The Medicaid Call Center will be closed on Monday, July 4

We will not be taking calls on Monday, July 4, due to the holiday.

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Helpful Resources

Download, view and print documents you may need to manage your plan.

Basic information on things like getting care, what's covered and solving problems with BCBSND.

Explanation of how your plan works. Or, can be used as proof of your coverage.

Authorized Representative Form

Give permission to others for ongoing access to your health information.

Prefer to download and mail your form?
Authorized Representative Form

Authorization to Release Information Form

Authorize limited access to your health information.

Prefer to download and mail your form?
Authorization to Release Information Form

If you wish to appeal a decision made by BCBSND.

Continuity of Care allows BCBSND members to continue receiving covered health care services for specific medical conditions from a non-participating or out-of-network provider. Request a review for continuing coverage for specific medical conditions from a non-participating or out-of-network provider. Complete this application with your physician and return it to BCBSND as soon as possible. 

If you believe BCBSND has failed to provide services or discriminated in another way.

A list of Prescription Medications or Drugs that may be covered under the medical benefit and may require Precertification (Prior Approval) for Medicaid Expansion members.

Request a paper copy

Call 833-777-5779 to request a paper copy of these documents.

Privacy and legal

Non-Discrimination Statement
Health care fraud

Need help with something else?

Find answers to some common questions. Or, visit our Contact page and get in touch with Member Services.