1. The individual completes a voucher application in the form and manner prescribed by the department;

2. The individual resides in North Dakota;

3. The individual is twelve years of age or older;

4. The individual grants the department access to treatment and payment records consistent with the confidentiality requirements found under title 42, Code of Federal Regulations, part 2 and title 45, Code of Federal Regulations, part 164;

5. The individual does not have resources to cover any care for treatment or meets one of the following conditions: a. Individual's third-party payment resources will not cover all costs for treatment; b. Individual has a pending application for medical assistance which presents a barrier to timely access to treatment; or c. Individual would not qualify for medical assistance and has no alternative third-party payment resources.

6. The individual has an annual income no greater than two hundred percent of federal poverty guidelines.

History: Effective July 1, 2016; amended effective April 1, 2020; July 1, 2022; April 1, 2024.

General Authority: NDCC 50-06-16

Law Implemented: NDCC 50-06-42