Mission Health no longer in State Health Plan

Oct 06, 2017

The deadline for a new contract between Mission Health and Blue Cross Blue Shield of North Carolina passed Thursday without a deal. That means Mission’s facilities in the western part of the state are now “out-of-network” for BCBSNC customers and members of the State Health Plan under most circumstances.

There are a few instances where Mission is still an in-network provider for all health plan members, including emergency care and patients who qualify for continuity of care.  If you think you qualify and have not filled out a continuity of care form, please do so as soon as possible. 

This also does not affect members who are enrolled in the Medicare Advantage plans offered by the State Health Plan through UnitedHealthcare. Mission Health facilities will remain “in-network” for members covered by these plans.

SEANC leaders and members from the west met with BCBSNC officials on Thursday to discuss the situation. As it told the SEANC Board of Governors in July, BCBSNC stated that Mission Health is pushing an increase in cost of 5 percent or more, which will be passed along to plan members in the form of higher premiums and co-pays. It will also result in more cost for the State Health Plan, meaning the plan would have to request more money from the General Assembly – money that could be used for pay raises and cost-of-living adjustments.

BCBSNC officials urge plan members to use other facilities in the area that are considered “in-network,” which can be found on this map. SEANC urges both sides to work toward a solution that best serves the patients as soon as possible.