Mission Health is now out-of-network
Blue Cross and Blue Shield of North Carolina and Mission Health have entered into discussions regarding a future network participation agreement and will refrain from public comment until those talks are completed.
Where can I go for in-network care?
In an emergency, Blue Cross NC customers should always go to the nearest hospital. Emergency care is always covered as an in-network benefit. Prior authorization is never required for emergency care. If an admission to the hospital is medically necessary after an emergency room visit at a Mission Health facility, we would process these benefits as in-network. Blue Cross NC customers in Western North Carolina should go to the hospitals listed on the map below for in-network care. You may also download a PDF Map for a comprehensive list of all in-network hospitals and surgery centers in the area, including Georgia, South Carolina, and Tennessee. We suggest using our Find a Doctor Search Tool which is updated often.
The video below explains in detail the Mission Health situation, how it impacts customers, and important things to know when needing care starting October 5th, 2017.
When did Mission Leave the Blue Cross NC Network?
All Mission hospitals, outpatient facilities, and most healthcare providers will be out-of-network October 5, 2017. Some Mission healthcare providers – mostly therapists – may stay in-network until March 2, 2018. You should contact Mission to see when your doctor is leaving the Blue Cross NC network.
CAN I CONTINUE TO USE MISSION HEALTH DOCTORS AND FACILITIES?
Yes, in certain situations customers may continue to use Mission Health doctors and facilities as part of their in-network benefits.
In an emergency, Blue Cross NC customers should always go to the nearest hospital. Emergency care is always covered as an in-network benefit. Prior authorization is never required for emergency care.
Customers already in a treatment plan for certain conditions at a Mission Health facility may be able to keep receiving treatments as part of our Continuity of Care program. (If you qualify for this program, you should have received a separate letter from us.) You may also Download the Continuity of Care form (North Carolina State Health Plan for Teachers and State Employees must complete this form.) and submit it by following the directions on the form. This form is only for Blue Cross North Carolina Commercial Members – it does not apply to Medicare Advantage or Blue Cross Insurance from another state. Please read all the details on the form to understand the process. Call the number on the back of your ID card for assistance.
- Our customers can also go to urgent care facilities for urgent, non-emergency care, and most independent physicians in the area also participate in our network. To find an urgent care or primary care provider near you, go BCBSNC.com.
- If you have a plan with out-of-network benefits, you can receive benefits for services at a Mission Health healthcare provider for non-emergency care (not part of an approved Continuity Care request), but you will pay more money for that care. And usually, the price is much higher than you would pay at an in-network facility.Blue Cross NC will pay you for the allowed amount of your care, and you will be responsible for paying the health care provider
I am a member of another Blue Cross plan, but I live in North Carolina. How does this affect me?
- Mission Health hospitals and providers are now out-of-network for you
- When you visit hospitals, doctors and other facilities in North Carolina, you are using the BlueCard®
- BlueCard allows members of a Blue Cross and Blue Shield plan to get in-network care while traveling or living in another Blue Cross and Blue Shield Plan’s service area.
- How members of other Blue Cross and Blue Shield plans can find in-network providers in NC:
- Call Customer Service at the number on your Blue Cross Blue Shield member ID card
- Use the provider search tool available from your local Blue Cross and Blue Shield plan’s website
- Use the “Find a Doctor” provider search tool at bcbs.com.
HOW DOES THIS AFFECT BLUE MEDICARE HMO, BLUE MEDICARE PPO (MEDICARE ADVANTAGE) and Blue Medicare Supplement CUSTOMERS?
For additional information on these specific plans visit the Mission Health Medicare FAQ page.
WHERE CAN I GET OTHER QUESTIONS ANSWERED?
You may contact customer service using the phone number listed on the back of your card or login to the Blue Connect Member Site and submit your question.
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