Just 775,000 people call North Dakota home, and of those, around 15% are aged 65 and over. With a relatively large senior population, Alzheimer’s disease and similar memory-related conditions are a growing concern in the state. In 2020, 15,000 people in North Dakota had Alzheimer’s disease, and it’s estimated that this number will rise to 16,000 by 2025.
North Dakota has a number of resources that can help seniors with memory-related conditions, including medical facilities, such as Sanford Broadway Clinic, with geriatric specialists on staff. At $4,239 per month, memory care in North Dakota is more affordable than the national average, and this, coupled with the state’s low cost of living, can help retirement incomes stretch further. As one of the country’s least densely populated states, North Dakota is an attractive retirement choice for seniors who love wide open spaces. It also offers retirees clean air and low levels of crime.
Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide provides an overview of memory care costs in North Dakota, as well as the costs of other senior living options in the state. You can also find information about memory care regulations, financial assistance options and free resources that can help you as you age.
When trying to decide how to pay for memory care, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of memory care in North Dakota and its 2 cities.
Note: Memory care in the United States is generally provided as an additional service in assisted living facilities. Currently, the cost of memory care isn’t tracked nationwide, but prices are typically 20%-30% higher than assisted living costs. The figures below are an estimate calculated by adding 25% to the assisted living prices in the Genworth 2021 Cost of Care Survey.
The average memory care price in North Dakota is $4,239 per month, which is significantly lower than the national average of $5,625. North Dakota is also very affordable when compared to its neighbors. Of neighboring states, only South Dakota has lower prices, with seniors there paying $4,188 per month. In Montana, the average price is $5,563, and seniors in Minnesota pay $5,635 per month. This is $1,396 higher than memory care in North Dakota.
North Dakota's average memory care cost of $5,899 a month is near the middle of costs for this area of the country. Costs vary with location, and cities in several adjacent areas show a wide range of costs. Sioux Falls, SD, for example, averages $4,832 a month, while memory care in Des Moines, IA, is as high as $8,550. Minneapolis, MN, is more affordable, $4,670, while Omaha, NE, averages $5,998.
North Dakota
$5,899
Sioux Falls, SD
$4,832
Omaha, NE
$5,998
Minneapolis, MN
$4,670
Des Moines, IA
$8,550
Memory care costs are rising in North Dakota, up from $3,641 to a projected $6,510 monthly between 2022-2024, thanks to inflation. This is a 79% increase, well above the 19% nationwide increase from $4,863 to $5,792. North Dakota's hikes are beyond many other states, including South Dakota's rise from $5,394 to a projected $5,635 (4%), Montana's 3% increase from $6,033 to $6,200 and Idaho's increase of $4,255 to $5,151, a 21% increase. Nebraska's memory care costs have also risen, $5,594 to a projected $6,914, or 24% by 2024.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| North Dakota | $3,641 | $5,899 | $6,510 |
| U.S. Average | $4,863 | $5,369 | $5,792 |
| South Dakota | $5,394 | $5,350 | $5,635 |
| Montana | $6,033 | $5,822 | $6,200 |
| Idaho | $4,255 | $5,170 | $5,151 |
| Nebraska | $5,594 | $5,997 | $6,914 |
Depending on a senior's needs, paying $5,899 a month for memory care might not be the best choice. Other care options may cost less, such as assisted living ($3,472) or independent living ($2,873), and be a better fit.
Assisted Living
$3,472
Memory Care
$5,899
Independent Living
$2,873
Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in North Dakota.
North Dakota Medicaid has two programs that may be able to assist with the cost of memory care in the state. The first is known as Medicaid State Plan – Personal Care Services, or MSP-PC. This isn’t a waiver program, so it’s open to all eligible applicants. However, the services provided through the program are limited to assistance with activities of daily living and instrumental activities of daily living.
The second program is the Home and Community-Based Services (HCBS) Waiver. This is sometimes referred to as the Aged and Disabled Waiver. This can provide a greater variety of services than MSP-PC, including case management, meals and transportation. Both programs can provide care in homes, adult foster care or assisted living communities, including memory care units.
Medicaid State Plan – Personal Care
Medicaid in North Dakota can help seniors pay for memory care through the Medicaid State Plan – Personal Care program. This program is designed to provide assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Care can be provided on an intermittent or ongoing basis. To receive assistance, applicants must reside at home, in the home of a loved one or in certain group living arrangements. This includes some types of assisted living facilities known as basic care facilities.
There are three different levels of the program available, known as A, B and C, and each has slightly different eligibility criteria. All provide the same type of care, but the number of hours provided differs based on the level.
To be eligible for the program, you must require personal care for at least 30 days. An assessment is performed as part of the application process to determine the amount of assistance you require, and this determines the level of care. At levels B and C, a nursing home level of care is required. Applicants must also be financially eligible for Medicaid. There are no age requirements for the program.
