Upcoming Benefit Changes for 2022 Individual Under 65 ACA and Transitional Commercial Plans

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to offering affordable health care coverage in North Carolina. To do this over the long term, we must ensure that our benefit offerings are aligned appropriately with member needs and industry standards.

We would like to inform you of upcoming benefit changes for our Individual Under 65 ACA and Transitional Commercial plans. These changes will not apply to any other plan segments. Blue Cross NC would like to remind providers to verify member benefits & eligibility via Blue E or by contacting the customer service number on the back of the member’s ID card.

Added coverage for family psychotherapy without patient present

• Removes the restriction for patient to be present for psychotherapy behavioral health treatment visits
• CPT code for family psychotherapy without patient present will be added
• Applies to Individual Under 65 ACA and Transitional plans

Visit limits to be applied to Nutritional Counseling

• A limit of 30 Nutritional Counseling visits will be covered per benefit year
• Applies to Individual Under 65 ACA and Transitional plans

Removal of weight loss drugs from covered medications

• Weight loss drugs and products for general weight loss will be excluded from coverage
• Applies to Individual Under 65 ACA plans only

Deductible Changes

• There will be some deductible changes, including lower deductibles, on many of the plans.
• Applies to Individual Under 65 ACA plans

If you have questions regarding these changes, please call 800-214-4844.