Programs & Benefits

Individuals with disabilities must have access to fully participate in their communities. Services and benefits should be available in the community to ensure people with disabilities can maintain health, safety, and independence.

Many people with disabilities rely on public benefits and support programs to meet their healthcare, income, housing, and daily living needs. Understanding these programs and your rights can help you make informed decisions and protect your benefits.

This page provides information about major benefit programs, your rights, and how Protection & Advocacy (P&A) may be able to help.

Medicaid 

Medicaid is a joint federal and state program that provides health coverage and long-term services for eligible individuals with disabilities and people with low income. In North Dakota, Medicaid is administered by the North Dakota Department of Health and Human Services.

Medicaid may cover:

  • Doctor visits and hospital care
  • Mental health and behavioral health services
  • Prescriptions and medical equipment
  • Home and Community-Based Services (HCBS)
  • Personal care and nursing services
  • Assistive technology
  • Long-term care supports

Many people who receive SSI automatically qualify for Medicaid in North Dakota.

It is important to:

  • Report changes in income, address, or household size
  • Renew your coverage when required
  • Review notices from Medicaid carefully

 

Health Tracks (EPSDT)

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) is a Medicaid benefit designed to get children the health care they need when they need it.  North Dakota’s EPSDT program is called Health Tracks. The right care, to the right child, at the right time, in the right setting. 

Health Tracks Eligibility  

All Medicaid-eligible children under the age of 21 can receive Health Tracks benefits.  

Health Tracks Benefits  

Health Tracks focuses on screening children regularly to: 

  • Make sure development is on track  

  • Diagnose developmental, mental health, or other health conditions  

  • Provide treatment and follow up for conditions 

Rights Under Medicaid

What are Home and Community Based Services (HCBS)?

Medicare

Medicare is a federal health insurance program for:

  • People age 65 and older
  • People who have received SSDI for a certain period
  • People with specific medical conditions

Medicare includes:

  • Part A (Hospital Insurance)
  • Part B (Medical Insurance)
  • Part D (Prescription Drug Coverage)
  • Medicare Advantage Plans (Part C)

Free assistance with Medicare questions and plan choices is available through the North Dakota Insurance Department and the State Health Insurance Assistance Program (SHIP). Some individuals may qualify for programs that help pay Medicare premiums and out-of-pocket costs.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are federal disability benefit programs administered by the Social Security Administration. These programs provide monthly income to eligible individuals with disabilities.

 

Supplemental Security Income (SSI)

SSI is a needs-based program for people with disabilities who have limited income and resources.

SSI may help pay for basic living expenses such as:

  • Housing
  • Food
  • Utilities
  • Clothing
  • Personal needs

Eligibility is based on:

  • Disability status
  • Income
  • Assets and resources
  • Living arrangements

In North Dakota, many people who receive SSI also qualify for Medicaid.

 

Social Security Disability Insurance (SSDI)

SSDI provides benefits to people with disabilities who have worked and paid into Social Security.

Eligibility is based on:

  • Work history
  • Payment of Social Security taxes
  • Medical disability determination

Unlike SSI, SSDI is not based on financial need.

After receiving SSDI for a certain period, most individuals become eligible for Medicare.

 

Reporting Changes and Avoiding Overpayments

People who receive SSI or SSDI are required to report certain changes to Social Security. Reporting changes on time helps prevent overpayments and protects your benefits.

You should report changes such as:

  • Starting or stopping work
  • Changes in income
  • Changes in living arrangements
  • Marriage, separation, or divorce
  • Changes in bank accounts or resources
  • Changes in disability status
  • Moving to a new address

Failure to report changes may result in an overpayment.

 

SSI and SSDI Overpayments

An overpayment occurs when Social Security determines that you received more benefits than you were eligible for.

Overpayments may happen when:

  • Income changes are not reported
  • Work is not reported timely
  • Living situations change
  • Information is missing or incorrect
  • Administrative errors occur

If you receive an overpayment notice, you may have options, including:

It is important to read overpayment notices carefully and respond by the deadline listed in the letter.

