Broad Network Plans:
Small and Large Employers
Consider Your Health Insurance Options with Sanford Health Plan
With Sanford Health Plan, you have a partner and advocate for you and your health. We align with you and our providers to deliver a patient-centered plan that meets your needs for the right care and right health plan coverage. Sanford Health Plan has created these tools and resources to help make your navigation smooth, whether you are a current member or looking to join our integrated system of care.
Please follow these 4-simple steps that give you access to all the information you need to consider when choosing the right plan that fits your needs, lifestyle, and budget.
Step 1: Employee Decision Guide
Makes it easy to choose the right plan by putting everything you need to know about Sanford Health Plan in one place. Download the employee decision guide here.
Download the Guide
Step 2: Are Your Providers in The Network
Broad Network - Large Employers
Sanford Health Plan’s Signature Series broad network expands beyond the Sanford Health system for access to providers and facilities within the Sanford Health Plan service area. To receive in-network benefits, see providers in this directory. Prior authorization for certain services is still required, regardless of where you receive care.
If you or a dependent live outside of the Sanford Health Plan service area complete an Out-of-Area Form to request access to the nationwide network. If access is approved, nationwide network providers and facilities will process at the in-network benefit level.
Broad Network - Small Employers
Sanford Health Plan’s Simplicity broad network is grouped into two tiers. Member cost share (copayments, deductibles, and coinsurance) is based on the tier of the provider from whom they receive care. Tier 1 Preferred (which has the lowest member cost-share) includes our large care system of Sanford Health providers and facilities. Tier 2 Affiliated (which has a higher member cost-share) includes a broad network that expands beyond the Sanford Health system for providers and facilities within the Sanford Health Plan service area. To receive in-network benefits, see providers in this directory. Prior authorization for certain services is still required, regardless of where you receive care. If you or a dependent live outside of the Sanford Health Plan service area complete an Out-of-Area Form to request access to the nationwide network. If access is approved, nationwide network providers and facilities will process under Tier 2 benefits.
Sanford Health Plan Service Area
All counties in SD & ND, and approved counties in IA: Clay, Dickinson, Emmet, Ida, Lyon, O’Brien, Osceola, Plymouth, Sioux, and Woodbury. MN: Becker, Beltrami, Big Stone, Blue Earth, Brown, Chippewa, Clay, Clearwater, Cottonwood, Douglas, Grant, Hubbard, Jackson, Kandiyohi, Kittson, Lac Qui Parle, Lake of the Woods, Lincoln, Lyon, Mahnomen, Marshall, Martin, McLeod, Meeker, Murray, Nicollet, Nobles, Norman, Otter Tail, Pennington, Pipestone, Polk, Pope, Red Lake, Redwood, Renville, Rock, Roseau, Sibley, Stearns, Stevens, Swift, Traverse, Watonwan, Wilkin, and Yellow Medicine.
Step 3: Understand the Comprehensive Prescription Drug Coverage
At Sanford Health Plan, we want to match you to the prescription drugs that are most beneficial to your health. Refer to your employer plan documents to learn what formulary option is applicable to your coverage. A formulary includes information about which benefit tier would cover a particular medication. All plans offered by Sanford Health Plan offer the same pharmacy network.
- Explore Large Employer 3-Tier Formulary here
- Explore Large Employer 5-Tier Formulary here
- Explore ACA Small Employer Formulary here
High Deductible Health Plans (HSA)
If your employer offers an HSA, compare the costs of different prescription drugs using OptumRX. This pricing tool will help you estimate what you will pay for your prescriptions if you choose an HSA.
Step 4: Understand Your Preventive Health Coverage
Our top priority is the health and safety of our members. That is why all preventive care and screening services are covered at 100% under our plans if you are using an in-network provider. Follow our preventive health guidelines to take full advantage of these covered benefits at no cost to you – access here.
Download the Guidelines