Welcome Members

Get connected to your health with the MySanfordHealthPlan member portal.

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Sanford Health Member Portal

Your MySanfordHealthPlan member portal-  NOW in MyChart, makes managing your health care easier than ever!

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Request an ID Card

Access Wellness Tools

Check Benefit Balances

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Member resources

Understanding Your EOB

Knowing how to read an Explanation of Benefits (EOB) is helpful to understanding your health insurance.

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My rights

You have rights, and we  are committed to resolving your concerns if an issue arises.

 

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Prior authorization

 Learn more about the prior authorization process and what services require prior authorization.

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Pharmacy information

 Learn more about pharmacy benefits and details on medication policies, coverage, participating pharmacies, and more.

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Members FAQs

What pharmacies can I use to fill my prescriptions?

Pharmacies that have contracted with OptumRx, on behalf of Sanford Health Plan are considered to be participating pharmacies. You can find a listing of participating pharmacies. If you choose to go to a non-participating pharmacy, you will have to pay full-price for the prescription, rather than your copay.

How do I know what expenses my HSA or FSA covers?

When you participate in a Health Savings Account (HSA) and/or Flexible Spending Account (FSA), you’re able to contribute pre-tax funds for use on hundreds of eligible expenses. Recently, you gained even more flexibility in your ability to save when the CARES Act was signed into law.

This new legislation expanded the list of expenses that are considered eligible by including popular over-the-counter products, which consumers can now purchase with their HSA or FSA without a prescription. This change went into effect on January 1, 2020, and allows over 20,000 new expenses as eligible moving forward. That’s great news for consumers, since the average American shops for over-the-counter medications 26 times each year. For more information, click here.


What if I need to see a specialist?

Sanford Health Plan does not require a referral from your primary care physician to see a specialist who is in the network. If the specialist is NOT a participating provider, you must contact Sanford Health Plan to request authorization. If authorization is received, your benefits will be considered In-Network. Failure to obtain prior authorization may result in reduced coverage to the specialty services.

What if there aren't participating providers in my residential area?

Sanford Health Plan has contracted with other networks for those members who reside, travel or attend school outside the Sanford Health Plan service area.  If you have an additional network listed on your identification card, you may seek medical care from a provider that is participating with the additional network.  If these additional networks do not provide you with access to a needed provider, the Sanford Health Plan Access and Availability rules will apply.  Please refer to your Policy for details.  You can find the links to the additional networks available to you here or by calling Member Services at 1-800-752-5863.  If you have questions or do not have access to our website and would like to request a printed provider Directory, please call Member Services. IMPORTANT:  If you choose to go to a non-participating provider when in network access is available, your claims will be paid according to your out-of-network benefits.

What does all of the information on the front and back of my ID care mean?

Always remember, the identification card is to be used only by the person listed on the card. It may not be used by anyone else. Use of your card by another person is fraud and will be grounds for termination from the Plan. Should you need to replace a lost card, please call the Customer Service Department at (605) 328-6800, (800) 752-5863, or TTY/TDD (877) 652-1844 and we will send you a new one.

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