for people who meet a nursing facility level of care. Services can be provided by agencies or by individual qualified service providers. MSP-PC is also offered in some basic care facilities.
The core of Medicaid State Plan Personal Care is hands-on help with daily activities: bathing, dressing, eating, toileting and getting around, plus household tasks tied to that care. As a state plan benefit, it is an entitlement in North Dakota, so there is no enrollment cap for people who qualify. It is narrower than a waiver, though, and the number of hours depends on an assessment.
Who qualifies in 2026
In general, to get Medicaid State Plan Personal Care a person must:
- be enrolled in North Dakota Medicaid;
- need help with at least one activity of daily living, as determined by an assessment (higher service levels need greater impairment);
- live in their own home or an approved residential setting; and
- have services authorized by a case manager.
Who qualifies financially. Applicants need regular North Dakota Medicaid, whose income limit for older adults is often below the long-term care limit. Some people who would qualify for nursing home care therefore qualify for state plan services only through a spend-down, or not at all.
MSP-PC is a regular Medicaid service, so the person must qualify for North Dakota Medicaid under their group’s rules, including any recipient liability for income above set levels.
The main North Dakota long-term care figures for 2026, taken from our state guide, are below.
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | No cap for nursing home care (income above the allowance goes toward care) |
| Asset limit (single applicant) | $3,000 |
| Asset limit (couple, both applying) | $6,000 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Half the couple’s assets, minimum $32,532 / maximum $162,660 |
| Spouse at home: monthly income allowance | Minimum $2,705 (from July 1, 2026) / maximum $4,066.50 |
| Personal needs allowance (nursing home) | $118 a month |
| Look-back period | 60 months (5 years) |
Married applicants. For many state plan services, both spouses’ income and assets are counted together, and the spousal protections used for nursing homes and waivers may not apply the same way.
Services Medicaid State Plan Personal Care can cover
The assessment sets the hours, and the help can include:
- bathing, dressing and grooming
- toileting and continence care
- eating
- transfers and mobility
- medication assistance
- housework, laundry and meal preparation related to personal care
Not included. Overnight supervision, rent and chores unrelated to care fall outside Medicaid State Plan Personal Care. People needing more help often move on to a waiver or managed long-term care.
How to apply for Medicaid State Plan Personal Care
The usual path is:
- Make sure the person is on North Dakota Medicaid.
- Contact the Aging and Disability Resource Link or a Human Service Zone office for an assessment.
- The case manager authorizes services.
- Choose an agency or a qualified service provider.
- Services start, with periodic reviews.
Staying organized. Copy every form before you send it and keep a simple call log. During the assessment, describe a typical bad day rather than a good day, and have a family member present who knows how much help is really needed. Memory problems, falls and the need for supervision all count, even when the person can still do some tasks alone. If the answer is no, the written notice explains how to request a fair hearing and the deadline.
Waiting lists and timing
MSP-PC has no enrollment cap; the main delays are the Medicaid application and finding a provider.
Medicaid State Plan Personal Care is not capped, so there is no formal waiting list. Delays come instead from paperwork, assessments and staffing.
How it relates to nursing home Medicaid
Many Medicaid State Plan Personal Care recipients have needs below a nursing home level of care. It is not designed for people who need care around the clock; for them, a waiver, managed care or a nursing home is the usual next step. Nursing home coverage uses different, often more generous income rules.
Planning around Medicaid State Plan Personal Care
Families usually look into Medicaid State Plan Personal Care after a health event or when a caregiver is stretched thin. A bit of preparation helps. A good first step is a short written picture of the day: which tasks need help, who does them now, and what the backup is. That list supports the assessment and shows where paid help would make the biggest difference.
On the financial side, gather recent bank statements, income letters such as Social Security and pension notices, health insurance cards, and proof of age and residence in North Dakota. If long-term care Medicaid may be needed later, five years of records will matter, so it helps to keep them now. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.
Finally, review the plan every few months. Needs change, and North Dakota’s programs are designed to change with them through reassessments. Notes on falls, hospital visits and new diagnoses make later reviews easier.
Tips for families
Write down each task, how often it happens and how long it takes before the assessor arrives. If a relative wants to be the paid worker, check the program’s rules early, since rules on paying relatives, training and background checks vary. If the approved hours seem too low, get the decision in writing and consider a fair hearing.
Many families find it worthwhile to talk with a Certified Medicaid Planner before applying for Medicaid State Plan Personal Care. A planner who knows North Dakota’s rules can review income and assets, explain which program fits, map the timing against any waiting list, and help with the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.
Related pages
- North Dakota Medicaid guide
- North Dakota HCBS Waiver
- In-home care and Medicaid
- Activities of daily living
- Consumer-directed care
- Paid family caregivers
- HCBS waivers explained
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.