Welcome to our ND Medicaid Member E-Newsletter
Get the most from ND Medicaid by reading about our program updates, seasonal reminders for staying healthy, resources for help, and more! Together, we can make North Dakota the healthiest state in the nation!
Welcome to the new year and if you just moved here, welcome to North Dakota!
Are you looking for care in your area for behavioral health, dental, vision, diabetes, wellness checks, and more? January’s issue offers new-year reminders and shares various options for health care in North Dakota.
We need your updates!
Have you moved, changed your phone number, or had a change in your employment or household size?
- It is important to let us know and send us proof of these changes. You can report changes or get help by contacting the Customer Support Center.
- Check your mail and read letters from ND Medicaid. There may be very important information included that can keep your coverage active.
- Complete any forms we send you right away and send them back. We understand forms can get lost or forgotten. Taking care of them right away gets it off your mind!
Customer Support Center:
- Toll-Free: (866) 614-6005
- 711 (TTY)
- Email: Applyforhelp@nd.gov
- Fax: (701) 328-1006
- Mail: Customer Support Center
PO Box 5562
Bismarck ND 58506
Coverage changes for diabetes supplies
Tubeless insulin pump coverage for Type 2 diabetes:
We cover the tubeless insulin pump, Omnipod, for people with Type 1 diabetes. Starting Jan. 1, 2025, if you have Type 2 diabetes, Omnipod may be covered for you if you are on an insulin pump or if you need multiple shots of insulin in a day. You should talk to your provider to see if this is an option for you.
New continuous glucose monitor coverage:
We cover the Continuous Glucose Monitor (CGM), Dexcom. This CGM works with most insulin pumps, but not Medtronic insulin pumps.
As of Oct. 1, 2024, we may be able to pay for the Guardian CGM that works with the Medtronic insulin pump. Talk to your doctor about the Guardian CGM if:
- You have a Medtronic insulin pump and need a CGM that works with your insulin pump; and
- You have had the Medtronic pump for more than a year; or
- Had a Medtronic insulin pump since before you were on Medicaid.
Coverage changes for diabetes supplies:
Starting Jan. 1, 2025, we are changing which brands we will cover for blood glucose test strips, insulin syringes, and pen needles for diabetes. If you use these products, you may have to switch brands.
Please work with your doctor or pharmacist if you must change brands or need help learning how to use the new brand of diabetic supplies.
Workers with Disabilities program
Workers with Disabilities Medicaid coverage allows some members to work or increase their earnings without fear of losing their Medicaid coverage.
The program provides coverage through Medicaid, including dental and mental health coverage. This program requires the member to pay a premium. You can apply at a human service zone office.
Don’t lose your benefits!
Already on the Workers with Disabilities program? Get your requirements processed on time by:
- Submitting income/paystubs by the 5th of each month as premiums will be figured correctly and timely.
- Make your premium payment by the 15th of each month (does not apply to Native American members).
- Return the portion of your notice that includes your client ID number when sending in payments.
- Write your client ID number in the “memo” section of your check.
Learn more about the Workers with Disabilities program.
Medication coverage updates
A prior authorization (PA) is a process of approval for medication costs to be covered. The need for a PA is changing for some medications. There may be other medication options for you.
Review the following changes and work with your doctor or pharmacist if these changes affect you.
Starting Jan. 1, 2025:
The migraine medication, Sumatriptan for nasal and injectable use requires PA. If you use these products, you may have to switch to a medication that you take by mouth.
The high cholesterol medication, Praluent will require PA. If you use this product, you may have to switch to a similar medication called Repatha.
The Attention Deficit Hyperactivity Disorder (ADHD) stimulants, Jornay PM, Aptensio XR, and amphetamine non-solid dosage forms (liquid, chewable tablets, dissolvable tablets, patches) will require PA. If you use these products, you may have to switch to a similar medication. All ADHD stimulants for children under six years old will require PA. Your doctor can discuss ways to help ADHD without medication and decide if medication is still needed.
Durable Medical Equipment survey
Durable Medical Equipment (DME) helps you in your activities of daily living. DME may be incontinence products, wound care supplies, or mobility devices.
If you struggle with walking, dressing, bathing, or eating, DME can help you prevent injury, recover from surgery, and improve your independence.
If you, or someone you know could benefit from DME, talk to your health care, urgent care, or ER provider. They can help get the right DME for you.
We want to know what you know about Medicaid coverage for DME. You may see a survey about DME in your mail or email this month. Taking this survey helps us better serve our ND Medicaid members!
If you have questions or concerns about DME, contact the DME Administrator, Tammy Holm at:
- (701) 328-2764
- TTY: 771
- Email: tamholm@nd.gov
What is a community health center and how do I find one?
Community Health Centers (CHC) provide care to rural and urban communities.
CHCs have services that promote health, diagnose and treat disease, and manage diabetes and other chronic conditions. CHCs offer dental, medical, behavioral health, vision, and other health care services.
North Dakota CHCs have 22 delivery sites in 20 communities.
What is a rural health clinic and how do I find one?
Rural health clinics (RHC) offer health care services to communities that cannot easily access hospitals and provider offices because of location.
Your RHC may offer immunizations and primary care services through clinic visits, virtual appointments, residential facility visits, or home visits.
What is a local public health unit and how do I find one?
Local public health units (LPHU) offer a variety of services like health screenings, immunizations for adults and children and ND Medicaid Health Tracks well-child checks.
Other common services offered by local public health teams include tobacco prevention and control, home health visits, vital sign checks, Naloxone supplies, medication management, and diabetes prevention. There are 28 LPHUs throughout North Dakota. Services vary by LPHU and are based on local needs.
What is a human service center and how do I find one?
Regional human service centers (HSC) provide services for behavioral health and substance use disorders.
Your HSC may offer medication management, group and individual therapy, assessments, and more. HSCs offer walk-in clinic hours and appointments. HSCs are a gateway to home and community-based services in your area. North Dakota Health and Human Services has eight HSCs located in major cities throughout North Dakota
What is an IHS/Tribal facility and how do I find one?
Indian Health Services (IHS) is a federal agency that is responsible for American Indian and Alaskan Native health care. IHS is also a health care provider.
IHS/Tribal health care facilities are specifically designed to offer a range of health care services to their tribal members, while working with Medicaid.
Your IHS/Tribal facility may offer basic health care, dental, vision, diabetes management, podiatry, behavioral health, and other services. You can find IHS facilities at each of the five tribal nations in North Dakota. Some tribes may also offer services in locations outside of tribal lands.
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
