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Blue Card Change to Out of Network

Effective January 1, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC)  implemented  benefit changes for Point of Service (POS) Individual Under 65 (IU65) ACA products, which includes Blue Home, Blue Local and Blue Value (see below for specific health care systems).  These changes included revisions to Blue Card access to be out-of-network (OON), meaning that all services outside of North Carolina and outside of the United States (Global Care) will be covered at the out-of-network (OON) benefit level with the exception of emergency care.  However, out of state (OOS) participating providers who are directly contracted with Blue Cross NC will remain in-network (INN) for IU65 POS members.  

Key Details 

  • Providers outside of NC and US will be covered at OON benefit level except emergency care  
  • OOS participating providers that Blue Cross NC contracts with directly will remain in-network  
  • Does not apply to Blue Advantage, Transitional or any Group products 

This change will apply to the following IU65 products: 

  • Blue Home (UNC Health Alliance and Novant Health) 
  • Blue Local (Atrium Health and Wake Forest Baptist Health) 
  • Blue Value   

As previously mentioned, Blue Cross NC directly contracts with certain OOS providers.  Since these providers are still contracted in some or all Blue Cross NC products, members can still choose these providers if they are participating in their network. 

Examples of providers in this category:  

  • Atrium Health Urgent Care in SC 
  • Rock Hill Pediatric Associates in SC 
  • Charlotte Radiology providers in SC 
  • Greensboro Radiology providers in VA 
  • Virginia Oncology Associates in VA 
  • Edgepark Medical Supplies  

For more information please contact the Customer Service Line at 800-214-4844