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MEDICAID APPLICATION FOR THE ELDERLY AND DISABLED DEPARTMENT OF HEALTH AND HUMAN SERVICES SFN 958 (32024)AGENCY USE ONLY Case Number:Date Requested:Date Received:Interview Date:Individual InterviewedIf.

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How to fill out the ND SFN 958 online

The ND SFN 958 is the Medicaid application form for individuals who are elderly or disabled. Filling it out accurately is crucial to ensure you receive the necessary assistance. This guide provides clear, step-by-step instructions for filling out the form online, making the process manageable for all users.

Follow the steps to complete your application for Medicaid.

  1. Click the ‘Get Form’ button to access and open the ND SFN 958 document online.
  2. Select all applicable assistance programs for which you are applying, including Medicaid, Workers With Disabilities, and others as listed. Refer to the provided guidebook for further information if needed.
  3. Answer all questions with as much detail as possible. If needed, attach additional sheets of paper for extra information.
  4. Return the completed, signed, and dated application to your local Human Service Zone office. Alternatively, you can submit it by mail, fax, or email, as detailed in the instructions.
  5. Remember to gather and submit proof of alien or citizenship status, income, assets, and other required documentation to expedite your application processing.

Complete your ND SFN 958 application online today to ensure you receive the necessary support.

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Who is eligible for North Dakota Medicaid Program? Household Size*Maximum Income Level (Per Year) 1 $20,030 2 $27,186 3 $34,341 4 $41,4964 more rows

How can this program help me? This program lets you get Medicaid benefits even if your income is higher than Medicaid program guidelines. It works by letting you spend down your income so that you meet Medicaid income limits. The spend-down amount is the amount of income that is over the Medicaid limit.

Generally, a person who is blind, disabled, or age 65 or older can have up to $3,000 in countable assets (such as savings accounts, checking accounts, stocks, bonds, or other types of assets) to qualify for Medicaid. The limit for couples is $6,000.

Covers medical and surgical services performed by a doctor; supplies and drugs given at the doctor's office; and X-rays and laboratory tests needed for diagnosis and treatment.

Do You Qualify? Medicaid Expansion is available to individuals between 19-64 with household incomes up to 138% of the federal poverty level (FPL). Individuals eligible for Medicare or Supplemental Security Income (SSI) are not eligible for coverage under Medicaid expansion.

Medicaid provides comprehensive medical, dental and vision coverage to North Dakota children and adults through a variety of coverage programs and waivers, including: Autism Spectrum Disorder Waiver provides services for young children from birth through age 11 who have a diagnosis of an autism spectrum disorder.

Some individuals may qualify for ND Medicaid benefits at no cost while others may have to pay a portion of their medical bills. This is called Client Share (Recipient Liability). Client Share is the monthly amount an individual must pay in medical bills before the Medicaid program will pay for care received.

Medicaid and the Children's Health Insurance Program (CHIP) provide no-cost or low-cost health coverage for eligible children in North Dakota. These programs provide health coverage for children so that they can get routine check-ups, immunizations and dental care to keep them healthy.

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