Medical and Retail Benefit Drug Policy Updates

Blue Cross Blue Shield of North Dakota is committed to providing members with access to high-quality healthcare consistent with evidence-based, nationally recognized clinical criteria and guidelines. To ensure value to our members, we're changing the way we manage certain medical and retail benefit drugs. 

How It Works

1. Ask for the member’s current ID card at each visit. 

• Throughout 2027, commercial members will receive new member ID cards with updated member information as their health plans renew and their information is migrated. Use the newest member ID card in 2027. Do not rely on a card saved from a previous visit. Note: Do not use a 2027 migrated member card for dates of service in 2026.
• Migrated members will have new information, such as shorter member ID numbers (9 digits instead of 12 digits after the prefix) and Customer Service phone numbers. 

2. Verify eligibility and benefits before services are provided. 

• Continue to use Availity Essentials to verify eligibility. Eligibility verification is the best way to confirm the member’s current coverage and determine which policies or processes apply. 
  • If the member is non-migrated, providers should continue to access policy and prior authorization workflows as they do today. 
  • If the member has migrated, providers can access medical and retail benefit policies starting Jan. 1, 2027. For a summary of updates, refer to the below information.