Helpful Resources
Download, view and print documents you may need to manage your plan.
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.
Coordinated Services Program
Call 833-777-5779 to request a paper copy of these documents.
Non-Discrimination Statement
Health care fraud
Find answers to some common questions. Or, visit our Contact page and get in touch with Member Services.