Helpful Resources

Member Handbook

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

Certificate of Insurance

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

Authorized Representative Form

Give others full access to your health information.

Complete the form online or submit via mail:

Authorization to Release Information Form

Give others limited access to your health information.

Complete the form online or submit via mail:

Appeal Rights and Form

If you wish to appeal a decision made by BCBSND.

Continuity of Care application

Continuity of Care lets Medicaid Expansion members keep getting covered health care services for certain medical conditions from a provider who is not in the network.

Ask for a review to keep coverage for specific medical conditions from a non-network provider.

Fill out this application with your provider and send it back to BCBSND as soon as you can.

Grievance Form

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

Medicaid Expansion Restricted Use Drug List

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.

Coordinated Services Program

Coordinated Services Program (CSP) Provider Selection Form

Coordinated Services Program (CSP) Appeal Form

Quality Assessment Improvement Program

Quality Assessment and Improvement Program (QAPI) helps improve health care for Medicaid members in North Dakota.

Clinical Practice Guidelines

Resources that may help in making decisions about your care plan with your provider.