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Medicaid Expansion

Access to the expanded Medicaid Program for North Dakotans

North Dakota has expanded access to Medicaid to cover more individuals.

Why Medicaid Expansion?

Expansion of Medicaid gives more individuals the opportunity to have affordable coverage, preventive services and greater economic security in the event of accidents or illness. We are building on the success of Medicaid to make health care coverage more accessible for North Dakotans.

Do You Qualify?

The expanded Medicaid program is available to individuals between 19-65 with household incomes up to 138% of the federal poverty level (FPL). Individuals eligible for Medicare or Supplemental Security Income (SSI) are not eligible for coverage under Medicaid expansion. If your household’s annual income is equal to or lower than the figures below, you will probably qualify for Medicaid.

1-person
2-people
3-people
4-people
5-people
6-people
7-people
8-people
$16,105
$21,707
$27,310
$32,913
$38,516
$44,119
$49,721
$55,324
For households with more than 8 people, add $5,603 for each additional person.

How to Apply for the Medicaid Expansion

Go to http://apply.dhs.nd.gov to apply for Medicaid coverage.

Individuals can also apply by submitting a paper application by telephone (855) 794-7308 or ND Relay TTY 1-800-366-6888 (for people with hearing impairments), mail, or in-person at their county social service office.

If an individual does not qualify for Medicaid, the individual can explore whether he or she may qualify federal health insurance marketplace coverage at www.healthcare.gov. The next open enrollment period is Nov. 15, 2014 to Jan. 15, 2015.

Medicaid Expansion Coverage

  • North Dakota’s Medicaid Expansion coverage is provided by Sanford Health Plan.
  • People who have been notified that they qualify for North Dakota Medicaid Expansion coverage, can get plan information at http://sanfordhealthplan.org/shopsanfordhealthplan/medicaid/ndmedicaidexpansion, or by contacting Sanford Health Plan Member Services at memberservices@sanfordhealth.org or toll-free (855) 305-5060 / TTY (877) 652-1844.

    Member Services can assist with questions about:

    • Benefits
    • Claims
    • How to find a provider
    • How to file a complaint
    • How to order ID cards

Pharmacy and Prescription Drug Coverage

  • What drugs are covered?
  • Email um@sanfordhealth.org or call toll-free (855) 276-7214 - Select option 1

Medical Management

  • How do I get prior-approval of health care services?
  • Email um@sanfordhealth.org or call toll-free (855) 276-7214 - Select option 2
Note: Sending an email to this Sanford Health Plan email address is not a secure form of communication. There is some risk that confidential information sent in an email may be misdirected, disclosed to or intercepted by, unauthorized third parties. To protect privacy, members or visitors concerned about security of email communications should call the numbers listed above. If you choose to send an email, you consent and accept the risk of transmitting confidential information via unencrypted email.

The Health Insurance Marketplace

As of January 2014, most Americans will be required to have health insurance. If individuals do not qualify for Medicaid, they may be able to research and buy health insurance through the federal government’s Health Insurance Marketplace at www.healthcare.gov or by calling the federal help line at 1-800-318-2596 (TTY Users Call: 1-855-889-4325) during open enrollment periods. The online federal Marketplace has information about private health insurance choices and tax subsidies.

Resources

Medicaid Expansion Brochure (1.29 MB pdf)

General Information Flyer (116kb pdf)

Information Flyer for American Indians (244kb pdf)

Poster - general population (1249kb pdf)

Poster - American Indian audience (1077kb pdf)

30 Second Television Public Service Announcement (Posted 1/2/2014) (27Mb .MOV) - May be a short delay before this plays

30 Second Radio Public Service Announcement (Posted 1/2/2014) (501kb MP3)

60 Second Television Public Service Announcement (Posted 1/2/2014) (50Mb .MOV) - May be a short delay before this plays

60 Second Radio Public Service Announcement (Posted 1/2/2014) (944kb MP3)

Drop-in Newsletter Article

Center for Consumer Information and Insurance Oversight (CCIIO) - State Planning and Establishment Grant Information

For questions about the Medicaid Expansion, contact:

Medical Service Division
North Dakota Department of Human Services
600 East Boulevard Avenue, Dept. 325
Bismarck, ND 58505-0250
Call: (701) 328-2321
Toll-free: (877) 543-7669
ND Relay TTY: (800) 366-6888
E-mail: dhsmed@nd.gov

 

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