Update: Discontinued IU65 ACA Members with Pharmacy Medical Authorizations Spanning into 2022

Jan. 21, 2022, Update: This communication has been reposted to provide an update on the prior communication posted November 18, 2021. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) previously communicated that existing authorizations would expire 12/31/2021, however, there are some scenarios where the members’ 2021 prior authorization did extend into 2022. Please see below update advising providers that not all authorizations expired. 

Providers can contact Blue Cross NC to confirm. In most cases, it will be necessary for members to contact their provider for a new authorization.  

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 that spanned into 2022 can be found below. 

Currently, some 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.