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.
- Notice on changes to ND Medicaid Expansion payments due to Senate Bill 2012
- 01/01/2020 Change to Administrator for ND Medicaid Expansion Outpatient Pharmacy Benefits
- Filling a CMS 1500 Claim for Vaccine Administration as a Medical Claim
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).
Summary of Benefits and Coverage (SBC for all NDME Members)
Transition of Care Form