WakeMed, Duke Health to fill gap left by Blue Cross ending ACA plan

August 10, 2018


WakeMed and Duke Health said Thursday that they are working to provide a new insurance plan to cover thousands of Triangle residents who would have to switch doctors next year when Blue Cross Blue Shield of North Carolina ends one of its plans.

The new plan, Ambetter of North Carolina, will be operated by Centene Corp., the largest carrier on the Affordable Care Act marketplace and one of the nation’s largest providers of managed care services for military families and veterans. The state Department of Insurance hasn’t yet approved the plan, so premiums haven’t been set, but WakeMed and Duke Health officials said they would be competitive with rates charged by Blue Cross.

Blue Cross officials said last week that it would discontinue Blue Local, an ACA plan offered through the HealthCare.gov exchange, at the end of the year. WakeMed and Duke Health physicians and hospitals were in the Blue Local network, but Blue Cross signed a new contract with UNC Health Alliance, a physician-led network that includes independent and UNC Health Care providers, and was switching its customers over to those providers.

“We feel strongly that no one should have to leave Wake County to receive world-class care, and patients and families deserve to have access to the health care partners they know and trust,” WakeMed President and Chief Executive Donald Gintzig said in a statement. “This partnership accomplishes that goal and allows us to maintain our focus on improving the health and well-being of our community.”

“We are very pleased that Ambetter will provide an exchange plan in Durham and Wake counties in 2019 that will allow our exchange patients to maintain uninterrupted continuity of care with their Duke providers,” Dr. Thomas Owens, president of Duke University Hospital and senior vice president of Duke Health, said in a statement. “It also provides a plan option for new exchange patients in these counties that offers the flexibility and high quality of both the Duke Health and WakeMed networks of physicians, facilities and convenient locations.”

Current Blue Local patients will continue to be covered by Blue Cross for services at Duke and WakeMed through Dec. 31. Ambetter is expected to be available during the ACA open enrollment period for 2019, which runs from Nov. 1 through Dec. 15.

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