Blue Cross NC’s Healthy Blue Plan Enrolls First Members, Launches Statewide Provider Network as Medicaid Managed Care Begins

March 15 open enrollment launch is milestone for N.C. Medicaid managed care

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) began enrolling its first members in Healthy Blue on March 15. The Medicaid managed care plan features a provider network with more than 48,000 physicians and other practitioners, including most of the state’s hospitals and health systems.

The start of Healthy Blue enrollment is part of a significant milestone for North Carolina as the state’s Medicaid program transitions to managed care.

Medicaid members will begin to receive health care services under the state’s Medicaid transformation program on July 1. The changes are designed to create a system of better-coordinated, high-quality care for Medicaid beneficiaries, while also offering additional community resources and bringing Medicaid budget predictability to the state.

“Medicaid transformation gives more than 1.6 million North Carolinians the ability to choose a health plan, but it’s more than that. It increases resources to address drivers of health, such as food security and transportation, that impact health outcomes,” said Fran Gary, senior vice president of Government Markets at Blue Cross NC. “Blue Cross NC has designed Healthy Blue to help our Medicaid members get access to the health services and community resources they need to improve their health.”

How Medicaid managed care works

The shift to Medicaid managed care will improve the way health care services are paid for in North Carolina.

Medicaid traditionally has paid doctors, hospitals and other providers on a fee-for-service basis, meaning the provider gets paid for each procedure, test or patient visit. Under managed care, the state pays prepaid health plans a set amount every month to manage the care of each member. This encourages preventive health, care coordination and meeting a full range of physical and behavioral health needs of members.

In 2015, the General Assembly approved Medicaid transformation, and now more than 40 states have transitioned their Medicaid program to managed care. Medicaid-eligible North Carolinians may choose a health plan by May 14 or be assigned one beginning May 15. Coverage under each plan begins July 1.

Healthy Blue plan features

In addition to required benefits, Blue Cross NC offers additional services to Healthy Blue members in all 100 counties to help them get the most out of their plan, including: Members are eligible for rides to medical appointments, up to $75 in annual rewards for visiting a doctor, $50 to use in an online catalogue for school supplies, and up to $200 to use to for asthma relief products for qualifying members with asthma. Qualifying members are also eligible for three months of fresh vegetables and fruits (up to $120 value).

North Carolinians eligible for Medicaid may select a primary care physician, search for other providers or find more information at HealthyBlueNC.com.

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