Monday, October 31, 2016

Pharmacy Changes for limited networks in 2017 - WALMART no longer in network

Beginning 2017, if you have a Blue Value, Blue Select, Blue Local- Carolinas Healthcare System or Blue Local - Duke Medicine and WakeMed network plan, you will see several participating pharmacy changes.

  • Walgreens will now be in-network.
  • CVS will continue to be in-network.  However not if you go to a CVS outside of NC.
  • Walmart will be out-of-network.
  • Rite-Aid will be out-of-network.
  • Harris Teeter will be out-of-network.

Affected existing members will receive a letter in early November advising of the changes.  
And as always, networks are subject to change due to new mergers and other negotiations.




CaroMont Health - Approved Networks in Gaston, Cleveland and Lincoln

BCBSNC® offers three networks in Gaston, Cleveland and Lincoln Counties. 

  • Blue Advantage
  • Blue Select
  • Blue Local - Carolinas Healthcare System.  (not in network with CaroMont)

If you are in one of these counties and want to go to CaroMont Health and CaroMont Regional Medical Center,  you must be in in the Blue Advantage or Blue Select network.  
While the hospital can't turn you away, if you have Blue Local, you will be out of network with higher out of pocket maximums.



IMPORTANT:  Anyone who had an Aetna or United Healthcare plan through the marketplace (healthcare.gov) will be automatically mapped to Blue Local in 2017.

If you need to make a change or have questions about your options, call me or make an appointment by clicking on the link below.







Sunday, October 30, 2016

WakeMed to exit Blue Value network in 2017

In 2016, we experienced a major disruption when BCBSNC® forced members in the Raleigh/Durham area into one of two networks - Blue Local DKWM (Duke Medicine and WakeMed) and Blue Value which included UNC, Rex and WakeMed.

WakeMed will no longer be in the Blue Value network beginning January 1, 2017.  

If you have a Blue Value plan, it's time to do a doctor search to see if your doctor(s) is still in network.  If they are affiliated with WakeMed, you'll need to switch to Blue Local DKWM.


If you need to make a change, or have questions about all your options, call me or make an appointment by clicking the link below and I'll help you enroll.