North Dakota Long-Term Care Resources

Discover state-specific information on long-term health care costs, taxes, rules, care options, and other information for North Dakota residents.

State Information

North Dakota participates in the federal/state long-term care partnership program, offering those with a qualified LTC Insurance policy dollar-for-dollar asset protection. Quality care options are available statewide, and several insurance solutions are available.

There are a variety of quality care options available throughout North Dakota. However, long-term health care costs are rising, especially in low populated areas. These rapidly increasing costs for care services throughout the state are becoming burdensome on residents and their families for those who do not have Long-Term Care Insurance.

The variety of quality care options available throughout North Dakota for those who require long-term health care services include:

  • adult day care centers
  • assisted living facilities
  • continuing care retirement communities
  • home health care providers
  • memory care facilities
  • rehabilitation facilities
  • traditional nursing homes

Top insurance companies have several insurance options to help residents safeguard income and assets, protect lifestyles, and preserve a legacy. Plus, policyholders will have access to quality care options giving loved ones the time to be family instead of caregivers.

Plus, all tax-qualified Long-Term Care Insurance policies in North Dakota have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

The State of North Dakota has been participating in the federal/state long-term care partnership program since 2007. The North Dakota Long-Term Care Partnership Program is a collaboration between the state government and insurance companies. Under this partnership, consumers who purchase qualifying long-term care insurance policies can access Medicaid coverage while retaining assets they would normally first be required to spend on their long-term care.

This is what is referred to as “dollar-for-dollar” asset protection or “asset disregard”. This additional asset protection allows you to keep assets you would normally not be allowed to keep if you didn’t have a policy and had to spend your own assets for care. Even a small policy can provide solid asset protection providing you and your family with additional peace-of-mind.

Policy Example

If your North Dakota Partnership Long-Term Care insurance policy paid $275,000 your estate would be eligible to shelter that same amount. This is above the normal asset allowance. The larger the amount of benefits paid by the policy gives you a larger amount of additional dollar-for-dollar asset protection. The Partnership Program also protects those assets after death from Medicaid estate recovery.


Most states have reciprocity with other states' long-term-care partnership programs including North Dakota. This means if you move from or to North Dakota your partnership asset protection follows you as well.


Long-Term Care Medicaid spend down is $3,000. A spouse’s minimum asset allowance is minimum of $6,076 up to a maximum of one-half of countable assets up to $130,380.   Your spouse’s minimum monthly income allowance is $3,259.50* The home equity limit is $603,000. 

For more information about the Medicaid program visit

Rate Stability Rules

In addition, North Dakota consumers enjoy additional peace-of-mind as the state has adopted Long-Term Care Insurance Rate Stability Rules.  These rules, developed the National Association of Insurance Commissioners, makes it much harder for an insurance company to get an approved rate increase.

Products Approved in North Dakota

A variety of products are approved in North Dakota for Long-Term Care planning. These include tradition long-term care insurance policies in addition to partnership certified plans and asset-based “hybrid” policies.

Tax Incentives

North Dakota Long-Term Care Partnership policies also qualify for an annual $250 North Dakota income tax credit. The tax credit appears on line 16 of Schedule ND-1TC. You are allowed a tax credit for premiums you pay for a partnership long-term care insurance policy that covers you or your spouse, or both. To qualify, you must be a North Dakota resident at the time you pay the premium.

Reverse Mortgages in North Dakota

Reverse mortgages are available in North Dakota. A reverse mortgage is a home equity loan where the borrower does not have to make payments.

This type of mortgage can increase monthly income, eliminate mortgage payments, and even fund Long-Term Care Insurance. However, North Dakota has many rules on these products, and you should seek the help of a qualified and licensed mortgage broker. 

If you have significant equity in your home and you and your spouse are at least 62 years old, you can get a reverse mortgage to turn your equity into funding long-term health care, pay for an LTC Insurance policy, pay bills and add to your retirement lifestyle.

The home must be the principal residence without any tax liens. 

Learn more about reverse mortgages by clicking here.

*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources.

North Dakota state emblem

State Breakdown

State Partnership Program
State Tax Incentives
Federal Tax Incentives
Medicaid Spend Down $3,000
Minimum Asset Allowance $29,724
Minimum Monthly Income Allowance $2,550
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North Dakota Cost of Care Calculator

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Long-Term Care Throughout North Dakota


Fargo is the largest metro area in North Dakota and accounts for nearly 17% of the state population. The average cost of a skilled nursing facility runs $9,957 a month. The cost of an Assisted Living Facility averages $3,665 a month. Adult Day Care Centers average $1,578 a month. Care at home, based on a 44-hour week, averages $5,266 a month.

Remember, assisted living cost estimates are for base costs. These long-term health care facilities will also have surcharges that will be added to the bill based on additional services that the care recipient requires. 

More Locations

Other population areas in North Dakota include Bismarck, Grand Forks, and Minot.

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