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Changes for BCBSNC Blue Local Members

A Change in 2019 for Blue Cross Blue Shield of North Carolina (BCSNC) Blue Local Members

BCBSNC Blue Local plan members, BCBSNC has elected to discontinue offering the Blue Local plan effective January 1, 2019. We are disappointed in this decision and know that many of our patients who value their relationship with WakeMed and our WakeMed Physician Practices providers may also be disappointed. We also recognize you may need some guidance about what this means for your ongoing care as well as how to make an informed decision during Open Enrollment this fall. As your partners in health care, we’re here to help answer any questions you may have and to guide you through the Open Enrollment process.

What Does This Mean for Current Patients Now?

Since the transition doesn’t occur until January 1, 2019, your coverage remains fully intact until the end of the year and there is no need to change doctors or health care partners today. WakeMed is working closely with BCBSNC to ensure that Blue Local patients with certain ongoing conditions (such as pregnancy) as well as those with acute, chronic or terminal conditions can continue to receive the care they need at WakeMed after January 1, 2019. Details on this process will be forthcoming later this year. Your physician will need to be involved to determine medical necessity, so you may want to begin these discussions with your provider(s) at your next visit.

I have Blue Local, I’m pregnant and planned to deliver my baby at WakeMed. Do I need to change OB-GYN doctors?

No. If the OB-GYN physician you’ve established a relationship with during your pregnancy (as defined by at least one visit prior to December 31, 2018) is currently in the current Blue Local network and delivers exclusively at WakeMed, you will qualify to receive in-network benefits for your WakeMed delivery and post partum care – whether it’s before OR after January 1, 2019. BCBSNC is working through the process for confirming this in-network transfer of benefits and we will be communicating those details with you later this year. Most likely, your physician will need to fill out some simple paperwork and submit to BCBSNC to ensure you are covered.

What Should I Do During Open Enrollment?

WakeMed is pleased to announce the availability of Ambetter of NC, a new network plan that will provide in-network access to both WakeMed AND Duke Health for 2019.

Ensuring you select this plan during Open Enrollment will allow you to continue paying lower out-of-pocket costs such as co-pays, deductibles, coinsurance, etc. while receiving care at WakeMed. As your current health care provider, WakeMed is committed to ensuring you can receive quality care at a great value right here in Wake County.

If you do nothing, BCBSNC will move you into another plan that does NOT include in-network benefits for WakeMed. Known as BlueValue with UNC Health Alliance plan, this plan would mean higher out-of-pocket costs for you when choosing WakeMed providers and facilities.