Updated September 5, 2026. Quick answer: North Dakota’s medically needy income level is $1,197 a month for one person, effective April 1, 2026, and it is not tied to the SSI benefit rate at all. North Dakota is a Section 209(b) state, and its own policy manual sets the figure at 90% of the federal poverty level, updated each April rather than each January the way SSI-linked cap states update.
A 209(b) state runs on a different clock
North Dakota’s Department of Health and Human Services policy manual states the current medically needy income level directly: “Monthly Income Level 1 $1,197” effective April 1, 2026, with medically needy income levels set at 90% of the federal poverty level by household size. Because federal poverty guidelines are typically published in mid-January and states then phase in updates, North Dakota’s own April 1 effective date means its figure changes on a different schedule than the January 1 SSI-COLA cycle that 300%-cap states follow.
A separate, smaller number for a different purpose
The same manual also sets a $118-a-month “nursing care income level”/maintenance allowance for nursing-facility residents, a distinct figure from the $1,197 medically needy income level itself; the two serve different purposes in North Dakota’s eligibility process and should not be conflated.
| Citation | North Dakota Department of Health and Human Services, Economic Assistance Policy Manual, section 510-05-85-40 |
| What it says | “Monthly Income Level 1 $1,197” |
This page covers the income eligibility figure itself. How a state handles income above that figure (a Qualified Income Trust, a medically needy spend-down, or something else) is covered on North Dakota’s excess income mechanism page.
Figures verified against the North Dakota Economic Assistance Policy Manual, section 510-05-85-40 (revised 7/1/2026), on September 30, 2026; North Dakota’s Section 209(b) classification was not re-checked.
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a county or state caseworker has the final say on any individual application.