Friday, September 11, 2015

Blue Value vs. Blue Local - Big Changes in Metro Areas

Many of my clients choose Blue Advantage because it provides the largest network statewide. Blue Cross and Blue Shield of North Carolina® has announced that they will no longer offer Blue Advantage or Blue Select in the Charlotte Metro area and the Raleigh Durham area in 2016.  My clients will have to choose between two limited networks for the coming year.  In the next month, you will receive a renewal notice explaining that if you had Blue Advantage or Blue Select, you will automatically be routed to a similar deductible Blue Value plan in 2016.  But you still have choices. 

Charlotte Metro Area:
If you are in the Charlotte Metro Area and make no change, you will no longer be able to go to Carolina’s Healthcare System.  You will be limited to the Novant network once you're routed to Blue Value.  If you want to go to Carolina's Healthcare System providers, you must switch to Blue Local with Carolina’s Healthcare System.
  • Blue Value = Novant
  • Blue Local = Carolina’s Healthcare System

Raleigh Durham Area:
The limited Blue Local network is new to the Raleigh Durham area.  Previously, if you wanted the Duke Medicine network, you had to choose Blue Advantage.  In the coming year, if you want to stay with Duke, you must switch to Blue Local with Duke Medicine & WakeMed network.
  • Blue Value = UNC, REX and WakeMed
  • Blue Local = Duke Medicine and WakeMed

Important Points to Remember
  • If you are comfortable with the Blue Value network, then no action is necessary. *
  • If you choose Blue Local instead of Blue Value, a binder premium payment will be required.  What that means is, if you’re mapped to Blue Value, but want Blue Local beginning January 1st, you must make the change via Blue Connect and your binder payment must be received by December 31st.
  • Walgreens is not included in either of these networks at this time.  If you currently use Walgreens, you will need to find a new pharmacy that is in network.
  • Counties impacted:  Anson, Cabarrus, Mecklenburg, Rowan, Stanly, Union, Alamance, Caswell, Chatham, Durham, Lee, Orange, Person, Franklin, Johnston and Wake.
Open enrollment begins November 1st.  I am here to help you navigate through your choices.  Don’t hesitate to call me with questions.

*If you are currently receiving a subsidy, you will need to update your income estimates at healthcare.gov to make sure you are getting the proper premium tax credit for 2016.

Take a look at the 2016 plan brochure here.    http://healthplansofnorthcarolina.com/agent_docs/Docs/ba_brochure_2016.pdf