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North Dakota Services Request Cover Sheet
Category:
State:
Multi-State
Control #:
US-143-AZ
Format:
Word;
PDF;
Rich Text
Instant download
Description
How to fill out Services Request Cover Sheet?
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FAQ
Medically necessary covered services may be provided outside of North Dakota if the services are not available within North Dakota and have been prior approved by the department or if the services are provided in an emergency situation.
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.
In 2023, the Medically Needy Income Limit (MNIL) in ND is $1,009 / month for an individual and $1,364 / month for a couple.
Hospital. Inpatient: Covers room and board, regular nursing services, supplies and equipment, operating and delivery room, X-rays, lab and therapy. Outpatient: Covers emergency room services and supplies, lab, X-ray, therapies, drugs and biologicals, and outpatient surgery.
North Dakota Medicaid members ages 0 through 20 are eligible for vision services. These services must be done by an eye doctor who is enrolled as a North Dakota Medicaid provider.
Vision. Covers exam, glasses, frames and some hard contact lenses for the correction of certain conditions. Replacement eyeglasses may only be provided after a minimum of 12 months for children under 21 or 24 months for adults if a lens change is medically necessary.
Adults enrolled in Medicaid in North Dakota are eligible for extensive dental services, although North Dakota does not offer dental benefits to those enrolled through the ACA's Medicaid expansion.
Medicaid Basic Fee Schedule Includes but is not limited to: Physicians, lab and x-rays, chiropractic, dental (child & adult), ambulance services, audiology, speech, physical, and occupational therapies, podiatry, and vision services).
Hear this out loud PauseMedicaid Expansion gives more individuals the opportunity to have affordable coverage, preventive services and greater economic security in the event of accidents or illness. We are building on the success of Medicaid to make health care coverage more accessible for North Dakotans.
Hear this out loud PauseQ. Can I use my Medicaid coverage in any state? A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.