The benefits of this program are limited to assistance with ADLs and IADLs. Help with ADLs can include dressing, grooming, eating and mobility. Those who need assistance with IADLs can get help with laundry, preparing meals and medication management, among other services.
As this isn’t a waiver program, assistance is available to everyone who is eligible. You can apply through your local Human Service Zones office or call (800) 472-2622 for more information.
Home and Community-Based Services Waiver
The Home and Community-Based Services Waiver is designed to help people stay living in their homes or the community. There are a range of services available through the program to keep those who need a nursing home level of care safe, comfortable and healthy.
The HCBS is available to people of all ages who are financially eligible for Medicaid and meet the medical eligibility criteria. Those under 65 years of age must be designated disabled by Social Services, and those 65 and over must require a nursing home level of care. The program has limited places, and applicants may be placed on a waiting list. North Dakota will also deny a place to someone if it would cost less to care for that person in a nursing home.
Benefits available to people on the program include case management, chore services, transportation and medical supplies or equipment. The program also covers residential care, which includes the services provided in the facility such as recreational and social programming, supervision, safety and security. However, the program doesn’t cover room and board.
Applications for the program can be made through the Aging and Disability Resource-LINK. They can be contacted at 1-855-462-5465 for more information.
Eligibility for Medicaid in North Dakota is based on a number of factors, including your health, finances and circumstances. Older adults who wish to access Medicaid programs must be:
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $12,108 | $3,000 | |
| Two People | 1 | $12,108** | $3,000 | $148,620 |
| Two People | 2 | $16,368 | $6,000 |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
Not all assets are counted when your financial situation is being assessed. Personal belongings, an automobile and irrevocable burial trusts are among the non-countable assets. A person’s primary home is also exempt if they intend to return or if their spouse is still living there.
If only one person in a couple is applying, the non-applicant may also be eligible for the Minimum Monthly Maintenance Needs Allowance. This lets you transfer income from the applicant to the non-applicant to ensure the non-applicant can continue to pay for their living expenses.
Applications for Medicaid are handled through local Human Services Zone offices. To apply by mail, request a form from your local office. Forms can also be found on the Medicaid website. Alternatively, you can use the online application portal, and your application will be forwarded to your local office.
Information You Will Need
To complete your application, you will need to provide:
North Dakota has resources available if you need help applying for Medicaid. Human Service Zone offices are the primary point of contact, as they process applications and have a thorough understanding of programs. The state also produces a guidebook to answer questions about applying. Finally, the State Health Insurance Counseling program can answer questions about health insurance, including Medicaid.
| Program | Contact | Services provided |
|---|---|---|
| Human Service Zone offices | Find local numbers online | Formerly known as County Social Services offices, Human Service Zone offices can help people access a range of services and support programs, including Medicaid. Local staff can answer questions, help identify resources you may be eligible for and process applications. |
| Application for Assistance Guidebook | N/A | This guidebook is produced by the Department of Human Services. It has extensive information about the resources available to help North Dakotans in need, including the Medicaid program. There are also detailed instructions on how to apply and the information you need to supply with your application. |
| State Health Insurance Counseling | (701) 328-2440 | SHIC is designed to help people navigate the Medicare program, but trained counselors can also answer questions about other health insurance, including Medicaid. |
The short answer is that no, Medicare does not cover the cost of memory care in North Dakota. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in North Dakota.
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy. |
There are many resources in North Dakota that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Department of Health and Human Services | 855-462-5465 | North Dakota's Area Agencies on Aging operates programs under the umbrella of the North Dakota Health and Human Services. The program offers specialized assistance to seniors based on an assessment of individual needs. These include services that help seniors stay in their homes instead of moving into long-term care. Examples include funding for in-home services, family home care and adult foster care. Other forms of practical assistance are homemaker services, such as chores, shopping, meal preparation and money management. |
Cash assistance programs in North Dakota provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Whether living in their own home or in a senior living community, North Dakota seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Medicaid Waiver for Home and Community Based Services | 855-462-5465 | The Medicaid Waiver for Home and Community Based Services is designed to help older adults and people with disabilities remain living in their homes with access to local community services. This waiver provides a wide range of services including personal care, transport, chore services and respite care. It can also pay for minor home modifications. Services can be provided at home, in adult daycare, adult foster care or memory care facilities. |
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help North Dakota seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Commodity Supplemental Food Program (CSFP) | The North Dakota Community Supplemental Food Program is a government program targeted at improving the health of seniors. CSFP food packages distributed to eligible older North Dakotans contain USDA-approved supplementary food items suitable for inclusion in a diet that addresses the nutritional needs of older adults. All low-income North Dakota residents aged 60 and over are invited to apply. Packages are available through nominated community action agencies with location details accessible online. | |
