Sanford Heart of America Health Plan
Sanford Heart of America Health Plan is a Medicare approved Cost Plan. Many Medicare beneficiaries find that managed care cost plans are a good way to get more health care for their dollar. Sanford Heart of America Health Plans (SHAHP) will provide or arrange for all Medicare covered services. This means if you join a managed care cost plan and get all of your services through the Sanford Heart of America Health Plan, your out-of-pocket costs are usually more predictable. Also, depending on your health needs, those costs may be less than you would pay if you were liable for the regular Medicare deductibles and co-insurance amounts.
What are the advantages of managed care cost plans?
- No Medicare deductibles - only monthly premiums
- No claim forms and virtually no paperwork for you
- Local administration
- Predictable expenses - so you can easily budget your health care dollars
- No health screening, waiting periods or pre-existing condition clauses
To be eligible for membership in SHAHP you must be entitled to Benefits under Medicare Parts A & B or Part B only. You must reside within the specified SHAHP service area. You must not be receiving any Hospice Care or currently have end-stage renal disease. There may be exceptions to these requirements. SHAHP offers continuous open enrollment. Please contact our office if you wish to enroll or click on the Enrollment Form and Instructions link. (see below)
How to enroll:
- Call Sanford Heart of America Health Plan (SHAHP) at 701.776.5848, 1.877.652.1845, 1.800.366.6888 (TTY) and request an enrollment form
- For coverage terms, exclusions, contract termination, members rights and responsibilities, and other information, please refer to the 2016 Evidence of Coverage.
- Please review the Summary of Benefits before enrolling.
- Or download the Cost Plan Enrollment form on this site, complete it and mail or fax it to SHAHP.
Receiving care once you are enrolled:
The Sanford Heart of America Health Plan coordinates its benefits with traditional Medicare coverage. As a member of the SHAHP, you must receive all of your primary medical care through one of the SHAHPs Plan Physicians, except in the case of an emergency or urgent care out of the service area. Plan physicians can be found under the Provider Directory link. (see below)
If as a member of SHAHP you need specialty care, you must obtain a referral from your primary care physician prior to receiving the specialty care. You can click the Referral Form link to see a sample of a referral form. (see below)
- 2016 Evidence of Coverage
- Summary of Benefits
- Service Area
- Enrollment Form
- 2016 Premiums
- Provider Directory
- Referral Form
- Appeals and Grievance Process
- Medicare Online Complaint Form
- Annual Notice of Changes for 2017
- Nondiscrimination Statement
- Language Assistance
Sanford Heart of America Health Plan is a Medicare-Approved Cost Plan
Sanford Heart of America Health Plan, 1749 38th Street South, Fargo, ND 58104
701.776.5848, 1.877.652.1845, 1.800.366.6888 (TTY)
Hours of operation: Monday through Friday, 8:00 am to 8:00 pm
Pending CMS Approval
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