Additional Information: Discontinuance of Blue Value for Individual U65 Members in Select Areas
Mar. 08, 2022 Update: An error in the Member Mapping Chart has been corrected to Blue Value Off Exchange in the Charlotte region from Blue Advantage Off Exchange in the Charlotte region. This communication was originally posted on Mar. 02, 2022.
This communication addresses various frequently asked questions related to a posting on November 1, 2021, regarding the discontinuance of Blue Value for Individual U65 members in select areas. Please note, Blue Home with Novant Health℠ is a narrow network anchored by Novant Health since 1/1/21. Blue Local with Wake Forest Baptist Health℠ and Blue Local with Atrium Health are both unique narrow networks anchored by Wake Forest Baptist Health and Atrium Health.
Q: How do I know if I am a participating network provider with Blue Home with Novant Health℠, Blue Local with Atrium Health℠ or Blue Local with Wake Forest Baptist Health℠?
A: Blue Cross and Blue Shield of North Carolina (Blue Cross NC) contracts with health care providers to be in these narrow networks. Your office manager or contracting manager/representative will have information on the networks you participate in, including Blue Home with Novant Health℠, Blue Local with Atrium Health℠ and Blue Local with Wake Forest Baptist Health℠.
As a participating health care provider, your practice will appear on our online “Find a Doctor” tool when a provider search is done in your geographic area. Please contact the Provider Blue Line at 800-214-4844 if you need additional assistance.
Q: If I am not a participating network provider, can I join Blue Home with Novant Health℠, Blue Local with Atrium Health℠ or Blue Local with Wake Forest Baptist Health℠?
A: When the anchoring health systems for Blue Home with Novant Health℠, Blue Local with Atrium Health℠ and Blue Local with Wake Forest Baptist Health℠, and Blue Cross NC developed these networks, we did intensive analysis on network adequacy, accessibility, and marketability, incorporating both CMS and NCDOI guidelines. The narrow networks are closed to network additions. We review network adequacy for each product annually.
Impacted Policy Prefixes
Product | Exchange | Prefix |
|---|---|---|
Blue Local with Atrium Health | On | PVX |
Off | PVY | |
Blue Local with Wake Forest Baptist Health | On | WKQ |
Off | WKU | |
Blue Home with Novant Health | On | NNO |
Off | NON | |
Blue Value | On | YPJ, BVR |
Off | YPV, BII |
Member Mapping
Blue Value members will be mapped to a new product. This will vary by county and On and Off Marketplace due to different products being available.
Previous Product | New Mapping |
|---|---|
Blue Advantage On Exchange in the Winston-Salem region
| Davidson, Davie, Forsyth, Stokes and Yadkin- Blue Local with WFBH |
Surry- Blue Value | |
All counties- Blue Advantage will remain Off Exchange
| |
Blue Value On Exchange in the Winston-Salem region
| Davidson, Davie, Forsyth, Stokes and Yadkin- Blue Local with WFBH |
Surry- Blue Value will remain both On and Off Exchange | |
Blue Value Off Exchange in the Winston-Salem region
| Davidson, Davie, Forsyth, Stokes, and Yadkin- Blue Advantage |
Blue Value On Exchange in the Charlotte region
| Cabarrus, Mecklenburg, Rowan, and Union- Blue Home with Novant Health |
Anson and Stanly- Blue Local with Atrium Health | |
Blue Value Off Exchange in the Charlotte region
| Cabarrus, Mecklenburg, Rowan, and Union- Blue Home with Novant Health
|
Anson and Stanly- Blue Advantage |
In 2022 for U65 ACA members, please note the following product changes in the Winston-Salem and Charlotte regions:
County/Area | Product Changes |
|---|---|
Davidson, Forsyth, Stokes, and Yadkin | Blue Local with Wake Forest Baptist Health℠ and Blue Home Novant Health℠ will be the products available for both On and Off Exchange members
|
Blue Advantage℠ will also be available for Off Exchange members | |
Davie | Blue Local with Wake Forest Baptist Health℠ will be the product available for both On and Off Exchange members
|
Blue Advantage℠ will also be available for Off Exchange members | |
Surry | Blue Value will continue to be offered On and Off Exchange
|
Blue Advantage℠ will also be available for Off Exchange members
| |
Cabarrus, Mecklenburg, Rowan, and Union | Blue Home Novant Health℠ and Blue Local with Atrium Health℠ will be the products available for both On and Off Exchange members |
Blue Advantage℠ will also be available for Off Exchange members | |
Stanly and Anson | Blue Local with Atrium Health℠ will be the product available for On and Off Exchange members |
Blue Advantage℠ will also be available for Off Exchange members | |
All counties | The U65 Transitional Blue Value product will also remain in all counties |
If you have further questions or concerns, please call Provider Blue Line at 800-214-4844.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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