Physicians/Specialists
Facilities/Hospitals
Ancillary
Pharmacy
Publication Date: 
2021-11-01

This notice is for systems, practices and acute care facilities who serve our Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members under the Blue ValueSMplan.

In an effort to achieve simpler, more affordable health care, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has reviewed its product offerings for 2022 and has decided to discontinue Blue ValueSM in several parts of NC, effective January 2022. As you may recall, Blue ValueSM is a lower-cost point-of-service (POS) product, which offers a smaller, more streamlined provider network while providing an affordable choice for our most cost-conscious employer groups and members.  We first communicated about these plans to the provider community in 2012.  

Blue Value will be discontinued for individual, under 65 ACA members in the Charlotte and Winston-Salem regions. Discontinuance letters were sent to impacted members in September 2021. This update is meant to provide additional information to share with your providers.

Blue Value will continue to be offered in the Hickory, Gastonia and Winston-Salem regions, as well as Surry county for individual, under 65 members. Your practice will continue to participate with this product under your Network Participation Agreement.  The individual, under 65 Transitional Blue Value product will remain in place.

 

Effective January 1, 2022, providers can expect the following due to this change:

  • Discontinuance of the individual, under 65 ACA Blue Value product in 2022 in the Charlotte region (Anson, Cabarrus, Mecklenburg, Rowan, Stanly and Union counties). This product will be discontinued both On and Off Exchange.
  • Discontinuance of the individual, under 65 ACA Blue Value product in 2022 in the Winston-Salem Region (Davidson, Davie, Forsyth, Stokes, and Yadkin counties), except Surry county.  

 

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.

  • Blue Advantage On Exchange in the Winston-Salem region
    • Davidson, Davie, Forsyth, Stokes and Yadkin - mapped to Blue Local with WFBH
    • Surry – mapped to Blue Value
    • Blue Advantage will remain Off Exchange in all counties
  • Blue Value On Exchange in the Winston-Salem region
    • Davidson, Davie, Forsyth, Stokes and Yadkin - mapped to Blue Local with WFBH
    • Blue Value will remain both On and Off Exchange in Surry County
  • Blue Value Off Exchange in the Winston-Salem region
    • Davidson, Davie, Forsyth, Stokes and Yadkin - mapped to Blue Advantage
  • Blue Value On Exchange in the Charlotte region
    • Cabarrus, Mecklenburg, Rowan, and Union – mapped to Blue Home with Novant Health
    • Anson and Stanly – mapped to Blue Local with Atrium Health
  • Blue Advantage Off Exchange in the Charlotte region
    • Cabarrus, Mecklenburg, Rowan and Union – mapped to 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 region.

  • Davidson, Forsyth, Stokes, and Yadkin counties:
    • Blue Local with Wake Forest Baptist Health SM and Blue Home Novant HealthSM will be the products available for both On and Off Exchange members
    • Blue AdvantageSM will also be available for Off Exchange members.
  • Davie county:
    • Blue Local with Wake Forest Baptist Health SM will be the product available for both On and Off Exchange members
    • Blue AdvantageSM will also be available for Off Exchange members.
  • In Surry county:
    • Blue Value will continue to be offered On and Off Exchange.
    • Blue AdvantageSM will also be available for Off Exchange members.
  • The U65 Transitional Blue Value product will also remain in all counties

 

In 2022 for U65 ACA members, please note the following product changes in the Charlotte region:   

  • In Cabarrus, Mecklenburg, Rowan, and Union counties: 
    • Blue Home Novant HealthSM and Blue Local with Atrium Health SM will be the products available for both On and Off Exchange members.
    • Blue AdvantageSM will also be available for Off Exchange members.
  • In Stanly and Anson counties:
    • Blue Local with Atrium HealthSM will be the product available for On and Off Exhange members.
    • Blue AdvantageSM will also be available for Off Exchange members.
  • The U65 Transitional Blue ValueSM product will also remain in all counties.

 

We understand product discontinuances are disruptive to members. In addition to the discontinuance notice, members will receive two additional communications from Blue Cross NC during the open enrollment timeframe (November 1 – January 15). We will also make outbound calls to members to make sure they understand the network changes and to help them transition to in-network providers, if necessary.  

If you have further questions or concerns, please call Provider Blue Line at 800-214-4844.