The insurer informed affected policyholders in a Dec. 16 letter that physicians and medical facilities outside of South Carolina would be out of the insurer’s network beginning in 2017. However, services provided at Charlotte, N.C.-based Carolinas HealthCare System are excluded from the reversal, as well as care provided in emergency situations and rare cases when patients’ care is unavailable in South Carolina.
Prior to the decision, Blue Essentials policyholders in South Carolina could access out-of-state healthcare services at in-network rates as long as the services were received at a provider in the state’s local BCBS health plan network. An insurer spokesperson told Post and Courier the change affects a “small percentage” of policyholders without specifying an exact number.
BCBS of South Carolina is the only payer selling health plans through the ACA marketplace.
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