Get a Quote and Apply–Special Enrollment

What is special enrollment?

Federal law allows people to enroll in a new health plan only during an open enrollment period.

Attention: Only agents that are currently appointed with BCBSND are authorized to submit applications. If you are not appointed or are unsure of your appointment status with BCBSND contact marketingsupportcoordinators@bcbsnd.com prior to submitting any applications.

Select a life event that most closely matches your situation.

On Exchange Plan Estimated Costs

An Advanced Premium Tax Credit does apply to plans below.

Coverage starting in for

Showing copay and high deductible plans for businesses in ##### with an effective date of August 4.

DakotaBlue | Altru is a plan built specifically to lower health care costs for members in your area.

DakotaBlue | Altru is not available in your county but there are many other great coverage options available to you with the available plans below.

Additional Plans

Back to Recommended Plans

BlueCare Gold 70 2000

$25 Primary Care Visit, $5 Value Based Drug List

Most Predictable Costs.

Apply Now
Plan Details Costs
Monthly Premium $2,000
DeductiblePreferred
Individual
$6,250
Family
$9,375
$2000
Out-of-Pocket Max
Individual
$6,250
Family
$9,375
$2000
Coinsurance
 $2,000
Plan Rating
Overall Rating: ()

Medical Care Rating: 2

Member Experience Rating: 5

Plan Administration Rating: 4

Overall Rating: 3
Preventive Visits
 $2,000
Plan Type
Easy Pricing
Doctor Visits
 $2,000
Telehealth Visits
 $2,000
Chiropractic Care, Physical, Speech and Occupational Therapy
 $2,000
Prescription Drugs
Value Drug: $5
Preventive Drug: $5
Generic: $5
Preferred Generic: $5
Non-Preferred Generic: $5
Brand: $5
Preferred Brand: $50
Non-Preferred Brand: $100
Specialty: $100
Preferred Specialty: 40% of total cost*
Non-Preferred Specialty: 50% of total cost*
N/A
Prescription Drugs Deductible
Individual: $5
Family: $5
Specialist Visits
 $2,000
Emergency Room Visit
 $2,000
Hospitalization
 $2,000
Hospitalization
$2,000

All cost sharing amounts apply to covered services you receive within the Preferred Blue PPO network. Covered services received out-of-network are paid at a lesser benefit or no benefit amount.

For a family plan, an individual on the plan must meet the individual deductible before coinsurance begins.

The BlueCare prescription drug coverage is considered creditable coverage.

Apply Now

Key Features

Additional Resources

Compare Plan Costs

Weigh the benefits and apply for your preferred plan.

Select up to 3 plans (0)

Off Exchange Plan Estimated Costs

An Advanced Premium Tax Credit does not apply to plans below.

Coverage starting in for

Showing copay and high deductible plans for businesses in ##### with an effective date of August 4.

DakotaBlue | Altru is a plan built specifically to lower health care costs for members in your area.

DakotaBlue | Altru is not available in your county but there are many other great coverage options available to you with the available plans below.

Additional Plans

Back to Recommended Plans

BlueCare Gold 70 2000

$25 Primary Care Visit, $5 Value Based Drug List

Most Predictable Costs.

Apply Now
Plan Details Costs
Monthly Premium $2,000
DeductiblePreferred
Individual
$6,250
Family
$9,375
$2000
Out-of-Pocket Max
Individual
$6,250
Family
$9,375
$2000
Coinsurance
 $2,000
Plan Rating
Overall Rating: ()

Medical Care Rating: 2

Member Experience Rating: 5

Plan Administration Rating: 4

Overall Rating: 3
Preventive Visits
 $2,000
Plan Type
Easy Pricing
Doctor Visits
 $2,000
Telehealth Visits
 $2,000
Chiropractic Care, Physical, Speech and Occupational Therapy
 $2,000
Prescription Drugs
Value Drug: $5
Preventive Drug: $5
Generic: $5
Preferred Generic: $5
Non-Preferred Generic: $5
Brand: $5
Preferred Brand: $50
Non-Preferred Brand: $100
Specialty: $100
Preferred Specialty: 40% of total cost*
Non-Preferred Specialty: 50% of total cost*
N/A
Prescription Drugs Deductible
Individual: $5
Family: $5
Specialist Visits
 $2,000
Emergency Room Visit
 $2,000
Hospitalization
 $2,000
Hospitalization
$2,000

All cost sharing amounts apply to covered services you receive within the Preferred Blue PPO network. Covered services received out-of-network are paid at a lesser benefit or no benefit amount.

For a family plan, an individual on the plan must meet the individual deductible before coinsurance begins.

The BlueCare prescription drug coverage is considered creditable coverage.

Apply Now

Key Features

Additional Resources

Compare Plan Costs

Weigh the benefits and apply for your preferred plan.

Select up to 3 plans (0)

Get started on your application

BlueCare 70 2000

$25 Primary Care Visit, $5 Value Based Drug List

Change Plan

$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

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We need documentation to support your qualifying life event

Max size for upload is 10MB. 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

    $25 Primary Care Visit, $5 Value Based Drug List

    $1250.50

    2 Adults, 2 Dependents

    Monthly Premium

    Nov 1, 2020

    Coverage Start Date

    Start

    Start
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    Subscriber, Spouse and dependents

    Subscriber
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    Dependent
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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.

    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.

    Agent Signature

    Note: Include leading zeros in BCBSND Agent Number and BCBSND Agency Number.

    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.

    I am submitting this application on behalf of the individual signee. I have received verbal or written consent from the individual to submit the application. The application accurately reflects the information provided. I have printed a copy of the application and provided it to the individual signee.

    Print this page
    Print this page for your records before submitting the application.