If you live in North Carolina and have a Blue Medicare HMO by BCBSNC insurance plan, you should note that there are changes to the provider network for 2018. To determine whether your providers are in the BCBSNC network for the upcoming year, you should take the time to review the 2018 Provider Directory that you can request and receive in the mail. You can also visit http://www.bcbsnc.com/content/medicare/member/index.htm.
It’s essential to understand that BCBSNC may make changes to the providers that are part of the plan throughout the year. In the event that your doctor or specialist does leave your plan, you have the following rights:
- Although the BCBSNC provider network may change throughout the year, Medicare requires that you are provided with uninterrupted access to qualified doctors and specialists.
- If your provider is leaving your BCBSNC plan, you will receive a notice of at least 30 days so that you have ample time to select a new one.
- If you need assistance selecting a new provider, BCBSNC will be more than happy to help you out.
- BCBSNC will work with you to ensure that any medical treatment you are undergoing is not interrupted.
- If you do not believe we have found you a qualified provider to replace your previous one or your care is not being managed appropriately, you may file an appeal of BCBSNC’s decision.
- Once you find out that your provider is leaving your plan, be sure to contact BCBSNC so that you can receive some assistance in finding a new provider.
Contact The MAIR Agency
The MAIR Agency understands how frustrating it can be to find out that your provider is no longer covered by your insurance plan. Therefore, if you find out that your provider is leaving BCBSNC, contact The MAIR Agency for more information about your rights.