Noridian Medicare Insurance Review

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Contributor, Benzinga
August 9, 2022

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Policy Options

Coverage in all 50 states?No
# of plan options3

Noridian offers three plans in North Dakota: Medicare Advantage, Medicare Supplement plans and stand-alone prescription drug plans.

Medicare Advantage Plans

For its Medicare Advantage plans, Blue Cross Blue Shield of North Dakota uses the brand NextBlue of North Dakota. BCBSND's NextBlue of North Dakota Medicare Advantage PPO plans have two options:

  • NextBlue Classic PPO: Additional features and nationwide coverage for members who travel are included in NextBlue Classic PPO, a $0-premium plan.
  • NextBlue Premium PPO: In addition to prescription medication coverage, NextBlue Premium PPO offers hearing, vision, dental care and a range of other benefits.

Medicare Supplement Plans

Medicare Supplement plans provide benefits to supplement Original Medicare. These plans do not cover all the costs Original Medicare pays. The only difference between carriers is the cost of these plans and whether the insurer gives additional benefits or coverage. These plan are standard for all carriers.

A, G, C, F, L and N are the six Medicare Supplement plans offered by BCBSND. Those who were eligible for Medicare before the end of 2019 are eligible for Plan F, which provides the most coverage. While there are no differences in Medigap plan benefits, there may be differences in the cost of the plan and any additional advantages.

Stand-Alone Prescription Drug Plans

Medicare does not cover all of the costs of prescription drugs, which is where stand-alone prescription drug plans (PDP) come in. They are associated with Original Medicare Parts A and B and Medicare Supplement (Medigap) policies and provide no additional medical coverage or benefits.

MedicareBlue Rx PDPs are available to BCBSND members in two tiers: Standard and Premier. While most people take generics, the Premier plan is better suited to those who also take brand-name medications.

Even though both plans cover generic, brand-name and specialty drugs at a national network of pharmacies and both have deductibles, Standard has lower premiums but does have a deductible; Premier has higher premiums and no deductible, making it likely to be the better choice for people who take more prescribed medicines Chains like CVS and Walmart have lower copayments because they are preferred pharmacies. Prescriptions can be ordered through CVS Caremark and delivered to members' homes.

Customer Service

According to the National  Association of Insurance Commissioners (NAIC), in 2018 and 2020, BCBSND received no complaints about any of its insurance products. An overall complaint index of 0.08 was recorded in 2019 by BCBSND, which received four complaints. Of the four complaints, only one was related to the Medicare Supplement business line (with a complaint index of 0.03) while the other three were related to non-Medicare participants in the individual accident and health category.

BBB RatingA+
AM Best RatingNo Rating
NAIC Complaint Index0.08
Moody’s RatingN/A
J.D. Power RatingN/A

Pricing

NextBlue PPO and MedicareBlue Rx rates are included in the BCBSND Medicare Advantage PPO plan prices for 2022.

Prices for NextBlue Classic PPO are:

  • Prescription drug copays of $250 per year
  • $6,000 yearly deductible cap
  • Prescription drug copays of $250 per year
  • $20 copayments on basic care appointments; $40 copayments on specialist visits  
  • Telehealth visits starting with $0 copayments
  • Copayments on specialist visits begin at $2 per month

Prices for NextBlue Premium PPO:

  • $69 monthly fees
  • $200 in annual medication deductibles
  • $4,250 in annual out-of-pocket maximums
  • Zero primary care copays
  • Primary care copays are $25
  • Zero cost for telehealth visits
  • There is no initial fee for prescription medicine copayments.

You can use MedicareBlue Rx as part of your BCBSND PDP if you choose to have a standalone prescription drug plan (PDP).

Blue Cross/Blue Shield Rx Costs for a typical PDP include:

  • $66.40 per month
  • $0 annual deductible
  • Copayments of $1 to $29 for Tiers 1 through 3
  • Copyaments of $10 to $46 for Tiers 4 and 5

Tiers 4 and 5 are subject to copays of 31% with preferred pricing and 36% with standard pricing. 

