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Sanford Health Plan

Sanford Heart of America Health Plan, a Medicare Cost Plan (HMO)

Sanford Heart of America Health Plan, a Medicare Cost Plan (HMO) 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 (Cost) 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 (Cost) 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

Obtaining membership:

To join the Sanford Heart of America Health Plan (Cost), you must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in our service area. Our service area includes the counties and zip codes in North Dakota listed here. You may not enroll in Sanford Heart of America Health Plan (Cost) if you currently have End-Stage Renal Disease (ESRD) unless:
a. You are a member of Heart of America Group/Commercial grandfathered plan in good standing and have been diagnosed with ESRD during your current membership, or
b. You do not need regular dialysis anymore.

How to enroll:

  • Call Sanford Heart of America Health Plan (Cost) and request an enrollment form:
    Sales: (701) 776-5848
    Customer Service: (877) 652-1845
    TTY/TDD: (877) 652-1844
  • For coverage terms, exclusions, contract termination, members rights and responsibilities, and other information, please refer to the 2017 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 (Cost) coordinates its benefits with traditional Medicare coverage. As a member of the Sanford Heart of America Health Plan (Cost) you must receive all of your primary medical care through one of the SHAHPs' (Cost) 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 or by searching our Online Provider Directory.

If as a member of SHAHP (Cost) 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)

 


Contact Information:

 

Mailing Address Sanford Heart of America Health Plan (Cost)
PO Box 1999
Fargo, ND 58107
   
Phone Numbers  
Sales: (701) 776-5848
Customer Service: (877) 652-1845
TTY/TDD:  (877) 652-1844
Fax:  (605) 328-6811
LanguageLine Solutions: (800) 892-0675
   
Hours of Operation Monday through Friday, 8:00 am to 8:00 pm

 


 

Sanford Heart of America Health Plan, a Medicare Cost Plan (HMO) is a Medicare Cost Plan with a Medicare contract. Enrollment in the Plan depends on contract renewal.


Pending CMS Approval
© 2010-2016 Sanford Heart of America Health Plan, a Medicare Cost Plan (HMO)

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Tell Us About Yourself

Insurance terms are confusing. Let us help make sense of it all.

Purchasing through Sanford Health Plan or the Marketplace, let us explain the differences

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Tell Us About Yourself

Insurance terms are confusing. Let us help make sense of it all.

Purchasing through Sanford Health Plan or the Marketplace, let us explain the differences

Sanford Health Plan offers two different provider network products in your area. Select what option that best fits your needs.

Click here to search our provider directory. If your doctor does not display, they most likely are not a participating provider with Sanford Health Plan. Feel free to continue the Plan Picker tool if you are still interested in what options Sanford Health Plan has to offer. If not, we appreciate you using our Plan Picker!

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