| North Dakota Meals on Wheels | North Dakota Meals on Wheels provides nutritious, well-balanced meals and support services for eligible seniors statewide. Seniors must be 60 years old or over to qualify, and the program focuses on those who aren't mobile enough to prepare or shop for food. Depending on circumstances, meals are served on a sliding-scale basis in a congregate setting, such as the local senior center, or they're delivered directly to the senior's front door with an accompanying safety check. | |
| North Dakota The Emergency Food Assistance Program (TEFAP) | The Emergency Food Assistance Program of North Dakota is a federal government program aimed at stemming food insecurity and nutritional deficiencies in older adults. North Dakota seniors aged 60 and over with limited financial means can access emergency food packages and attend free communal meals. TEFAP partners with local North Dakota agencies such as the Great Plains Food Bank in Fargo to distribute food to pantries statewide. Seniors can make inquiries through TEFAP or their local seniors' agency. |
Due to the high cost of purchasing new medical equipment, several organizations in North Dakota collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Healthcare Equipment Recycling Organization (HERO) | 701-212-1921 | Based in Fargo, this program provides donated durable medical equipment to people in need locally and worldwide. It also has a shopfront where anyone can purchase low-cost medical equipment and supplies. |
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in North Dakota have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Rehab Accessibility Project | 800-292-8621 | North Dakota Housing Finance Agency is in Bismarck, ND. The agency operates diverse programs to assist homeowners, renters and homeless people. Low-income individuals with a physical disability may qualify for financial assistance through the Rehab Accessibility Program. Grants for home renovations may cover fitting accessibility features, such as grab rails, ramps and wheelchair-accessible showers, as well as widening doorways and installing door levers. To qualify, households must earn less than 80% of the county's median income. |
Social Security offices in North Dakota help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Seniors can apply for tax assistance from several North Dakota resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Homestead Property Tax Credit | The Homestead Property Tax Credit reduces the taxable value of a person's home. The credit amount is variable, based on an individual's income. | |
| North Dakota Renter's Refund | 701-328-7088 | The Renter's Refund provides a partial refund for the rent of a person's place of residence or mobile home lot. The benefit provides a refund if 20% of your rent is more than 4% of your annual income. The overpayment is refunded, up to $400. |
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. North Dakota retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota Low Income Home Energy Assistance Program (LIHEAP) | 866-614-6005 | LIHEAP partially pays for home heating costs, including natural gas, electricity, coal or other fuel sources. It can also help with weatherization, furnace cleaning and repair, chimney cleaning and emergency assistance. |
North Dakota retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| North Dakota VA Benefits and Health Care | North Dakota VA Benefits and Health Care helps seniors access long-term care and various in- and out-patient medical services throughout the state. Eligible veterans can receive treatment and nursing home care at clinics and veteran's centers in North Dakota, as well as utilize financial benefits such as Aid and Attendance. Typically, individuals must serve 24 months of active duty to be eligible for these benefits; however, this is sometimes waived for people discharged due to disability or hardship. |
In North Dakota, memory care services are provided in basic care facilities that are licensed to provide specialized services exclusively to those who have Alzheimer’s, dementia and other special memory care needs. These facilities are governed and licensed by the North Dakota Department of Health, which enforces regulations to ensure a standardized level of care.
| Topic | Rule |
|---|---|
| Scope of Care | Memory care facilities may admit and retain residents who require around-the-clock personal care, but they can’t retain residents who need more than intermittent nursing or medical care. They must serve at least three nutritious, well-balanced meals daily, along with regularly scheduled snacks. Facilities must also provide housekeeping and laundry services, assistance with activities of daily living and instrumental activities of daily living, social support and medical care arrangements, transportation and assistive devices. |
| Care Plans | Within 14 days of admission and at least once every three months, memory care facilities are required to conduct an assessment that covers factors such as personal care needs, capability for self-care and social and activity interests. Memory care facilities must create person-centered care plans with the resident’s input within 21 days following this functional assessment. |
| Medication Management | Memory care facilities are required to provide assistance to residents in obtaining necessary medications. These medications may be administered by a licensed health care practitioner, licensed nurse or a medication assistant. Residents may self-administer their medications and keep them in their unit with the consent of a licensed practitioner. In the event of a significant medication error, a medication assistant must file a report with the Department of Health. |
| Staffing | The state doesn’t enforce minimum staffing ratios, but staff members must be available 24 hours per day to see to residents’ scheduled and unscheduled needs. Staff members must complete a training program that addresses topics such as residents’ rights, fire and safety procedures, infection control and managing difficult behaviors. They must also complete at least eight hours of training that covers dementia-related topics, including behavioral symptoms of dementia; alternatives to chemical and physical restraints; positive therapeutic interventions; and addressing care and safety aspects, such as food and fluid intake, pain and wandering. An additional four hours of ongoing training must be completed annually. |
| Medicaid Coverage | North Dakota Medicaid covers memory services via the Home and Community Based Services Waiver and the Basic Care Assistance program. |
| Reporting Abuse | Incidents of abuse, neglect or exploitation should be reported to the Department of Human Services’ Long-Term Care Ombudsman by calling 701-328-4617 or 855-462-5465, by emailing dhsagingombud@nd.gov or by completing an online form on the program’s website. |
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