Welcome to our ND Medicaid Member E-Newsletter
Get the most from ND Medicaid! Find program updates, seasonal reminders for staying healthy, resources for help and more! Together, we can make North Dakota the healthiest state in the nation!
This month’s issue will help you stay healthy and manage your health care this winter.
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Make sure your medical bills are paid
Your health care providers and ND Medicaid must have all your health care coverage information. Health care providers include your pharmacies and health care facilities.
ND Medicaid and other health care coverage
Some of our members have more than one source of health care coverage. If you have other health insurance and ND Medicaid coverage, both parties work together to cover your medical costs. When your health care providers and ND Medicaid don’t know about your other health insurance, certain billing errors can happen. You must tell all your health care providers and ND Medicaid about all active health insurance you have. You must also let your health care providers and ND Medicaid know when your other health insurance ends. When this happens, you need to send ND Medicaid a document from your other health insurance company stating the dates your coverage ended.
Client share
Some of our members have a recipient liability or a client share. This means that the member must help pay their medical costs. Your client share is the amount of health care costs that you are responsible for paying. You must pay your client share amount every month before ND Medicaid starts covering the remaining costs.
You can learn more about your costs and member responsibilities in the “Understanding Cost” and “Your Responsibilities” chapters of the Medicaid Member Handbook.
If you have any questions or concerns, contact the Customer Support Center, Monday-Friday, 8 a.m. – 5 p.m. CT:
- Phone: (866) 614-6005 or (701) 328-1000
- TTY: 711
- Free translation is available
- Fax: (701) 328-1006
- Mail: Customer Support Center
P.O. Box 5562
Bismarck ND, 58506 - Email: applyforhelp@nd.gov
- In person: Visit a human service zone office. Find a human service zone office near you.
Best practices for therapy appointments
Each calendar year, our members can have one evaluation for each: physical, occupational and speech therapy.
A therapy evaluation is the first appointment where your therapist reviews your condition and makes a plan to treat you. Your health care provider will order your therapy evaluation. Evaluations must be done by the therapist or facility you will see for your full treatment plan. Consider requesting a therapist or facility that is located near you, so you don’t miss appointments.
You should not have more than one evaluation for the same condition. If you feel you need another evaluation or a different therapist, you should talk to the provider who ordered your evaluation. You may not get a new evaluation approved if you have missed appointments or failed to follow your current treatment plan.
Evaluations are just the beginning of your treatment. Your full treatment plan may include more appointments and a home exercise program. You should attend all the appointments your therapist recommends. You should follow all your therapist’s instructions for activities to do at home that support your therapy. Ending your treatment plan early because you start feeling better may result in your symptoms returning because you weren’t fully treated.
Community health worker services now covered
Now, you can get covered services from a community health worker (CHW). CHWs work with members who have chronic health conditions, are at risk of or already have a chronic health condition or have documented barriers to getting regular health care.
CHWs work with you to slow the development of and manage your chronic health condition. Your CHW can help you better understand your health through coaching, education and training. They can help you use preventive health care practices instead of emergency health care services. They can connect you to health care systems and social service resources.
CHWs can offer services in health care clinics, community settings, through telehealth or in your home. CHWs are supervised by a doctor, dentist, pharmacist or other licensed practitioners.
For more information on whether there is a CHW in your area, check in with your provider. If there is a CHW working near you, your provider can put in a referral to get you started with a CHW.
Human service centers become behavioral health clinics
North Dakota Health and Human Services has renamed the state’s regional human service centers. They are now called regional behavioral health clinics. This name better reflects the behavioral health care and supports they offer.
The clinics continue to offer therapy, case management, medication support, substance use treatment, walk-in assessments and 24/7 crisis care. There are no changes to locations or hours. You can learn more about these changes!
Prior authorization updates
A prior authorization (PA) is the process of approval for medication costs to be covered.
As of January 1, 2026, a PA is required for generic liraglutide. If you use this product, you may have to switch to a similar medication, either Ozempic or Rybelsus.
You can see if Medicaid covers your medications with our look-up tool. If these changes affect you, visit with your doctor or pharmacist so they can work with us and make sure you get the medications you need!
Take charge of your coverage with the SSP
The Self-Service Portal (SSP) is your online space to apply for assistance, complete a review, update your information, view details about your case, report changes, upload documents, and view notices.
You will need your client ID number to log in. You can find this by calling our Customer Support Center, Monday-Friday, 8 a.m. – 5 p.m. CT:
- Email: applyforhelp@nd.gov
- Phone: (866) 614-6005 or (701) 328-1000
- TTY: 711
- Free translation is available
- Fax: (701) 328-1006
- Mail: Customer Support Center
P.O. Box 5562
Bismarck, ND 58506 - In person: Visit a human service zone office. Find a human service zone office near you.
Winter prep: coats, mittens, vaccines, go
Flu and other respiratory viruses circulate in the winter. Vaccines are the best way to keep you from getting sick from serious respiratory viruses. Those most at risk include children ages 5 and younger, pregnant women, older adults and those with underlying health conditions.
Be prepared by getting your seasonal respiratory immunizations. It's not too late. Your trusted clinic or pharmacy can get you up to date on your immunizations.
Know which immunizations are suggested at different ages. You can also check with your family’s health care provider.
Check your family’s immunization records online. You can also check with your local public health unit or your health care provider.
Pre-plan when you can 
Pre-planning your health care appointments can make all the difference in your treatment experience.
We've got some great tips for working with your health care professionals and how to know where to go for treatment!
Pre-planning your health care appointments can make all the difference in your treatment experience.
Cancel appointments as soon as you know you can’t attend:
When you can’t attend your appointment, cancel and/or reschedule.
Pre-plan your health care:
Schedule health care appointments ahead of time. Schedule summer child wellness checks and combine them with sports physicals!
Ask about your Medicaid coverage:
Ask your provider if Medicaid will cover your medical care. Review our Medicaid Member Handbook to learn more about your coverage.
Know where to go for treatment:
- Provider’s office
- For services like: Wellness checks, counseling, vaccines, non-emergent concerns, manageable pain
- Wait: You will have less wait time at the office because you have an appointment
- Cost: Less costly for members with recipient liability
- Urgent care clinic
- For services like: Unmanageable pain or illness, a worsening condition, minor injuries
- Wait: Wait times vary depending on how many patients need to be seen
- Cost: Moderate cost for members with recipient liability
- Emergency room (ER)
- For services like: Life-threatening conditions, uncontrolled bleeding, extreme fever, severe cuts, difficulty breathing, broken bones
- Wait: Wait times can be lengthy depending on how many patients are at the ER
- Cost: Most costly for members with recipient liability
Want to connect about member engagement?
Hey there! I’m Jen Sheppard, ND Medicaid’s Member Liaison. I work with the Medicaid Member Engagement Committee (MMEC), Medicaid Member E-News, our member engagement webpage, and more. You can connect with me for questions, concerns, or ideas about member engagement at medicaidmembers@nd.gov
Visit the Medicaid Member Engagement webpage.