If you or a family member is on North Dakota Medicaid and needs a ramp, grab bars, or other accessibility work, the state's Medicaid Waiver for Home and Community Based Services (HCBS Waiver) may help pay for it. The program is run by North Dakota Health and Human Services (HHS), through its Aging Services Division. It covers a service called Environmental Modification. Here is how the program works and how to apply.
What North Dakota offers#
The HCBS Waiver, also called the Aged and Disabled Waiver, is a 1915(c) home and community-based services waiver, named for the section of the Social Security Act that authorizes it. It serves North Dakota residents age 65 or older, and people age 18 or older with a disability, who meet Nursing Facility Level of Care.
The waiver covers a service called Environmental Modification: adapting the home, or the person's primary vehicle, to enhance independent functioning. Covered examples include widening doorways, ramps, relocating plumbing or electrical fixtures for specialized equipment, bathroom modifications, kitchen accessibility changes, and grab bars with installation.
Some things are excluded. Routine maintenance does not qualify, including carpet, plumbing repair, roof repair, electrical repair, heating and cooling (HVAC) repair, or appliances. Additions that increase a home's square footage are also excluded.
Amounts and eligibility#
North Dakota does not publish a flat dollar cap for Environmental Modification. Instead, the cap is set by a formula: the lesser of the highest monthly rate for the highest-cost skilled nursing facility, or 20% of the tax evaluation of the home. Program administration may approve exceptions to this formula.
There is a process step tied to cost. If the estimated cost of a modification exceeds $500, the case manager must obtain a written recommendation from an appropriate professional, along with a minimum of two licensed-contractor bids. North Dakota's HCBS Program Administration must then give prior approval before work begins.
For financial eligibility, you must be financially eligible for North Dakota Medicaid. Do not assume income figures from other states apply here. North Dakota's income rules for this waiver are determined through your local Human Service Zone, so check with that office directly rather than relying on a number you may have seen elsewhere.
How to apply in North Dakota#
Contact the Aging and Disability Resource-LINK at 1-855-462-5465, or your local Human Service Zone office (formerly called county social services), to start an application. An online application is also available through North Dakota HHS.
North Dakota does not run this waiver through managed care. Instead, an HCBS Case Manager handles the process end to end. The case manager confirms that the requested modification relates to your care needs, inspects the home, and obtains the required contractor bids for costs over $500. The case manager then submits the request for prior approval and, once approved, enrolls the chosen contractor as a Qualified Service Provider. The case manager also inspects the completed work.
That Qualified Service Provider step matters for families choosing a contractor. Contractors must enroll as a Qualified Service Provider with the state before they can be paid for waiver work, so confirm your contractor is willing to complete that enrollment.
Be prepared for the possibility of a wait. Enrollment slots in the HCBS Waiver are limited, and when they are full, a waitlist can form. No official count or wait-time figure is published. Contact the Aging and Disability Resource-LINK at 1-855-462-5465 to ask about current status.
If you need help finding local aging services beyond the Resource-LINK, the federal Eldercare Locator (eldercare.acl.gov, 1-800-677-1116) is a fallback.
How it stacks with federal programs#
If the person needing modifications is a veteran, grants from the U.S. Department of Veterans Affairs (VA) may help fund a larger project alongside North Dakota Medicaid. See our VA home modification grants guide for details.
Original Medicare does not cover structural home modifications. Some Medicare Advantage plans, also called Part C, cover extras like grab bars or ramps as a supplemental benefit. Coverage is plan-specific, with no standard dollar amount. Call your plan directly to ask what it covers.
Finding a provider who knows this program: Not every contractor has handled HCBS Waiver paperwork or Qualified Service Provider enrollment. Adapta Home USA verifies providers' Medicaid Waiver Billing experience, so you can filter for pros who have done this before in North Dakota. Find Home Modifications & Remodeling providers in North Dakota with Medicaid Waiver Billing experience →
For the bigger picture on combining programs, see our national Medicaid HCBS waiver guide and our full guide to paying for home modifications.
FAQ#
Does North Dakota Medicaid pay for home modifications like wheelchair ramps or grab bars?#
Yes. The HCBS Waiver covers a service called Environmental Modification, which can include ramps, widened doorways, bathroom modifications, and grab bars with installation for people who qualify for the waiver.
What is North Dakota's HCBS (Aged and Disabled) Waiver and who is eligible?#
It is North Dakota's home and community-based services waiver, run by North Dakota HHS through its Aging Services Division. It serves residents age 65 or older, and people age 18 or older with a disability, who meet Nursing Facility Level of Care.
Is there a dollar limit on home modifications under North Dakota's waiver?#
There is no flat dollar figure. The cap is set by a formula: the lesser of the highest monthly rate for the highest-cost skilled nursing facility, or 20% of the tax evaluation of the home. Program administration may approve exceptions.
How do I apply for North Dakota's HCBS Waiver?#
Contact the Aging and Disability Resource-LINK at 1-855-462-5465, or your local Human Service Zone office, to start an application. An online application is also available through North Dakota HHS.
Find a verified provider near you#
Adapta Home USA's directory lets you search Home Modifications & Remodeling providers in North Dakota and filter for Medicaid Waiver Billing experience. Our wheelchair ramp cost guide can help you budget while you wait to hear back.
This article is for general educational purposes only and does not constitute medical, legal, or financial advice. Consult a qualified professional about your specific situation.
Program amounts, eligibility rules, and application procedures change. Figures on this page were verified against official government sources on the date shown, but you should confirm current details at VA.gov or with the administering agency before making decisions. Adapta Home USA is not affiliated with the U.S. Department of Veterans Affairs or any government agency.