Blue Cross NC Continues to Offer ACA Plans in 2017

In September, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced our commitment to offer Affordable Care Act (ACA) plans in all 100 North Carolina counties in 2017. We made this decision to help ensure ACA plans continue to be available to all North Carolinians, including those who purchase coverage through the Federal Health Insurance Exchange (Marketplace).

Since we are the only health insurer choosing to stay in all 100 NC counties, we need your help, now more than ever! Given the tremendous challenges we face due to the addition of approximately 260,000 new members from United Healthcare (UHC) and Aetna, we’re asking providers to help prepare their patients for transitioning insurance coverage. Starting today, we will publish a series of articles about how we can work together to make the 2017 Annual Enrollment Period (AEP) as smooth as possible.

During October and November, please do the following:

• Instruct your patients to log in to HealthCare.gov in early November to pick health plans that include their doctors. Please remind them to pay their binder payments so they’ll have continuous coverage and access to services.
• Remind patients that Blue Cross NC drug formularies might be different than their current UHC and Aetna formularies, and suggest they review plan formularies before choosing new plans.

Other things to consider:

• When seeing your patients through the end of 2016, please make sure they have refills on medications so there is no delay or lapse in availability.
• Review medications with your UHC and Aetna patients to determine if they might need prior approval authorizations from Blue Cross NC when they switch to Blue Cross NC plans.
• As patients switch from UHC and Aetna plans, please be prepared to complete the necessary prior approval forms and CoverMyMeds drug authorization requests the first two weeks of January.
• Review any ongoing courses of treatment for your UHC and Aetna patients, and prepare to request required prior authorizations by Blue Cross NC for treatment plans and services carrying over to 2017. This includes necessary authorizations for:
• Patients’ continued access to rented durable medical equipment and supplies.
• Patients’ ongoing access to physical therapy, occupational therapy, and speech therapy services.

We will continue to update you as information becomes available.