North Dakota Medicaid Expansion

This webpage is dedicated to North Dakota’s Medicaid Expansion Program. The North Dakota Department of Human Services (ND DHS) chose Sanford Health Plan to provide eligible North Dakota residents with health insurance benefits.

ND DHS manages the application process, pharmacy benefit administration, and eligibility determination.

Sanford Health Plan manages the following services: medical management, claims adjudication, customer service, claims, provider relations and provider network.

The State of North Dakota’s Traditional Medicaid program and the program administered by Sanford Health Plan, known as North Dakota Medicaid Expansion (NDME), operate under different systems.

Announcements:

Appeal Rights & Filing Form

Medicaid Expansion Lock-In (CSP) Program Request - requires log in to mySanfordHealthPlan.

Provider Enrollment Guidance

Provider Network: Select the “Individual – ND Medicaid Expansion” network from the dropdown menu

Apply for Coverage: For detailed information on the North Dakota Medicaid Expansion Program, including how to apply for coverage, visit the North Dakota Medical Services website or call (844) 854-4825 (toll-free).

Member Travel, Lodging and Meal Guide

Summary of Benefits and Coverage (SBC for all NDME Members)

HHS-687 Consent for Sterilization Form


Transition of Care Form