Discontinued IU65 ACA Members with Pharmacy Medical Authorizations Spanning into 2022

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) would like to share additional information related to communications posted on November 1 and November 9 regarding the discontinuance of Blue Value and Blue Advantage in select areas for some U65 ACA members. More information about these impacted members with existing authorizations for pharmacy medical drugs under these products can be found below.

Currently, some Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Individual Under 65 ACA members are on Blue Value and Blue Advantage plans that will be discontinued on December 31, 2021. Effective January 1, 2022, these members will be mapped to a new product that may have a different network for 2022. Additionally, some of these members have pharmacy medical authorizations spanning into 2022. When these members are mapped to their new network, the existing pharmacy medical authorization that spans into 2022 will expire on December 31, 2021.

Letters will be sent to impacted members and their providers in mid-November 2021.

Key points for members

• Existing authorizations for the member will not transfer to the member’s new policy.
  
• Members will need to use the Find a Doctor tool available online to find an in-network provider for 2022 or confirm whether their current provider is in-network for their new 2022 plan.
• Members will need to have their in-network provider submit a new authorization request.
• Please note: Most of their providers will no longer be in-network on the member's new plan.

Key points for providers

• Existing authorizations will not transfer to the member's new policy.
  
• Beginning January 1, 2022, providers may be out of network for the member whom they requested authorization for.

We understand product discontinuances are disruptive to members.  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 the Provider Blue Line at 800-214-4844.