Common member questions

Online: Pay your bill on the online Member Services portal. Choose the Pay Premium link.

By phone: Follow the payment and billing prompts on the automated phone system at 844-363-8457.

BCBSND providers will file claims on your behalf. If you receive care outside of the BCBSND doctor network and need to file your own claim, use the Member Submitted Claim form.

Read the "Making Sense of Your EOB" article here .

No. It details how your claim was processed—the portion of the charge paid by BCBSND on your behalf and the portion that is your responsibility. The bill for your portion comes from your provider.

Open enrollment for the upcoming year is typically from early November through mid-December. Outside of the open enrollment period, enrollment is limited to those with special life circumstances.

Some households qualify for Advanced Premium Tax Credits to help pay the monthly insurance premium. See if you qualify.

With a high deductible health plan, also known as a consumer directed plan, you pay a lower monthly premium cost, but more for your medical costs, at least until you’ve met your deductible.

With a high deductible plan, you pay for your care until you meet your deductible. Most often, people pay those expenses from a special tax-free savings account called an HSA. Once you meet your deductible, the insurance plan kicks in and shares the cost.

The exception is preventive services and wellness benefits, which are covered from the start, with no copays.

Once logged in to online Member Services, go to Account Settings and follow the prompts to change your password.

Access the forgot password page and follow the prompts for information. Be sure to have your member identification information available.

Access the forgot password page and follow the prompts for information. Be sure to have your member identification information available.

Once logged in to online Member Services, go to Account Settings and follow the prompts to change your security questions.

No. Access to online Member Services is available only while your BCBSND health insurance plan is active. You can call us to help you with any questions.

Log in to the online Member Services portal and choose the wellness tab. After you complete the annual Authorization for Release of Information - Wellness Programs, you’ll have access to HealthyBlue anytime, 24/7.

Learn more about how you can use HealthyBlue

Call the number on the back of your BCBSND member ID card if you’ve not received your cash card after three weeks after redemption.

Present your BCBSND card to a participating health club and fill out the enrollment form. Learn more about setting up and using HCC.

Check with your health club or online at nihcarewards.org.

Common reasons for not receiving your credit include misspelled names, incorrect date of birth, failure to meet minimum visit criteria and no completed authorization on file.

Visit www.silversneakers.com to check your eligibility and print your SilverSneakers member ID. If the site doesn’t recognize you, call the number on the back of your BCBSND member ID card.

Please note: The earliest the SilverSneakers site will recognize newly eligible members is the first Friday after your health plan coverage is effective.

Your deductible is the amount you owe for health care services before your insurance begins to contribute. After you have met your deductible, you and your insurance company will share the cost of covered services.

Check out this article to learn more about health insurance terminology. 

It’s a specified amount you pay for each covered health care service—things like prescription refills, physical therapy appointments or a visit to the emergency room. Providers may request payment of the copayment amount at the time of service.

Check out this article to learn more about health insurance terminology. 

Some of the services covered by your plan may require that you pay a percentage of the cost (coinsurance) instead of a set fee (copay). In most situations, your deductible must be met before coinsurance will apply.

Check out this article to learn more about health insurance terminology. 

There’s an upper limit to what you’ll contribute each year known as your out-of-pocket-maximum. After you’ve met that amount, your health insurance policy will pay 100% of the allowed amounts on your behalf.

Check out this article to learn more about health insurance terminology. 

A BCBSND provider requests authorization for you to receive care from a provider who is not part of your chosen network. You will need to work with your provider to initiate the referral process.

Check the listing of services that require precertification. 

Find medical policies here. 

Find common forms here. 

When you disagree with the claim determination you can submit an official inquiry.

There are two major types of appeals—preservice or post service. An appeal can be verbal or written.

Verbal appeals: call 844-363-8457

Written appeal: use this form and mail or fax to:

Fax: 701-277-2209
Mail: Blue Cross Blue Shield of North Dakota, P.O. Box 1570, Fargo, ND 58107-1570

The formulary is a list of drugs proven to be safe, therapeutically effective, high quality and cost effective, as determined by a committee of physicians and pharmacists. Formulary drugs are covered at the highest benefit level.

A non-formulary drug is a drug that is not included on the formulary listing.

A brand name drug is the registered trademark name given to a prescription medication by its manufacturer. Generics are lower-cost alternatives developed after the original drug’s patent has ended. Brand name and generics are the same in dosage, safety, effectiveness, strength, stability, quality and delivery system.

BCBSND participating pharmacies will submit medication claims on your behalf. For medications purchased outside the network, complete a Pharmacy Member Submitted Claim form.