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If You’ve Had Trouble Getting Medical Care Recently, Please Read This

By Dr. John Fong | February 1, 2016 | Healthy Lifestyle, Insurance Education

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We know some customers may not have received ID cards yet. Some were enrolled in the wrong plan or have not received a bill. None of these circumstances are acceptable. We’re working to correct these issues to ensure our customers are confident they are covered and can get the care they need.

These errors have created a lot of confusion, leaving many customers worried that they might not have health insurance. That’s why we are in constant communication with doctors and hospitals across the state. They are aware and working with us to assure you receive the care you need. We will not stop until every customer problem is corrected. Resolving these issues is our top priority.

If you need help getting medical care, please read this important information: 

1.) If you have a medical emergency, do NOT delay care. You’re covered.

If you need immediate medical attention, please seek it. Claims will be processed based on the appropriate benefit plan once the pharmacy or doctor files or refiles the claim under the appropriate subscriber ID number. You may have to pay cash for your visits, services or drugs, but BCBSNC will pay you back accordingly once the claim is processed. We are working with doctors, hospitals and pharmacies to make sure they are aware of the situation.

2.) If you haven’t received your ID card, you’re covered.

If you can log into Blue Connect, you can print a temporary ID card. You can take that card to your doctor or pharmacy to continue getting the care you need. If you cannot log into Blue Connect, please call your doctor or pharmacist and ask them to call BCBSNC and verify your coverage. We have set up a dedicated line for medical professionals. Your doctor or pharmacy can also check online on our provider portal.

3.) Even if you have an incorrect ID card, you’re covered.

If you need to visit your doctor or pharmacy before receiving your corrected card, please do. Your doctor can verify coverage online or by phone. If you must pay out of pocket, BCBSNC will pay you for those out-of-pocket expenses, according to your plan and benefits, after we receive and process the claim from your doctor or pharmacy.

4.) If you haven’t received a bill, you’re still covered.

You have insurance if you completed your enrollment and made any initial required payments.

5.) If your medication costs more, it could be because of your new plan’s benefits.

Your new plan might have different pharmacy benefits than your old plan. In some of our new 2016 plans, there is now a preferred pharmacy. If you do not get your prescriptions filled at the preferred pharmacy, you will pay more for your prescriptions.These pharmacy changes also encourage customers to choose a generic medication when available. If you choose a brand-name drug when a generic option is available, you will be responsible for paying the brand-name copayment or coinsurance amount for the drug plus the difference in cost between the brand-name drug and the generic drug. We made these choices to encourage customers to make more affordable health care choices, which can help control health care costs for everyone.

Until these issues are resolved, my team and I will continue to work with our provider teams to collaborate with the North Carolina Hospital Association, the North Carolina Medical Society, the North Carolina Medical Group Managers and doctors and hospitals across the state, asking them to please work with our customers to confirm their health insurance coverage so they can get the care they need.

If you have additional questions, please visit for the most up-to-date information. If you need to call customer service to resolve a problem with your health insurance, be aware that wait times are still long. We are scheduling callbacks, but during this busy time we expect most customers to receive a return call within a week or so of their request.

On behalf of BCBSNC, I apologize to every customer who has been affected by our errors. We are working to make this right for each of you.