June 15, 2021 Update: This communication has been updated to include details on the plans that are expiring the cost-share waiver. The original communication was posted on June 1, 2021.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has put multiple benefit provisions in place to assist our members during the COVID-19 public health emergency.
Our cost-sharing waiver for COVID-19-related treatment will expire on June 30, 2021 for customers on the following plans:
- Fully-insured commercial plans (individual and group plans)
- State Health Plan
- Balance funded Administrative Services Only (ASO) plans
- Other ASO plans, unless the employer has opted to extend this waiver
- For Medicare Advantage plans offered or administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the COVID-19 treatment cost-sharing waiver will remain in place through December 31, 2021. Medicare Supplement members should contact Medicare, or refer to www.medicare.gov, regarding how Medicare manages COVID-19-related claims.
- When we first announced our cost-share waivers in April 2020, limited therapeutics and public health measures were in place to address this pandemic. With new COVID-19 cases declining in North Carolina and nationally, the distribution of the COVID-19 vaccine and more effective treatments available, we better understand the costs and the role treatments play in helping our members.
- Governor Cooper lifted many COVID-19 restrictions, including capacity and gathering limits, social distancing requirements, and most mandatory mask requirements, on May 14, 2021.
- Most health plans that had similar measures in place have already ended those measures. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) kept these measures in place several months longer than many other health plans.
- After the cost-share waiver expires, COVID-19 treatments will continue to be covered, but members may be responsible for a portion of their treatment costs to include copayments, coinsurance and deductible amounts, as applicable, according to their health plan.
- Blue Cross NC will continue to cover 100% of the cost of COVID-19 vaccines that are FDA approved for emergency use authorization (EUA).
Members should contact the Blue plan listed on their ID card for information about their COVID-19 benefits.
We will continue to closely monitor the situation and take further action, as needed, based on health care trends that affect our members.