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We're currently in a Special Enrollment Period

During open enrollment anyone can apply for coverage. But right now you can enroll only if you've had a qualifying life event — a big life-changing incident that impacts your previous health insurance coverage.

Get started on your application

$1250.50

2 Adults, 2 Dependents

Monthly Premium

Nov 1, 2020

Coverage Start Date

Subscriber Information

*Required Fields

We only offer coverage to residents of North Dakota. Call 800-280-2583 if you feel you qualify.

How Can We Contact You?

*Required Fields

We need documentation to support your qualifying life event

Max size for upload is 2MB. Acceptable file formats include: .pdf and image files.

    Mail Documentation

    Your application will not be completed until we receive your documentation. If you do not have it at this time, you may mail it to our Fargo Headquarters.

    Include the following:

    • Your full name
    • Reference: Member application

    Blue Cross Blue Shield of North Dakota
    Attn: Consumer Sales
    4510 13th Ave. S.
    Fargo, ND 58121


    Now, we need more details about your spouse and dependents

    BlueCare 70 2000

    $1250.50

    2 Adults, 2 Dependents

    Monthly Premium

    Nov 1, 2020

    Coverage Start Date

    Subscriber, Spouse and dependents

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    Subscriber signature

    Terms and Conditions

    I understand that any company(s) with which I am applying for coverage reserves the right to accept or decline this application in whole or in part. I further understand that no contractual right is created by this application or advance premium payment and the same shall not be considered accepted unless or until the Benefit Plan is issued to me.

    I have read this application in its entirety and understand and acknowledge that the accuracy and sufficiency of the information I provide (or fail to provide) in each and every section of this application serves as the basis in determining my eligibility (and the eligibility of my dependents) for coverage and receiving a Benefit Plan(s), and by signing this application I certify the information is accurate and complete. I understand and agree that inaccurate, incomplete, or omitted information represented in this application may constitute a fraudulent act or intentional misrepresentation of material facts voiding or retroactively cancelling any Benefit Plan(s) issued, as well as any claims for medical benefits and services paid, based on the information I submit through this application.

    I further understand a person who submits an application or files a claim with intend to defraud or helps commit a fraud against an insurer is guilty of a crime.

    I understand Members are subject to limitations and exclusions outlines in the relevant Benefit Plan or Policy.

    By checking this box, I understand I am creating an electronic signature that carries the same legal obligations as a written signature and am agreeing to all of the terms and conditions set forth within this application, including the Notification and Authorization.