This webpage was created to assist North Dakota residents in understanding the costs of senior care assistance. Below one will find the average cost of living in an assisted living facility, in-home medical and non-medical care, and adult day care services (sometimes called adult day health). Programs that provide assistance with the cost of care, as well as a variety of elderly care services, are also included on this page.
The list of programs found below includes all of the programs funded by the state of North Dakota. That being said, those seeking senior care assistance should not limit themselves to only these options. There are also national, local, and non-profit programs available. Based on one’s senior care needs, some programs better serve some individuals than others, and it’s important to find the program that best serves the circumstances. Our free Resource Locator Tool is invaluable at assisting one in this endeavor.
North Dakota Eldercare Costs for 2024
Assisted Living / Memory Care
In North Dakota, per Genworth’s Cost of Care Survey, the average monthly cost of assisted living is $5,0506 (as of 2024) across the state. In Bismark and Fargo, assisted living is less expensive than the statewide average at $4,386 and $4,299 a month, respectively. The most expensive assisted living care is found in Grand Forks ($7,000).
Alzheimer’s patients, and those suffering from dementia, often need a higher level of care and security as the disease progresses. Assisted living facilities provide care specifically for this purpose in Alzheimer’s units (also called Memory units), which costs approximately 20% – 30% more per month than traditional assisted living.
Home Care
For seniors who wish to remain living in their own homes, but require assistance with daily living activities, home care is a great option. As of 2024, per Genworth’s Cost of Care Survey, the average hourly rate for in-home care across the state is $24.
While in-home care is non-medical in nature, home health care, which is provided by health care professionals, is also available at an hourly rate in North Dakota. The cost is, on average, $8 more per hour statewide.
Adult Day Care
In North Dakota, according to Genworth’s Cost of Care Survey, as of 2024, the average cost of adult daycare throughout the state is $180 a day, which is significantly higher than the nationwide average of $95 a day. Still, adult day care offers a much more affordable option than in-home care, while also allowing an individual to be supervised during daytime hours.
North Dakota Medicaid Financial Assistance Programs
Medicaid Programs & Waivers for the Elderly
Medicaid is a federal and state funded health care program for low-income individuals, families, seniors, and those who are disabled. While the parameters for the program are federally set, each state implements the program as best serves their state within the set guidelines. The state Medicaid program in North Dakota will cover the cost of nursing home care for those who are elderly or disabled (as it does in every state).
North Dakota state Medicaid also offers the program Personal Care Services, which provides in-home assistance, preventing or delaying unnecessary nursing home placement. Supports may include assistance with bathing and grooming, food preparation and eating, shopping for essentials, housecleaning, and laundry. Aid may be provided in one’s home, the home of a friend or relative, an adult foster care home, or an assisted living facility.
North Dakota also offers a Home and Community Based Services (HCBS) waiver. Unlike the state plan, which is open to all eligible applicants, the waiver program has a limited number of slots that are available for individuals to receive services. This means, at times, there may be a waitlist. The Aged and Disabled Waiver provides services for seniors and / or disabled individuals in their homes, in adult foster care homes, and in assisted living facilities, including Alzheimer’s care units. Services and supports may include adult day care, non-medical transportation, home modifications, personal care, and specialized medical equipment.
Medicaid Eligibility
Income Limits
For a senior to be eligible for North Dakota Medicaid in 2024, functional ability is considered, and income and assets are restricted. Single elderly individuals are limited to $1,130 a month in income, while married applicants are allowed up to $1,533 a month.
Over the Income Limits?
Being over the income limit does not automatically mean one is not able to qualify for Medicaid. North Dakota has a medically needy pathway. This allows applicants who exceed the income limit but have high medical bills to still qualify for Medicaid after spending down their excess income on medical expenses. This can be thought of as similar to a deductible, and once one has spent down their income on illegible expenses to the income limit, they will be eligible for Medicaid services for the remainder of the spend down period.
Asset Limits
The limit for assets for single seniors is $3,000, and $6,000 for married couples. However, some assets are considered exempt, such as one’s home (if it is an individual’s primary residence and his / her equity interest is not valued at more than $713,000). Other exemptions include household furnishings, personal belongings, such as clothing, one motor vehicle if used by the Medicaid applicant, and burial plots.
Over the Asset Limits?
Having excess assets, like excess income, does not mean one cannot become eligible for Medicaid. For instance, one can spend down assets on home reparations and modifications or pay off debt. However, it is critical one does not give away assets or sell them inexpensively in order to meet the asset limit. Doing so is in violation of Medicaid’s look-back rule and can result in a period of Medicaid ineligibility.
Applying for Medicaid can be a complicated process, and it should not be taken lightly. If one is over the eligibility limits for income and / or asset(s), or is married, it can be extremely beneficial to have a professional Medicaid planner assist in the application process.
North Dakota Non-Medicaid Assistance Programs
In North Dakota, there are also non-Medicaid, state funded programs available to assist in the cost of senior care. Currently, there are two such programs.
Service Payments for the Elderly and Disabled (SPED) and Expanded SPED, also referred to as Ex-SPED, provide a variety of supportive services for seniors and disabled individuals who wish to age while living at home. While services under SPED may require a minimal service fee, with services under Ex-SPED, there are no fees. Supports may include adult day care, adult foster care, personal care, homemaker services, and more. These programs allow for consumer direction, which means eligible applicants are able to hire the service provider of their choosing. This includes select relatives.
Through the Older Americans Act (OAA), elderly care services are provided to assist seniors in living at home, again reducing unnecessary nursing home placements. Services may include meals, transportation, companion care, assistance with Activities of Daily Living (ADLs), and essential household errands.
PACE Programs in North Dakota
The Program of All-Inclusive Care for the Elderly (PACE) is a joint initiative between Medicare and Medicaid to help seniors get the care and services they need in the community rather than transitioning to a nursing home for care. Because Medicaid differs in each state, PACE eligibility varies between states.
PACE services in North Dakota provide qualified individuals with full-spectrum health care services, including primary care, emergency care, dentistry, nutritional counseling, and in-home services designed to promote independence and a good quality of life among senior citizens. Eligibility requirements include the following:
- Age 55 or over
- Resident of service areas
- Require a nursing home level of care
- Eligible for Medicaid in North Dakota
How To Get Started With PACE in North Dakota
Contact the service provider listed below or visit North Dakota’s Medicaid page for more information on PACE, including who’s eligible and how to apply.
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PACE Provider
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Contact
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Areas Served
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Northland PACE
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(701) 751-3050
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Bismark, Dickinson, Fargo, and Minot
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Other Financial Options for Care
In addition to the state specific programs that assist in covering the cost of elderly care in North Dakota, there are also federal and non-profit programs available. In order to find other programs that assist in paying for care or reduce your out-of-pocket cost, make sure to use our Resource Locator Tool. This tool makes it easy to locate and consider all of your options and choose the program that best fits the circumstances. Eldercare loans and programs that aid veterans with assisted living are other available options.
Finding Affordable Care in North Dakota
As one can see, the cost of elderly care varies greatly across the geographic regions of North Dakota. With this extreme variance in cost, finding the most affordable rate for elderly care is a very important cost saving measure. Through partnerships with other organizations that maintain large databases of caregivers throughout North Dakota, one is able to find high quality care at the most affordable rate in one’s preferred geographic region. Click here to find the most affordable senior care.
Top Cities for Senior Care in North Dakota
For more information about the costs and resources available in North Dakota cities, click on the links below.
