Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
Search Saved

North Dakota program

Children’s health insurance above the Medicaid line (CHIP)

Health insurance for children under 19 whose family income is above the ordinary Medicaid line.

What it is

Health insurance for children under 19 whose family income is above the ordinary Medicaid line.

North Dakota runs CHIP as a Medicaid coverage group, also called the Optional Children’s Group. One application checks ordinary Medicaid first and CHIP next. Existing insurance and any free offer of coverage matter as well as income.

Eligibility rules
  • CHIP is the Optional Children’s Group, formerly Healthy Steps. It generally covers uninsured children under 19, including the month of the nineteenth birthday under the state’s published application guide. The zone checks income above the ordinary child Medicaid line and the other-insurance rules.
  • From April 1, 2026, the 205% poverty upper line is $5,638 monthly for four, $4,668 for three and $3,697 for two. The five-point allowance is already included.
  • Current creditable coverage, or coverage available at no cost, excludes a child under NDAC 75-02-02.1-44(2).
What you get
  • The same children’s health coverage as North Dakota Medicaid.
  • Hospital care, cancer treatment, medicines and specialist visits.
What the help includes
  • This group has the same insurance coverage as Medicaid. The zone confirms current premiums, enrollment fees, copays and exceptions before you rely on a cost estimate. The separate Children with Disabilities premium is not the CHIP cost rule.
If you decide to apply
  1. Ask your human service zone to check CHIP on the same Medicaid application.
  2. Have current pay, your child’s ID, insurance cards and any letter offering free job coverage ready.

Human service zone, 866-614-6005 · Official page ↗

After you ask
  • The usual Medicaid decision standard is 45 days. The approval notice names the coverage group and its dates.
  • The approval notice identifies the start date. The zone checks eligibility separately for any earlier month.
  • Children under 19 generally keep eligibility for 12 months, subject to limited exceptions; an income increase alone does not end that period. Through 2026, up to three earlier eligible months may be covered. North Dakota has announced a two-month traditional-Medicaid lookback from January 1, 2027; the zone should confirm the Optional Children’s Group dates on the child’s notice.
Good to know

An offer of coverage at no cost can block CHIP even if you never accepted it.

Other details
  • A coverage offer and coverage actually held are separate questions on this application. The zone can explain which insurance rule affected a decision.

Federal background: Children’s Health Insurance Program.

Official sources
Ask your social worker

“If our income is above ordinary Medicaid, could CHIP work for our child? What would it cost, what insurance rules might block it, and could you help us apply if it fits?”

Why I’m asking: I want to understand the next coverage option without creating a gap in treatment.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File once and answer the insurance question exactly: what your child holds, and what is offered to them free.

Your social worker

The zone office checks Medicaid first and CHIP next without a second form.

The care team

Records and letters when the application asks for them.

Who decides
Your human service zone office, using the same application as Medicaid.
Ask the agency
“If we are over the children’s Medicaid line, please look at this same application for CHIP, and tell me what it costs a month.”

How to apply

First step: File the same application as Medicaid on the Self-Service Portal, or call 866-614-6005.

  1. File one application; the zone office checks Medicaid first and CHIP next.
  2. Say clearly what insurance your child holds today and what is offered to them.
  3. Ask what the cover costs each month before you accept it.

Official application / program page ↗

Where it starts: The same application as Medicaid: the Self-Service Portal or 866-614-6005.

What to gather

  • Insurance cards and any letter about cover offered through a job
  • This month’s pay for the tax household
  • Your child’s ID

How long: The same 45-day decision standard as Medicaid.

What a yes looks like

A notice naming the Optional Children’s Group or CHIP, with the dates the cover runs.

What a no looks like, and the next move

If the no is about other insurance, ask which cover the office counted and whether it really costs you nothing.

Watch out

  • Being offered free cover through a parent’s job can shut this door even if you never took it.
  • North Dakota did not publish what CHIP costs a family here, so ask before you count on it.

Dates that change this

2026-09-11: Whether North Dakota charges a CHIP premium or enrolment fee, and any buy-in above the line, was not published. Ask the human service zone what this costs before you count on a figure. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Children’s cover to 205% of poverty: $5,638 a month for four, $4,668 for three, effective April 1, 2026.

  • $5,638/month — Household of 4, published upper line (205% of poverty, allowance included)
  • $4,668/month — Household of 3, published upper line
  • $3,697/month — Household of 2, published upper line

Covers: The same insurance cover North Dakota gives Medicaid children · Hospital, chemotherapy, medicines and specialist care

What it costs the family: The human service zone confirms the Optional Children’s Group’s current premiums, enrollment fees and copays. The separate CWD premium does not apply to CHIP.

The eligibility facts, as published

Age
under 19, including the nineteenth-birthday month under the application guide
Age max exclusive
19
Income
above the child Medicaid line for the child’s age and up to 205% of poverty with the five-point allowance included
Insurance status condition
a child holding current creditable cover, or with cover available at no cost, is excluded (NDAC 75-02-02.1-44(2))
Residency
North Dakota
Retroactive months
up to 3 prior eligible calendar months through 2026; HHS announces 2 for traditional Medicaid from January 1, 2027; the zone confirms individual coverage dates
Statute
NDCC ch. 50-29; NDAC 75-02-02.1-44

The trap: The bar is being enrolled in other cover, or being offered cover at no cost to you. An employer offer you have to pay for is a different thing, and the state does not spell that case out; ask the zone office rather than assuming.

Where I read this

← Back to your options