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General Product Information

Q: When is open enrollment for current members?

A: Open enrollment is the span of time when applications for changes to current health plans are accepted. Open enrollment dates are November 1 through November 30.

Q: When can I change my deductible?

A: You can raise your deductible at any time. You can only lower your deductible during open enrollment by completing the Change Form. Please note, you must have been on the policy for a minimum of six months at open enrollment in order to lower your deductible.

Q: When can I add or remove a dependent?

A: For information about adding or removing a dependent, see "When Coverage Begins and Ends" section of your Member Booklet, or call Customer Service at 1-888-206-4697.

Q: How can I pay my bill?

A: Subscribers on individual and family policies can pay online by logging in to Member Services and going to Manage Billing and Payments.

Q: When is my bill due?

A: Your bill is due on the first day of the billing cycle. We are unable to process partial payments for your insurance premiums. We must receive the current premium in full for each billing cycle to avoid termination of coverage.

Q: What if I have a medical question in the middle of the night?

A: You can call your Primary Care Physician or Health Line Blue. This 24-hour, toll-free health information line (1-877-477-2424) allows you to have a confidential conversation about your health questions with a registered nurse anytime of the day or night.

Benefits and Coverage

Q: What emergency coverage do I have while I am traveling?

A: Blue Cross and Blue Shield of North Carolina's traditional BlueCard® program allows members traveling outside or temporarily residing outside the North Carolina service area to visit participating providers and take advantage of the savings that the local Blue Cross and Blue Shield Plan has negotiated with doctors and hospitals in that area. You should not have to pay any amount above these negotiated discounts. The provider will file your claim with BCBSNC.

In addition, BlueCard Worldwide offers BCBSNC members the ability to receive in-network benefits for inpatient health care at participating hospitals in major travel destinations and business centers throughout the world. You can find participating providers by calling 1-800-810-BLUE (2583) or by visiting the BlueCard Doctor and Hospital Finder. The member is responsible for contacting BCBSNC for any care requiring precertification.

Q: What if a primary care physician cannot see me right away?

A: You may visit any provider in the Blue Assurance network. Participating providers will not bill you any amounts over the allowed amount of charges. You can locate Blue Assurance participating providers by visiting our online provider search or by calling Customer Service at 1-888-206-4697.

Providers

Q: What happens if I need to see a specialist?

A: Just make sure they are participating and a referral is not necessary — except if you are seeking mental health services. (Mental Health services must be authorized by Magellan.)

Q: How can I find a participating doctor?

A: Use our online provider search. New providers will continue to be added to the network and some providers may elect to discontinue their participation. We update our online provider listings weekly. Please check again if your provider is not included in this week's listing.

Claims

Q: What do I do with a foreign medical bill for care I received outside of the U.S.?

A: If you receive a bill for inpatient, outpatient or professional medical care received outside the United States, please send the bill with an international claim form to our foreign claims center at:

BlueCard Worldwide Service Center
P. O. Box 90320
Richmond, VA 23230

You may view a listing of participating hospitals or obtain an international claim form at http://www.bcbs.com/bluecardworldwide/index.html.

The BlueCard Worldwide Service Center translates foreign claims and calculates the foreign exchange rate. The Service Center then forwards the claim to BCBSNC to be processed.

If you receive a foreign medical bill for prescription drugs, outpatient hospital services or other medical services that you received outside of the United States, please file those claims directly to BCBSNC.

Out-of-Pocket Expense

Q: If I take all of my children to their Primary Care Physician at the same time, how much do I pay?

A: You pay one copayment for each child.

Q: What is a copayment?

A: A copayment is a fixed dollar amount that you pay for some services (usually paid at the time the service is provided).

Q: Do I have to pay a copayment for my weekly allergy shot?

A: Not necessarily. You only pay a copayment when there is a medical service provided by your Primary Care Physician or specialist. If your provider elects to file an office visit combined with the service, the office visit is subject to copayment.