Duke Health, WakeMed working with Centene to fill insurance gap for 50K

Durham, N.C.-based Duke Health and WakeMed Health & Hospitals in Raleigh, N.C., are in talks with Centene to offer a health plan on the ACA marketplace that will network with the two health systems, according to WRAL.

The move comes after Blue Cross Blue Shield of North Carolina said in early August it will eliminate a health plan affiliated with the two systems in an effort to cut premiums for policyholders who purchase coverage on the ACA individual market. However, in the process, BCBS will transfer about 50,000 members who previously had in-network access to Duke Health and WakeMed to a plan that is part of a new contract with Chapel Hill, N.C.-based UNC Health Alliance. The alliance is a physician-led network including UNC Health and independent providers.

Patients wanting to keep Duke and WakeMed providers in their insurance network may be able to do so through a new plan operated by Centene. The health plan, Ambetter of North Carolina, still requires approval from the North Carolina Department of Insurance, according to WRAL.

BCBS of North Carolina members affected by the change will be eligible for in-network services at Duke and WakeMed through Dec. 31. Ambetter, if approved, will be available for enrollment during the ACA open enrollment period from Nov. 1 through Dec. 15.

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