Advocating for Members with Special Circumstances
Once the initial shock wears off, the challenges of a being diagnosed with a critical medical condition can be overwhelming. What are your choices? What's covered? What's next?
Through Member Advocacy, a personal advocate can help walk you through this difficult time with help in:
- Obtaining pre-authorizations and prior approvals
- Understanding medical jargon
- Navigating health care networks and managing physician referrals
- Walking through medical bills and Explanations of Benefits (EOBs)
- Speaking to medical staff with you, or on your behalf
- Suggest community resources for services not covered by insurance
- And more
If all that seems beyond the scope of services you would normally expect from an insurance company, that's because it is. We're here to remove barriers to health care and vow to be creative and caring in doing so.
Member Advocacy is available at no extra cost to BCBSND members who qualify.
Who Can Participate?
Those going through life altering medical conditions are eligible for member advocacy. Examples of conditions that qualify for member advocacy include:
- Are born severely premature
- Have congenital defects
- Have pediatric cancer
- Experience a traumatic injury
- Undergo a transplant
Additional cases are considered on an individual basis.
Know Someone Who Would Benefit From This Program?
If you, or someone you know, may be a candidate for Member Advocacy, please contact an advocate at 877-528-5140 or firstname.lastname@example.org. There's no need to include personal health information in your email message, we'll contact you for that information.
Meet the Hagers from Fergus Falls, MN:
Born in 2015 with a rare disease, congenital anomalies and pulmonary disease, with asthma, epilepsy and seizures, Anna Jo Hager and her mom and dad, Jennifer and Royce, rely on Blue Cross Blue Shield of North Dakota as they navigate the health care system--and travel the United States.
With Anna Jo's care requiring regular travel to out-of-state specialists, our Member Advocacy team helps them navigate the bills and secure equipment they need to provide Anna with the best quality of life possible.
BCBSND helps Jennifer and Royce share more meaningful experiences with their daughter through travel in their RV. As they explore the country with their daughter, they plan ahead to make sure they know where the best care facilities and hospitals are along their route. Their coverage—and peace of mind—follow them everywhere, giving them the freedom to enjoy quality time with Anna Jo.