North Dakota Medicaid Expansion

Welcome to the North Dakota Medicaid Expansion Program, administered by Sanford Health Plan. Please note that Medicaid Expansion benefits through Sanford Health Plan are different from traditional Medicaid services provided by the state of North Dakota. Sanford Health Plan does not determine eligibility or enrollment in North Dakota Medicaid Expansion.

For detailed information on enrollment, eligibility, or to apply for coverage, visit the North Dakota Department of Human Services-Medical Services Division website for Medicaid or call (701) 328-7068 | Toll-free: (844) 854-4825. ND Relay TTY: (800) 366-6888.

Remember: if you have a change in income (like overtime or shift changes), the number of people who live with you changes, or you move (even if it is temporary), you must tell the state of North Dakota within 10 days of when the change happens to make sure you don’t have a gap in health coverage. To find your local County Social Service office, click here.

To find a doctor, hospital or clinic in your Sanford Health Plan network click here and select your network as “North Dakota Medicaid Expansion.” 

To find a pharmacy in your network, click here.

Please refer to the state PDL (Preferred Drug List) link below for details on available rebates. If the state PDL does not address a specific drug, please refer to the Sanford Health Plan NDME formulary for coverage detail.

STATE PDL: SHP NDME Formulary 2019

To see a list of covered drugs, view the Formulary by clicking here.
To see the Member Handbook, view by clicking here.
To see the Certificate of Insurance, view by clicking here.
To see the Summary of Benefits and Coverage (SBC) for your plan, click here if you have copays. Click here if you do not have copays.

Sanford Health Plan Customer Service is available whenever you have a question or concern about your Medicaid Expansion benefits or covered services. We can help you find a doctor, understand what’s covered, and also help if you need to file an appeal. We are open Monday-Friday, 8 a.m. to 5 p.m. Central Time. If you speak a language other than English, call our free translation services at (800) 892-0675. TTY/TDD: (877) 652-1844.

If you have an ID card and are covered now, you can view your account online or send us a message at mySanfordHealthPlan.

Business hours are Monday through Friday from 8 a.m. to 5 p.m. Central Standard Time.

 

Department Questions about... Email Phone Number
North Dakota Department of Human Services Medical Service Division Eligibility
Household income
How to apply for coverage
dhsmed@nd.gov

Website
(701) 328-2321

Toll-free:
(877) 543-7669

ND Relay TTY:
(800) 366-6888
Sanford Health Plan Customer Service Benefits
Claims
How to find a doctor
How to file a complaint
How to order ID cards
memberservices@sanfordhealth.org Toll-free:
(855) 305-5060

TTY/TDD:
(877) 652-1844
Sanford Health Plan Pharmacy and Prescription Drugs Questions about which drugs are covered pharmacyservices@sanfordhealth.org Toll-free:
(855) 263-3547
Sanford Health Plan Utilization Management Prior-approval of health care services um@sanfordhealth.org Toll-free:
(855) 276-7214

 

Nondiscrimination Rights and Help in A Language Other Than English