Prices for a PDP with MedicareBlue Rx Premier are:

  • $0 deductible for all prescription plans' month
  • $0 copayments for Tiers 1 and 2 with preferred pricing, but there are fees of $15 for Tier 1 and $20 for Tier 2 with regular pricing (between 17% and 45% , depending on the drug tier and whether there is preferred or standard pricing)

Age, gender and other characteristics, such as smoking, influence the price of Medicare Supplement (Medigap).

Application Experience

Noridian's application process is simple.

Read and agree to the following terms and conditions and privacy statement on the Noridian Medicare portal homepage before clicking on "Start Registration."

The registration procedure consists of:

  • Enter personal information.
  • Log on to your account.
  • Answer security questions.
  • Confirm your account.
  • Complete registration.

Eligibility requirements for Medicare:

Before you may join a Medigap (Medicare Supplement) plan, you must enroll in Medicare Parts A and B. 

Open enrollment  for Medicare is from Oct. 15 to Dec. 7, but this is not the case for people looking for Medigap coverage. The six-month open enrollment period for a Medigap policy begins on the first day of the month after you reach 65 and are enrolled in Part B.

Your ability to get a Medigap policy beyond this time may be limited, and it may be more expensive. Although each state handles things differently, several states have additional open enrollment periods.

Note: If you enroll in a Medigap plan, it will automatically renew every year as long as you make your payments and the plan is still available. 

Claims Process

Noridian prides itself on effective claims management. Claims management and payment systems that are effective save government healthcare programs millions of dollars and improve patient satisfaction. With approximately 265 million healthcare claims processed annually, Noridian optimizes outdated systems to bring efficiency and transparency to the process.

Noridian offers:

  • Payment for claims
  • Payment disputes
  • Controlling documents
  • Validation of coding
  • Receipt of overpayments
  • Resolving payment issues
  • Exchange of electronic data (EDI)
  • Receipt imaging for inbound mail

Noridian vs. Competitors

When comparing Medicare providers, a few things make Noridian stand out including its pricing and large preferred provider network. Here is how Noridian stacks up against the competition.

  • Blue Cross Blue Shield Health Insurance
    More Details
    # of Healthcare Providers
    28k+
    Online Application?
    Yes
    securely through Blue Cross Blue Shield Health Insurance's website
    More Details
  • Sidecar Health Access Plan
    More Details
    # of Healthcare Providers
    See any doctor
    Online Application?
    Yes
    securely through Sidecar Health Access Plan's website
    More Details

    Plans referred to above are excepted benefit fixed indemnity insurance products marketed and administered by Sidecar Health Insurance Solutions, LLC and underwritten by Sirius America Insurance Company or United States Fire Insurance Company, depending on the state. As an excepted benefit plan, it does not provide comprehensive/major medical expenses coverage, minimum essential coverage, or essential health benefits. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such an excepted benefit fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. Coverage and plan options may vary or may not be available in all states.

  • Kaiser Permanente Health Insurance
    More Details
    # of Healthcare Providers
    150k+
    Online Application?
    Yes
  • UnitedHealthCare Health Insurance
    More Details
    # of Healthcare Providers
    855k+
    Online Application?
    Yes
  • Cigna Health Insurance
    More Details
    # of Healthcare Providers
    875k+
    Online Application?
    Yes

Overall Rating

North Dakota's Blue Cross and Blue Shield of North Dakota has been in business since 1940 and is the operating company of Noridian Insurance in the state. Nearly all of North Dakota's healthcare providers participate, and it includes the most basic aspects of the Medicare program. BCBSND is a good option for customers looking for a well-established local plan with extensive knowledge of Medicare processes.

Frequently Asked Questions

Q

What types of insurance does Noridian offer?

A

Health, dental and life insurance are all available through the company’s brands, including Blue Cross Blue Shield of North Dakota, which in 2012 had a 96% share of the state’s health insurance market.

Q

Am I automatically enrolled in Medicare?

A

Most people are automatically enrolled in Medicare when they turn 65 or begin collecting disability payments. Contact Social Security if you haven’t received an enrollment notice.