How to Apply for the Medicare Savings Program in North Dakota
Three Ways to Apply
North Dakota accepts Medicare Savings Program applications through multiple channels. You don't have to use the online portal — paper and phone options work just as well.
Online: The ND HHS Self-Service Portal at apply.nd.gov lets you submit an application, upload documents, and track your case status. It's available 24/7, though account setup and document uploading can be frustrating if you're not comfortable with web forms.
Paper: Download and complete Form SFN 958 (Health Care Application for the Elderly and Disabled). This is the primary form for aged, blind, or disabled applicants seeking MSP coverage. You can also use Form SFN 1909 (Application for Health Coverage and Help Paying Costs) for combined household screenings. Mail, fax, or hand-deliver completed forms to any local Human Service Zone office.
Phone: Call the ND HHS Customer Support Center at 1-866-614-6005 (TTY: 711). Staff can take applications over the phone and mail out forms if needed.
Documents You'll Need
Gather these before starting the application to avoid processing delays:
- Medicare card (showing Part A and/or Part B enrollment)
- Social Security benefit statement showing the gross monthly amount
- Two months of bank statements for every account
- Proof of any pension, VA benefits, or other unearned income
- Proof of earned income if your parent still works
- Documentation of burial fund designations (if claiming the $1,500 exclusion)
- Proof of citizenship or qualifying immigration status
- Property records if claiming mineral rights exclusions
Self-attestation is accepted for primary residence value and household goods. Financial balances that don't match electronic records require written verification.
Applying as an Authorized Representative
If you're applying on behalf of a parent, complete the Authorized Representative section on Form SFN 958. Your parent needs to sign that section. Alternatively, a Power of Attorney document or court guardianship order grants representation authority automatically.
Note that Social Security representation (SSA Form 1696) does not extend to state HHS proceedings — you need state-level authorization separately.
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Where to Submit
Applications can go to any local Human Service Zone office or to the central Customer Support Center in Bismarck (PO Box 5562, Bismarck ND 58506). The online portal routes electronic applications to the appropriate processing queue automatically.
In-person visits go to the Human Service Zone serving your parent's county. If you're unsure which zone, call the Customer Support Center and they'll direct you.
What Happens After You Apply
ND HHS runs automated checks through the Federal Data Services Hub and SSA's BENDEX files to verify Medicare status and income. A Human Service Zone eligibility worker then reviews all documentation.
The state has 45 calendar days to make a decision from the date they receive a complete application. If disability determination is needed, that extends to 90 days. If information is missing, you'll get a written request with 10–14 days to respond before the case closes.
Approval notices state the program tier, effective date, benefit level, and how income was calculated. Denial notices cite the specific regulation, show the financial figures, and include Form SFN 162 (Request for Hearing) so you can appeal.
The North Dakota Medicare Savings Programs & Extra Help Guide includes a document checklist and line-by-line form guidance to help get the application right the first time.
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Download the North Dakota — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.