Work Requirements

Start preparing now for the new Medicaid Expansion requirement.

Starting January 1, 2027, some North Dakota Medicaid Expansion members ages 19 to 64 may need to complete 80 hours of qualifying activities each month to keep their health coverage. Qualifying activities may include work, school, job training, or volunteering. Most members will not be affected.

It’s important to learn about these changes now. Medicaid will send updates by mail, so be sure your contact information is current.

How to meet your hours

There are different ways some Medicaid Expansion members can meet the monthly work requirement.

You do not need to have a job to meet your hours. Qualifying activities can include one or a mix of the following:

• Paid employment
• Education, if you’re enrolled at least half-time in a career/technical education program
• Job training or workforce programs
• Community service or volunteer work

These activities can help you learn new skills, meet new people and give back to your community.

Does this apply to you?

This rule does not apply to:

• Older adults (65 and older)
• Native American or Alaska Natives 
• A parent or caregiver of a child age 13 or younger 
• A parent or caregiver for someone with a disability 
• Have special health needs that make it hard to work
• Pregnant women or current members who were pregnant in the last 12 months
• Are in a drug or alcohol treatment program
• In jail or prison, or released in the last three months
• A former foster youth under age 26
• A veteran with a 100% disability rating from Veterans Affairs
• People who qualify for Medicare

If one of these applies to you, you’ll need to confirm your exclusion through the North Dakota Health and Human Services Self-Service Portal.

Visit hhs.nd.gov/StayCoveredND to find out if this rule applies to you.

What to do now

The requirement starts Jan. 1, 2027. Here’s how to get ready:

• Keep your contact information up to date.
• Open and read any mail you receive from North Dakota Medicaid.
• Respond with any information requested by North Dakota Medicaid on time. Missing deadlines could result in a loss of coverage.

Questions?

For help understanding whether this rule applies to you or what activities count, contact the Customer Support Center:

• 866-614-6005 - 711 (TTY), 8 a.m. to 5 p.m. (CT), Monday – Friday
• hhs.nd.gov/StayCoveredND

Free language translation is available. Call and an agent will connect you at no cost.