NextBlue expands Medicare Advantage in North Dakota

Over the past year, Beth West has seen something exciting happen across North Dakota.

She has seen doors open for NextBlue of North Dakota to expand across the state, bringing Medicare Advantage to areas that previously did not have the option.

NextBlue, an affiliate of Blue Cross Blue Shield North Dakota, started by serving five counties in the state in 2021, but the company’s map will look much different in 2022.

“We're very excited,” West, plan president of NextBlue in Fargo, N.D., told Prairie Business. “In 2021, our inaugural year, NextBlue entered five counties. We’ve worked diligently throughout the year to be able to expand our footprint for 2022, adding 35 other counties.”

Not bad, if she does say so herself.


The expansion is helped by adding participating providers to its network. Existing health systems in the NextBlue network include Essentia Health and Sanford Health, but now there will be the additions of Altru Health System and Trinity Health, among other critical access hospitals and rural health clinics.

What is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, combines traditional Medicare -- parts A and B -- into one plan with additional health-enhancing benefits. According to information from NextBlue, these plans fit the needs of seniors by offering low premiums and expanded benefits.

NextBlue expands Medicare Advantage in North Dakota

Plans often include coverage for prescription drugs, routine vision and eyewear coverage, dental coverage, hearing aids, fitness center memberships, over-the-counter medications and supplies, and clinical support.

The company said enrollment in Medicare Advantage plans is growing year over year.

According to the 2021 Deft Research Medicare Shopping and Switching Study, 42.5% of people nationwide who are Medicare eligible have chosen Medicare Advantage plans for their coverage. With the NextBlue expansion, it now will be available to 87% of North Dakotans eligible for Medicare.

Painting North Dakota in Blue

Increasing the number of counties served from five to 40 in a year’s time is not bad, but West would like to see the North Dakota map eventually covered in blue.


That means more work is in store for West and her team, but she says they are up for the challenge. She is trying to be patient.

“Medicare requires that a health plan meets network adequacy requirements,” she said. That means there has to be an available network “that is sufficient to ensure its membership has access to health care when they need it, and at a reasonable time and distance. That’s the standard. We have 13 counties that we're still working on in our network, building that out, and we hope to be able to expand it statewide in the future.”

West said she and her team have learned some things over the past year, primarily that underserved people in rural communities are excited to have more options with their health care insurance.

“We learned a lot about what's happening with health care costs in the state. We've learned that there is a lot of interest in Medicare Advantage in rural North Dakota,” she said.

“Historically, many (Medicare eligibles) of these counties have had very few options for their health care coverage. They've been very limited in that way. As we've started the enrollment period for 2022 in these expansion areas, it's been met with a lot of openness. People are signing up, they're very excited to learn more and know that they have new options.”