What To Do If Social Security Overpays Me

Representative Payees

If the Social Security Administration determines that a person cannot manage their benefits independently, it may appoint a representative payee.

A representative payee:

  • Receives benefit payments
  • Uses the money for the person’s needs
  • Keeps records of spending
  • Reports to Social Security
  • Acts in the best interest of the beneficiary

Payees must use funds only for the person’s benefit. Misuse of benefits is not allowed and should be reported.

Individuals have the right to:

  • Request a change in payee
  • Report concerns about misuse
  • Be involved in decisions whenever possible

Your Rights to Benefits

People who apply for or receive public benefits have important rights, including the right to:

  • Apply without discrimination
  • Receive clear and understandable information
  • Access services in community-based settings
  • Request reasonable accommodations
  • Receive notices about changes to benefits
  • Appeal denials, reductions, or terminations
  • Submit evidence and attend hearings
  • Receive information in accessible formats

You have the right to challenge decisions you believe are incorrect. Deadlines for appeals are very important. Missing a deadline can affect your ability to keep or restore benefits.

How Protection & Advocacy (P&A) May Be Able to Help

Protection & Advocacy may be able to help individuals with disabilities understand and protect their benefits.

We might be able to help with:

  • Explaining benefit programs and rules
  • Answering questions about notices and letters
  • Helping with applications and reporting changes
  • Assisting with appeals and hearings
  • Addressing service denials or reductions
  • Advocating for community-based supports
  • Providing information about rights

There are times when we may not be able to assist, including when:

  • The issue must be resolved directly with the agency
  • The matter is outside our legal authority
  • There is a conflict of interest
  • The case is not within P&A’s focus areas, or you are not an eligible individual

If we cannot provide direct representation, we may be able to offer information or referrals.

The North Dakota Protection & Advocacy Project provides free and confidential advocacy services.

 

Learn More and Get Help

If you have questions about your benefits or are experiencing problems with services, you may contact P&A for assistance. Our staff can help you understand your options and determine whether we may be able to support you.

Programs & Benefits Related Resources: 

Family Voices of North Dakota

North Dakota’s Family to Family Health Information and Education Center

Family Voices of North Dakota
North Dakota Medicaid Website

Medicaid is a state and federally funded program that helps pay for health care services for qualifying low-income adults, children, pregnant women, older adults and people with disabilities. Find out if you might qualify for ND Medicaid by learning more about what groups of people we cover, eligibility requirements, and income/asset levels as applicable. You can apply online or by using a paper application. 

North Dakota Medicaid Website
North Dakota Insurance Department

The North Dakota Insurance Department offers the State Health Insurance Assistance Program (SHIP) program to assist residents with finding the right coverage and answering questions. 

ND Medicare
Disability Determination Services

Disability Determination Services (DDS) evaluates claims and makes medical disability determinations for North Dakotans using Social Security Administration (SSA) guidelines. The Social Security program provides benefits to persons with disabilities who are unable to work. Those benefits include Social Security Disability Insurance (SSDI) and/ or Supplemental Security Income (SSI).

Disability Determination Services (SSDI/SSI)
Social Security Income (SSI) Website

SSI provides monthly payments to people with disabilities and older adults who have little or no income or resources.

Social Security Income (SSI)
Social Security Disability Insurance (SSDI)

Social Security Disability Insurance (SSDI) or “Disability” provides monthly payments to people who have a disability that stops or limits their ability to work.

Social Security Disability Insurance (SSDI) Website
Representative Payee Program

Social Security's Representative Payment Program provides benefit payment management for our beneficiaries who are incapable of managing their Social Security or Supplemental Security Income (SSI) payments.

Representative Payee Program Website
ND Health and Human Services Health Tracks

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. 

ND Health and Human Services Health Tracks