NextBlue of North Dakota expands Medicare Advantage plans, receives high national rating

By Andrew Weeks

NextBlue of North Dakota continues to color the state in blue with its Medicare Advantage plans.

Beginning in January, the plans will be available in 52 of North Dakota’s 53 counties. That means MA coverage for more North Dakotans.

NextBlue, an affiliate of Blue Cross Blue Shield of North Dakota, offers one comprehensive, easy-to-use plan made specifically for North Dakotans, according to company President Beth West.

NextBlue plans combine Original Medicare Part A and B coverage with prescription drug coverage (Part D), along with extra benefits not covered by traditional Medicare, such as routine vision and eyewear coverage, dental coverage, hearing aids, fitness center memberships, over-the-counter medications/supplies, and clinical support.

The process of getting counties onboard involves a number of efforts, West said, among them working with network providers to “make sure (members) get the care they need in the areas in which they reside and … even nationally as they travel or have a need to go somewhere else.”

She aid, “We’re required to meet what is called network adequacy standards or standards through Medicare, and so we work with providers to contract for our members,” noting “there are time and distance requirements.”

A county must have a certain number of hospitals or health systems to meet the standard. “So that’s what we’ve been working on,” she said.

“Our first year, the pandemic hit and so we were a little slow out of the gate with that provider network build-out, because the providers were very busy taking care of patients during the pandemic,” West said. “Now that we’re out of that, in some way, we’ve been able to build out our provider network across the state. We pretty much are statewide now, but we have one county that we’re still working on.”

That county is Stark, in the southwest portion of the state, which West said will eventually get on board. The plan going forward, she said, is “continued expansion and growth.”

NextBlue’s health network includes most major health systems such as Altru Health System, Essentia Health, Sanford Health and Trinity Health, but also a number of critical access hospitals and providers throughout the state. Members also have access to the national BCBS provider network.

More news with NextBlue, it recently received a star rating of 4.5 from the Centers for Medicare & Medicaid Services, which rates MA plans on a scale of one to five stars.

Not a bad rating, West said, especially considering this was the company’s first eligible year to receive the independent rating. She said star ratings are an important factor for beneficiaries to review as they consider Medicare coverage options.

“We are really excited about the four and a half stars. That’s a major accomplishment,” she said. “I think it’s a testament to a lot of different things that we’re doing.”